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NCLEX Trainer Test 5 Questions

Extract:

An adolescent for a lumbar puncture.


Question 1 of 5

It is MOST important that the nurse make which of the following statements?

Correct Answer: C

Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) general anesthetic is not used (2) fluids are not restricted before the Test (3) correct-to prevent a post-lumbar puncture headache, client should remain flat in bed for eight hours after the Test (4) inappropriate for this procedure

Extract:


Question 2 of 5

The nurse is caring for a client with a history of heart failure who is receiving spironolactone (Aldactone) 25 mg PO daily. Which of the following client statements would be of GREATest concern to the nurse?

Correct Answer: C

Rationale: Muscle cramps suggest hyperkalemia, a serious side effect of spironolactone, a potassium-sparing diuretic, requiring immediate evaluation to prevent arrhythmias. Options A, B, and D are less concerning: fatigue and dry mouth are nonspecific, and taking with food is acceptable.

Question 3 of 5

The nurse is assessing a client who may be bulimic. What objective finding indicates bulimia?

Correct Answer: B

Rationale: Loss of tooth enamel from frequent vomiting is an objective sign of bulimia, distinguishing it from subjective emotional symptoms.

Question 4 of 5

The nurse is teaching a client with a new diagnosis of gout about colchicine. Which of the following instructions should the nurse include?

Correct Answer: B

Rationale: Diarrhea is a serious colchicine side effect, indicating potential toxicity. Options A, C, and D are incorrect.

Question 5 of 5

A client receiving Gentamycin (garamycin) IVPB has a morning peak level of 12 μg/mL. The nurse should:

Correct Answer: A

Rationale: The nurse should notify the physician because the level is too high (therapeutic range for Garamycin is 4-10 μg/mL). Answers B and C are incorrect because they would increase the peak level. Answer D refers to the time for drawing a trough level, making it incorrect.

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