NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
Following her surgery, a 5-year-old child will return to the pediatric unit with a long-arm cast. She experienced a supracondylar fracture of the humerus near the elbow. Which nursing action is most essential during the first 24 hours after surgery and cast application?
Correct Answer: D
Rationale: Neurovascular status of the extremity is of primary importance. The risk of circulatory impairment exists with any cast application, especially with fractures near the elbow.
Question 2 of 5
As the nurse assesses a male adolescent with chlamydia, the nurse determines that a sign of chlamydia is:
Correct Answer: C
Rationale: An enlarged penis is not a sign of chlamydia. Secondary lymphadenitis is a complication of lymphogranuloma venereum. Untreated chlamydial infection can spread from the urethra, causing epididymitis, which presents as a tender, scrotal swelling. Hepatomegaly is not a complication.
Question 3 of 5
The nurse would be concerned if a client exhibited which of the following symptoms during her postpartum stay?
Correct Answer: C
Rationale: Bradycardia is an expected assessment during the postpartum period. Diuresis can occur during labor and the postpartum period and is an expected physiological adaptation. A return of rubra after the serosa period may indicate a postpartal complication. Diaphoresis, especially at night, is an expected physiological change and does not indicate an infectious process. Bradycardia, diuresis, and diaphoresis are normal postpartum physiological responses to adjust the cardiac output and blood volume to the nonpregnant state.
Question 4 of 5
The client will be more comfortable and the results more accurate when the nurse prepares the client for Leopold's maneuvers by having her:
Correct Answer: A
Rationale: A full bladder would cause discomfort and possible urinary incontinence during the exam. The left side-lying position would not accommodate the exam. The head of the exam table or bed can be slightly elevated to prevent supine hypotension. Arms extended over the head would cause the abdomen to be tighter and less easily palpable. Forcing fluids would encourage a full bladder, which is not desired for the exam.
Question 5 of 5
A 6-month-old infant has developmental delays. His weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviors might indicate the possibility of maternal deprivation?
Correct Answer: B
Rationale: Normal infant attachment behaviors include responding to touch and wanting to be held. Maternal deprivation behaviors include poor feeding, stiffening and refusal to eat, and inconsistencies in responsiveness. Attachment behavior includes maintaining eye contact. Maternal deprivation behaviors include displeasure with touch and physical contact.