NCLEX-PN
NCLEX PN Practice Questions Questions
Extract:
Question 1 of 5
A nursing diagnosis of 'ineffective airway clearance related to pain' is identified for a client who had open abdominal surgery 2 days ago. Which intervention should the nurse implement first?
Correct Answer: A
Rationale: Pain control is the priority to enable effective coughing and airway clearance.
Question 2 of 5
The nurse is reinforcing teaching for a client recently diagnosed with heart failure who is being discharged with a prescription for lisinopril. Which of the following information should the nurse include?
Correct Answer: D
Rationale: Lisinopril can cause orthostatic hypotension, so slow position changes prevent dizziness and falls.
Question 3 of 5
The nurse is monitoring a client with suspected pulmonary tuberculosis. Which characteristic signs and symptoms does the nurse expect? Select all that apply.
Correct Answer: D,E,F
Rationale: Night sweats, weight loss, and purulent/blood-tinged sputum are hallmark symptoms of pulmonary tuberculosis.
Question 4 of 5
The nurse auscultates the heart sounds of a 77-year-old client with chronic heart failure. Which heart sound should the nurse document?
Correct Answer: C
Rationale: An S3 heart sound is commonly associated with heart failure due to fluid overload and ventricular dysfunction.
Question 5 of 5
The nurse is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube and a gastric residual volume of 75 mL. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: A,C,D
Rationale: A residual of 75 mL is typically acceptable to proceed with feeding. High-Fowler position and flushing are standard. Residual is returned, not discarded, and pH >5 is not concerning.