NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
At 12 hours postvaginal delivery, a female client is without complications. Which of the following assessment findings would warrant further nursing interventions?
Correct Answer: B
Rationale: Bradycardia of 50-70 bpm may be considered normal postpartally because the heart compensates for the decreased resistance in the pelvis. The uterus is displaced from the midline by a full bladder. This condition could lead to a boggy uterus and increased risk of postpartal hemorrhage; therefore, the bladder should be kept empty. Re-establishment of normal bowel function is delayed into the first postpartum week. A postpartum woman's oral temperature may go as high as 100.4°F within 24 hours of delivery resulting from muscular exertion, dehydration, and hormonal changes.
Question 2 of 5
The nurse has just received the change of shift report. Which client should the nurse assess first?
Correct Answer: A
Rationale: The client two hours post-lobectomy with 150mL of chest drainage is at risk for complications such as hemorrhage or tension pneumothorax, requiring immediate assessment. The other clients are stable: scant drainage is expected post-gastrectomy, a fever in pneumonia is concerning but less urgent, and a fractured hip in traction is typically stable.
Question 3 of 5
A 14-year-old teenager is hospitalized for anorexia nervosa. She is admitted to the adolescent mental health unit and placed on a behavior modification program. Nursing interventions for the teenager will most likely include:
Correct Answer: A
Rationale: Providing a more structured, supportive environment addresses safety and comfort needs, thereby helping the anorexic client develop more internal control. Medications (commonly antidepressants) are frequently ordered for the体系, but lithium (used primarily with bipolar disorder) is not commonly used to treat the anorexic client. Requiring and/or demanding that the anorexic client 'eat more' at mealtimes increases the client's feelings of powerlessness.
Question 4 of 5
To prevent deformities of the knee joints in a client with an exacerbation of rheumatoid arthritis, the nurse should:
Correct Answer: C
Rationale: Encouraging joint motion within pain limits prevents stiffness and deformities in rheumatoid arthritis. Bed rest, discouraging motion, or prolonged immobilization can worsen contractures.
Question 5 of 5
The client is diagnosed with a retinal detachment. Which symptom is most likely reported by the client?
Correct Answer: A
Rationale: Retinal detachment typically causes sudden vision loss, often described as a curtain over the visual field. Pain, redness, and double vision are less common.