NCLEX-PN
NCLEX Trainer Test 5 Questions
Extract:
Question 1 of 5
During the first 72 hours post CVA, the nurse should position the client:
Correct Answer: B
Rationale: Semi-Fowler's position (30-45 degrees) reduces intracranial pressure and promotes venous drainage in the acute phase post-stroke.
Extract:
A man is presently employed as a night watchman. When he comes to the clinic for a visit, he tells the nurse he is having difficulty sleeping and is fatigued much of the time.
Question 2 of 5
Which of the following responses by the nurse is BEST?
Correct Answer: A
Rationale: Strategy: Answers are a mix of assessments and implementations. Does this situation require assessment? Yes. (1) correct-assessment, open-ended, encourages discussion (2) judgment based on inadequate information, nontherapeutic (3) generalization with no factual basis, closed communication (4) closed communication, generalization
Extract:
Question 3 of 5
The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings would be of GREATest concern to the nurse?
Correct Answer: B
Rationale: A temperature of 100.4°F suggests infection, a serious complication in TPN due to catheter-related bloodstream infections. Options A, C, and D are less urgent: hyperglycemia is common and manageable, rapid weight gain may indicate fluid overload, and potassium 3.8 mEq/L is normal.
Extract:
At 11 AM a patient returned to the nursing unit from the postanesthesia care unit (PACU) following a hemorrhoidectomy. At noon the patient complains of pain. The physician has ordered meperidine (Demerol) 50 mg IV q 3-4 hrs. The chart indicates that the patient was given Demerol 50 mg IV at 9:15 AM.
Question 4 of 5
The nurse should
Correct Answer: D
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) no reason to call the physician (2) can't change amount of medication ordered by physician (3) medication is ordered every 3 to 4 hours, should not wait if patient needs medication after 3 hours (4) correct-give patient the medication as ordered
Extract:
Question 5 of 5
The nurse is caring for a client suspected to have Tuberculosis (TB). Which of the following diagnostic tests is essential for determining the presence of active TB?
Correct Answer: B
Rationale: Sputum culture. The sputum culture is the most accurate method for determining the presence of active TB.