NCLEX Questions, NCLEX RN Practice Questions, NCLEX-RN Questions, Nurselytic

Questions 148

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Question 1 of 5

The client admitted 2 days earlier with a lung resection accidentally pulls out the chest tube. Which action by the nurse indicates understanding of the management of chest tubes?

Correct Answer: C

Rationale: Covering the insertion site with Vaseline gauze prevents air from entering the pleural space, which is the priority action for a dislodged chest tube.

Question 2 of 5

A client admitted to the psychiatric unit claims to be the Pope and insists that he will not be kept away from his subjects. The most likely explanation for the client's delusion is:

Correct Answer: C

Rationale: Delusions of grandeur, such as claiming to be the Pope, often stem from low self-esteem, compensating with an inflated sense of identity.

Question 3 of 5

A client asks what diabetes mellitus does to the body over time. Which condition should the nurse include in teaching as a common chronic complication of diabetes mellitus?

Correct Answer: D

Rationale: Retinopathy is a common chronic complication of diabetes due to long-term damage to retinal blood vessels, unlike the acute conditions listed.

Question 4 of 5

The nurse is working in the trauma unit of the emergency room when a 24-year-old female is admitted after an MVA. The client is bleeding profusely and a blood transfusion is ordered. Which would the nurse be prepared to administer without a type and crossmatch?

Correct Answer: D

Rationale: O negative blood is the universal donor type, safe for transfusion without type and crossmatch in emergencies, as it lacks antigens that could cause reactions.

Question 5 of 5

A 14-year-old boy comes in for a yearly exam and confides in the nurse that he feels embarrassed he is shorter than most of the girls in his class. He asks if he will catch up in height. The best therapeutic response from the nurse is

Correct Answer: B

Rationale: This response validates the boy’s feelings, provides factual reassurance about growth during puberty, and is empathetic without dismissing his concerns.

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