Questions 151

NCLEX-RN

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NCLEX-RN Test Bank

NCLEX RN Test Bank Questions PDF Questions

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Question 1 of 5

An elderly client has been bedridden since a cerebrovascular accident that resulted in total right-sided paralysis. The client has become increasingly confused, is occasionally incontinent of urine, and is refusing to eat. In planning the client's care, which of the following factors should the nurse consider as most critical in contributing to skin breakdown in this client?

Correct Answer: A

Rationale: Poor nutritional status impairs skin integrity and healing, making it the most critical factor for skin breakdown.

Question 2 of 5

A client with a history of rheumatoid arthritis is prescribed etanercept (Enbrel). The nurse should monitor the client for which of the following adverse effects?

Correct Answer: A

Rationale: Etanercept, a biologic, increases infection risk due to immunosuppression.

Question 3 of 5

A client with a history of type 2 diabetes is prescribed glipizide (Glucotrol). The nurse should instruct the client to:

Correct Answer: A, B

Rationale: Glipizide should be taken 30 minutes before meals to optimize glucose control, and alcohol should be avoided to prevent hypoglycemia.

Question 4 of 5

What is the purpose of administering diphenhydramine before a blood transfusion?

Correct Answer: A

Rationale: The clinical indicators of urticaria are a rash accompanied by pruritus. Urticaria is a manifestation of a transfusion reaction when it occurs during a blood transfusion and is preventable by premedicating the client with an antihistamine, such as diphenhydramine. The remaining options are incorrect. Clients can also be premedicated with acetaminophen to help prevent fever and chills.

Question 5 of 5

A comprehensive health assessment includes:

Correct Answer: A

Rationale: A comprehensive health assessment includes a complete medical history, a general survey (vital signs, appearance), and a complete physical assessment covering all body systems.

Similar Questions

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The nurse is administering eyedrops to a client with glaucoma. Which of the following is a correct technique for instilling the eyedrops? The eyedrops are placed:
The nurse is teaching a client with a new diagnosis of asthma about the use of a peak flow meter. Which of the following instructions is most important?
An adolescent with type 1 diabetes mellitus is hospitalized for appendicitis. He is weak and nauseated with poor skin turgor. The nurse notes a fruity odor to the client's breath. The client uses insulin. The nurse should suspect:
A nurse is caring for a woman who delivered a term neonate at 6 a.m. At 4 p.m., the woman has a distended bladder and is reporting pain of 5 on a scale of 1 to 10. The nurse reviews the client's output record. What should the nurse do first?

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