NCLEX-PN
NCLEX PN Practice Questions Questions
Extract:
Question 1 of 5
Following a cholecystectomy, drainage from the client's T tube for the first 24 hours after the operation was 350 cc. What is the appropriate nursing action?
Correct Answer: D
Rationale: T-tube drainage of 300–500 mL in the first 24 hours post-cholecystectomy is expected as bile drains externally. Continuing to observe and measure is appropriate unless other signs of complications arise.
Question 2 of 5
The nurse is caring for a client who is having a thoracentesis. Following the procedure, the nurse monitors for complications. The initial post-procedure monitoring plan should include what? Select all that apply.
Correct Answer: A,B,C,D
Rationale: Monitoring alertness, lung sounds, oxygen saturation, and respiratory pattern detects complications like pneumothorax or respiratory distress.
Question 3 of 5
The nurse is talking with the parent of an adolescent client who arrived at the emergency department after discovering that the client was involved in a motor vehicle collision. The parent asks about the clients condition. The client is unconscious and is currently receiving CPR. Which of the following responses would be appropriate for the nurse to make?
Correct Answer: C
Rationale: Honest, clear communication about the critical situation (CPR) is appropriate while maintaining sensitivity.
Extract:
Laboratory reference ranges
Hemoglobin
1-6 years: 9.5-14.0 g/dL
(95-140 g/L)
Question 4 of 5
The nurse is caring for a 5-year-old client with sickle cell disease who is experiencing an episode of acute pain. The client has shortness of breath, nausea with vomiting, and severe generalized body and joint pain. Which of the following findings requires immediate intervention?
Correct Answer: A
Rationale: An enlarged spleen may indicate splenic sequestration, a life-threatening complication requiring immediate intervention.
Extract:
Question 5 of 5
The nurse is caring for a 2 month-old infant with a congenital heart defect. Which of the following is a priority nursing action?
Correct Answer: A
Rationale: Infants with congenital heart defects are at increased risk for developing congestive heart failure. Infants with congestive heart failure have an increased metabolic rate and require additional calories to grow. At the same time, however, rest and conservation of energy for eating is important. Feedings should be smaller and every 3 hours rather than the usual 4 hour schedule.