NCLEX Questions, NCLEX RN Practice Questions Quizlet Questions, NCLEX-RN Questions, Nurselytic

Questions 149

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Question 1 of 5

A psychiatric nurse is assigned to conduct an admission nursing history on a new client. The admission should include which of the following?

Correct Answer: C

Rationale: complete nursing history includes biopsychosocial data; client’s psychosocial and physical status are evaluated along with an assessment of the client’s family system and social support network; evaluation of the client’s cognitive ability is important during the physiological status assessment

Question 2 of 5

A client has developed diabetes insipidus after removal of a pituitary tumor. Which finding would the nurse expect?

Correct Answer: A

Rationale: Diabetes insipidus causes excessive water loss due to low ADH, leading to polyuria. The other symptoms are unrelated.

Question 3 of 5

The nurse is caring for a client on a ventilator that is set on intermittent mandatory ventilation (IMV). Assessment on the ventilator is IMV mode of 8 breaths per minute. The nurse assesses the client's respiratory rate of 13 per minute. These findings indicate that:

Correct Answer: D

Rationale: IMV delivers a set number of breaths (8 per minute), but the client can breathe spontaneously. A respiratory rate of 13 indicates the client is taking 5 additional spontaneous breaths (13 - 8 = 5).

Question 4 of 5

The client has an order for heparin to prevent post-surgical thrombi. Immediately following a heparin injection, the nurse should:

Correct Answer: D

Rationale: Checking the site for bleeding ensures early detection of hematoma or excessive bleeding post-heparin injection.

Question 5 of 5

A mother brings in her 9-month-old son for a routine checkup. She asks the nurse what developmental milestones to expect by 12 months of age. All of the following are correct responses by the nurse EXCEPT

Correct Answer: C

Rationale: By 12 months, infants can imitate gestures, hold a bottle, and respond to their name. Pointing to a named object typically develops closer to 18 months.

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