NCLEX-PN
NCLEX Trainer Test 5 Questions
Extract:
Question 1 of 5
An adult is admitted to the unit with a fractured femur and will be in Buck's extension traction for several days. The client tells the nurse that she has all of the following. Which is likely to cause the client the most problems at this time?
Correct Answer: B
Rationale: Hiatal hernia can be exacerbated by prolonged immobility in traction, increasing reflux and discomfort. Hypertension, finger osteoarthritis, and high cholesterol are less directly impacted by traction.
Extract:
A client with a marked depression of T cells.
Question 2 of 5
To promote safety in the environment of a client with a marked depression of T cells, the nurse should
Correct Answer: D
Rationale: Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) protocol for handling soiled articles is accomplished within universal guidelines with double biohazard bags (2) universal precautions and client protection may call for plastic utensils, but not just spoons (3) not protocol unless the client has an active pulmonary infection (4) correct-water should not be allowed to stand in containers, such as respiratory or suction equipment, because this could act as a culture medium
Extract:
Question 3 of 5
The nurse is assigned to work with the parents of a retarded child.
Correct Answer: D
Rationale: A family assessment is essential to understand the parents’ grieving, coping, and support needs, guiding tailored interventions. Interpreting grief, discussing placement, or assisting with plans are premature without first assessing the family’s situation.
Question 4 of 5
The nurse is to administer Lanoxin(digoxin) elixir to a 6-month old with a congenital heart defect. The nurse auscultates an apical pulse rate of 100 . The nurse should:
Correct Answer: B
Rationale: A pulse of 100 in a 6-month-old is normal (80-150 bpm), so the nurse should administer digoxin . Calling the physician or holding the dose is unnecessary. Rechecking later is not standard.
Question 5 of 5
The nurse is caring for a client who is 4 days post-op for a transverse colostomy. The client is ready for discharge and asks the nurse to empty his colostomy pouch. What is the best response by the nurse?
Correct Answer: D
Rationale: Most adult learners obtain skills by participating in the activities. Anxiety about discharge can be causing the client to forget that they have mastered the skill of emptying the pouch. The client should show the nurse how the pouch is emptied.