NCLEX-PN
Free NCLEX-PN Practice Questions Questions
Extract:
Question 1 of 5
A young adult who was in a motorcycle accident is brought to the emergency room with a closed head injury with suspected subdural hematoma. Although the client complains of a severe headache, he is alert and answers questions appropriately. The nurse would question which of the following orders?
Correct Answer: B
Rationale: Morphine sulfate, a narcotic analgesic, causes central nervous system (CNS) and respiratory depression. In patients with head injuries, it is contraindicated because it masks signs of increased intracranial pressure (ICP), such as changes in level of consciousness, which are critical for monitoring neurological status. Promethazine is an antiemetic, docusate is a stool softener, and ranitidine prevents stress ulcers, none of which pose the same risk in this context.
Question 2 of 5
A 15 month-old child comes to the clinic for a follow-up visit after hospitalization for treatment of Kawasaki Disease. The nurse recognizes that which of the following scheduled immunizations will be delayed?
Correct Answer: A
Rationale: MMR. Medical management of Kawasaki involves administration of immunoglobulins. Measles, mumps, rubella (MMR) is a live virus vaccine, and its administration should be delayed to ensure the body’s ability to form antibodies.
Extract:
A patient with pain and paresis of the left leg is scheduled for an electromyography.
Question 3 of 5
Before the test, the nurse should explain that:
Correct Answer: C
Rationale: Electromyography involves needle insertion into muscles to assess electrical activity, requiring patient education.
Extract:
Question 4 of 5
A client is receiving nitroglycerin ointment (Nitrol) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
Correct Answer: C
Rationale: Hypotension and headache are the most common adverse effects of nitroglycerin.
Therefore, blood pressure is the vital sign most likely to reflect an adverse effect of this drug. The nurse should check the client's blood pressure 1 hour after administering nitroglycerin ointment. A blood pressure decrease of 10 mm Hg is within the therapeutic range. If blood pressure falls more than 20 mm Hg below baseline, the nurse should remove the ointment and report the finding to the physician immediately. An above-normal heart rate (tachycardia) is a less common adverse effect of nitroglycerin. Respiratory rate and temperature don't change significantly after nitroglycerin administration.
Question 5 of 5
A 57-year-old woman is recently widowed. She states, 'I will never be able to learn how to manage the finances. My husband did all of that.' Select the nurse's response that could help raise the client's self-esteem.
Correct Answer: C
Rationale: Affirming the client's strength and ability to learn builds self-esteem and encourages confidence. The other responses are either critical or directive, potentially lowering self-esteem. Psychosocial Integrity