NCLEX-RN
NCLEX RN Predictor Exam Questions
Extract:
Question 1 of 5
Endotracheal tube cuff pressure should never exceed:
Correct Answer: B
Rationale: Pressure in the endotracheal tube cuff should never exceed 20 mm Hg, because higher pressure places the client at risk for tracheal erosion.
Question 2 of 5
A 52-year-old client's abdominal aortic aneurysm ruptured. She received rapid massive blood transfusions for bleeding. One potential complication of blood administration for which she is especially at risk is:
Correct Answer: C
Rationale: Massive transfusions can cause hypocalcemia due to citrate in stored blood binding with calcium, especially in rapid transfusions.
Question 3 of 5
The well child assessment of a one-year-old reveals orange discoloration of the nasolabial folds. Based on this finding the nurse should:
Correct Answer: A
Rationale: Orange discoloration of the nasolabial folds may result from excessive dietary beta-carotene (e.g. from carrots or sweet potatoes). Obtaining a diet history is the most appropriate action to identify the cause. The other options are more relevant for jaundice or liver issues.
Question 4 of 5
The nurse caring for a client with anemia recognizes which clinical manifestation as the one that is specific for a hemolytic type of anemia?
Correct Answer: A
Rationale: Jaundice is specific to hemolytic anemia due to increased bilirubin from red blood cell destruction. Anorexia (
B), tachycardia (
C), and fatigue (
D) are nonspecific and occur in other anemias.
Question 5 of 5
The nurse is caring for a client with a diagnosis of ectopic pregnancy. Which symptom is most likely to be present?
Correct Answer: A
Rationale: Ectopic pregnancy causes sudden abdominal pain from tubal stretching or rupture. Painless bleeding is more typical of placenta previa fetal heart tones are absent and fever is not common.