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

Questions 158

NCLEX-RN

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Extract:


Question 1 of 5

An appropriate nursing intervention for the client with borderline personality disorder is:

Correct Answer: A

Rationale: Clients with borderline personality disorder often experience mood instability and are at risk for self-harm or suicide. Observing for signs of depression or suicidal thinking is a priority nursing intervention to ensure safety. Allowing the client to lead group sessions or select a caregiver may reinforce manipulative behaviors, and restricting activity to the unit is not typically therapeutic unless specified for safety.

Question 2 of 5

The nurse is performing discharge teaching on a client at high risk for the development of skin cancer. Which instruction should be included in the client teaching?

Correct Answer: D

Rationale: Wearing sunscreen protects against UV radiation, a key skin cancer risk factor. Regular checkups (
A) are less specific, sunbathing at peak hours (
B) increases risk, and routine mole removal (
C) is excessive.

Question 3 of 5

The nurse is caring for a client with a history of Addison’s disease. The nurse should expect the client to have:

Correct Answer: A

Rationale: Addison’s disease causes adrenal insufficiency, reducing cortisol and aldosterone, leading to hypotension due to fluid and sodium loss.

Question 4 of 5

A child is admitted with suspected epiglottitis. Which action is not a part of the nursing care?

Correct Answer: B

Rationale: Assessing the throat with a tongue blade is contraindicated in suspected epiglottitis as it may trigger airway obstruction. Vital signs oxygen and antibiotics are appropriate interventions.

Question 5 of 5

A client is a victim of domestic violence. She is now receiving assistance at a shelter for battered women. She tells the nurse about the cycle of violence that she has been experiencing in her relationship with her husband of 5 years. In the 'tension-building phase,' the nurse might expect the client to describe which of the following?

Correct Answer: C

Rationale: This description is characteristic of the 'tension-building' phase prior to the volatile discharge of tension found in the battering phase.

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