NCLEX Questions, ATI NCLEX-RN Practice Questions Questions, NCLEX-RN Questions, Nurselytic

Questions 158

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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 client is diagnosed with Bell’s palsy. Which intervention should the nurse implement to protect the client’s affected eye?

Correct Answer: A

Rationale: Bell’s palsy causes facial paralysis, impairing eye closure and risking corneal damage. An eye patch at night protects the eye from drying and injury. Corticosteroids reduce inflammation, blinking is encouraged, and antibiotics are not indicated.

Question 3 of 5

When the nurse is evaluating lab data for a client 18-24 hours after a major thermal burn, the expected physiological changes would include which of the following?

Correct Answer: D

Rationale: Hematocrit is elevated due to hemoconcentration from hypovolemia. Sodium, calcium, and protein levels are typically decreased due to losses into edema fluid or increased capillary permeability.

Question 4 of 5

The patient is prescribed metronidazole (Flagyl) for adjunct treatment for a duodenal ulcer. When teaching about this medication, the nurse would include:

Correct Answer: D

Rationale: Metronidazole can cause a disulfiram-like reaction (nausea, vomiting) when combined with alcohol, so patients should avoid alcoholic beverages and products. It should be taken for the full course, can be taken with food to reduce GI upset, and does not cause photosensitivity.

Question 5 of 5

The nurse is assessing a client with suspected hypercalcemia. Which finding is most consistent with this condition?

Correct Answer: B

Rationale: Hypercalcemia causes constipation due to reduced gastrointestinal motility. Muscle weakness, hypotension, and bradypnea are more common than hypertension or tachypnea.

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