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
A client is being admitted to the labor and delivery unit. She has had previous admissions for 'false labor.' Which clinical manifestation would be most indicative of true labor?
Correct Answer: B
Rationale: Contractions of true labor produce progressive cervical effacement and dilatation.
Question 3 of 5
The parents of a 2-year-old child are ready to begin toilet training activities with him. His parents feel he is ready to train because he is now 2 years old. What would the nurse identify as readiness in this child?
Correct Answer: B
Rationale: A child must be able to use verbal or nonverbal skills to communicate needs, indicating readiness for toilet training.
Question 4 of 5
The health team needs to realize that the compulsive concern with cleanliness that a client with severe anxiety exhibits is most likely an attempt to:
Correct Answer: A
Rationale: These behaviors are attempts to relieve anxiety, as compulsive actions often serve as a coping mechanism for severe anxiety.
Question 5 of 5
The client has surgery for removal of a prolactinoma. Which of the following interventions would be appropriate for this client?
Correct Answer: C
Rationale: After prolactinoma surgery (transsphenoidal hypophysectomy) elevating the head of the bed 30° reduces intracranial pressure and prevents cerebrospinal fluid leakage. Trendelenburg position coughing and nose blowing may increase pressure or disrupt the surgical site.