NCLEX-PN
NCLEX Trainer Test 2 Questions
Extract:
Question 1 of 5
As a client is being discharged following resolution of a spontaneous pneumothorax, he tells the nurse that he is now going to Hawaii for a vacation. The nurse would warn him to avoid
Correct Answer: B
Rationale: Scuba diving. The nurse would strongly emphasize the need for clients with history of spontaneous pneumothorax problems to avoid high altitudes, flying in unpressurized aircraft and scuba diving. The negative pressures could cause the lung to collapse again.
Question 2 of 5
The client with cancer has an order for Adriamycin. Which of the following untoward effects is of particular concern to the nurse?
Correct Answer: C
Rationale: Adriamycin (doxorubicin) is cardiotoxic, and dysrhythmias are a serious concern. Alopecia, fatigue, and nausea are common but less life-threatening.
Question 3 of 5
The nurse is caring for a client who is receiving IV vancomycin for a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following findings would be of GREATest concern to the nurse?
Correct Answer: C
Rationale: Redness at the IV site suggests phlebitis or infiltration, which can lead to tissue damage or reduced vancomycin delivery, requiring immediate action. Options A, B, and D are normal: blood pressure 130/80 mmHg, heart rate 88 bpm, and urine output 50 mL/hour indicate stability.
Question 4 of 5
The nurse is caring for a client with a suspected stroke. Which of the following actions should the nurse perform FIRST?
Correct Answer: C
Rationale: Hypoglycemia can mimic stroke symptoms; checking blood glucose is the first step to rule out treatable causes. Options A, B, and D are secondary.
Question 5 of 5
During a first aid class, the nurse instructs clients on the emergency care of second-degree burns.
Correct Answer: B
Rationale: Removing clothing and wrapping the victim in a clean sheet minimizes contamination and prevents infection in an emergency setting. Soap, ointments, or delaying action increase infection risk by introducing irritants or leaving the wound exposed.