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

Questions 148

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Question 1 of 5

A trauma client is admitted to the emergency room following a motor vehicle accident. Examination reveals that the left side of the chest moves inward when the client inhales. The finding is suggestive of:

Correct Answer: D

Rationale: Inward chest movement on inhalation indicates flail chest, where multiple rib fractures cause a segment of the chest wall to move independently.

Question 2 of 5

The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?

Correct Answer: D

Rationale: Video games can improve hand-eye coordination and muscle control, aiding in rehabilitation for a child with cerebral palsy.

Question 3 of 5

A client diagnosed with COPD is receiving theophylline. Morning laboratory values reveal a theophylline level of 38 mcg/mL. The most appropriate action by the nurse would be to:

Correct Answer: B

Rationale: A theophylline level of 38 mcg/mL is toxic (therapeutic range: 10-20 mcg/mL), requiring immediate physician notification to prevent complications like seizures.

Question 4 of 5

A client is scheduled for a hypophysectomy following the discovery of a pituitary gland tumor. The nurse is teaching the client about the procedure. Which statement by the client indicates effective learning? Select all that apply.

Correct Answer: A, C, D, E

Rationale: Soft toothbrushing, avoiding bending, not blowing the nose, and mouth breathing due to nasal packing are correct post-hypophysectomy instructions. The nasal pad should not be removed the next morning without orders.

Question 5 of 5

A client returns from surgery with a total knee replacement. Which of the following findings requires immediate nursing intervention?

Correct Answer: B

Rationale: A CPM set at 90° flexion immediately post-knee replacement is excessive and could damage the surgical site, requiring immediate adjustment.

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