NCLEX-RN
RN NCLEX Practice Test Questions
Extract:
Question 1 of 5
The client is admitted to the ER with multiple rib fractures on the right. The nurse's assessment reveals that an area over the right clavicle is puffy and that there is a "crackling" noise with palpation. The nurse should further assess the client for which of the following problems?
Correct Answer: B
Rationale: Puffy skin and crackling (crepitus) over the clavicle suggest subcutaneous emphysema, where air escapes into tissues, often with rib fractures. Flail chest (
A) involves paradoxical chest movement, infiltrated IV (
C) is unrelated, and pneumothorax (
D) causes absent breath sounds.
Question 2 of 5
The client is admitted with a diagnosis of gestational hypertension. Which assessment finding requires immediate notification of the physician?
Correct Answer: C
Rationale: Headache and visual disturbances in gestational hypertension suggest severe preeclampsia or impending eclampsia requiring immediate physician notification. BP of 140/90 proteinuria and edema are concerning but less urgent unless severe.
Question 3 of 5
The nurse is caring for a patient hospitalized with leukopenia. Which of the following assessments should be reported to the physician immediately?
Correct Answer: C
Rationale: A temperature increase to 99.8°F in a patient with leukopenia (low white blood cell count) may indicate an infection which is a medical emergency due to the patient’s compromised immune system. The other vital signs are within normal limits and less urgent.
Question 4 of 5
A client is hyperactive and not sleeping. She will not remain at the table during mealtime. She is getting very limited calories and is using a lot of energy in her hyperactive state. The most therapeutic nursing action is to:
Correct Answer: C
Rationale: Providing finger foods increases the likelihood of eating for hyperactive persons. They may be eating 'on the run,' accommodating their high energy state.
Question 5 of 5
A client is experiencing visual problems at school. She has complained of difficulty seeing the blackboard and squinting. She no longer likes to participate in physical activities such as softball. The client has displayed possible classic symptoms of which refractive error?
Correct Answer: C
Rationale: Visual images are blurred and distorted. Symptoms are headaches, burning eyes, fatigue, squinting, and difficulty reading. These symptoms are classic for myopia. Amblyopia is not a refractive error. It is a loss of vision in one or both eyes.