NCLEX-PN
NCLEX Trainer Test 3 Questions
Extract:
Question 1 of 5
A psychiatric nurse is assigned to conduct an admission nursing history on a new client.
Correct Answer: C
Rationale: A comprehensive psychiatric nursing history should use a biopsychosocial approach, including physical, psychological, social, and family system assessments, to provide a holistic understanding of the client’s needs. Focusing only on emotional state or mental status is too narrow, and the nurse’s opinion lacks objectivity without assessment data.
Question 2 of 5
The nursing care plan for a toddler diagnosed with Kawasaki disease (mucocutaneous lymph node syndrome) should be based on the high risk for development of which problem?
Correct Answer: D
Rationale: Coronary artery aneurysms. Kawasaki disease can lead to inflammation and aneurysms in coronary arteries.
Question 3 of 5
Which of the following symptoms is not indicative of autonomic dysreflexia in the client with a spinal cord injury?
Correct Answer: C
Rationale: Hypotension is not indicative of autonomic dysreflexia; rather, hypertension is a sign of autonomic dysreflexia.
Question 4 of 5
An adult is receiving lithium carbonate 600 mg tid. Which of the following observations is of greatest concern to the nurse?
Correct Answer: B
Rationale: A low-sodium diet increases lithium retention, risking toxicity, a serious concern requiring immediate education or intervention.
Question 5 of 5
A nurse assigned to a manipulative client for 5 days becomes aware of feelings of reluctance to interact with the client. The next action by the nurse should be to
Correct Answer: A
Rationale: The nurse who experiences stress in the therapeutic relationship can gain objectivity through supervision. The nurse must attempt to discover attitudes and feelings in the self that influence the nurse-client relationship.