NCLEX-RN
NCLEX Practice Test RN Questions
Extract:
Question 1 of 5
During morning assessments, the nurse finds that a client's nephrostomy tube has been clamped. The nurse's first action should be to:
Correct Answer: C
Rationale: Unclamping the nephrostomy tube is the priority to restore urine flow and prevent complications like hydronephrosis or infection.
Question 2 of 5
The nurse is teaching a client with a history of type 2 diabetes about foot care. The nurse should tell the client to:
Correct Answer: A
Rationale: Daily foot inspection helps detect early signs of injury or infection in type 2 diabetes, preventing complications like ulcers.
Question 3 of 5
A 52-year-old client is scheduled for a small-bowel resection in the morning. In conjunction with other preoperative preparation, the nurse is teaching her diaphragmatic breathing exercises. She will teach the client to:
Correct Answer: A
Rationale: This is the correct method of teaching diaphragmatic breathing, which allows full lung expansion to increase oxygenation, prevent atelectasis, and move secretions up and out of the lungs to decrease risk of pneumonia. Quick, short breaths do not allow for full lung expansion and movement of secretions up and out of the lungs. Quick, short breaths may lead to O2 depletion, hyperventilation, and hypoxia. Expelling breaths through the nose does not allow for full lung expansion and the use of diaphragmatic muscles to assist in moving secretions up and out of the lungs. Inhaling and exhaling at a rate of 20-24 times/min does not allow time for full lung expansion to increase oxygenation. This would most likely lead to O2 depletion and hypoxia.
Question 4 of 5
The nurse is teaching about irritable bowel syndrome (IBS). Which of the following would be most important?
Correct Answer: A
Rationale: A balanced diet with adequate fiber (soluble for IBS) helps regulate bowel function and reduce IBS symptoms. High fluid intake with meals may exacerbate symptoms, low-fiber diets can worsen constipation, and limiting fruits/vegetables is not advised.
Question 5 of 5
A client with a history of a deep vein thrombosis is receiving Warfarin (Coumadin). The nurse should teach the client to avoid:
Correct Answer: A
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarin’s anticoagulant effect. Dairy, citrus, and high-fat foods do not significantly affect warfarin.