NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
The client is admitted with a diagnosis of gestational trophoblastic disease. Which vital sign change is most likely to be observed?
Correct Answer: A
Rationale: Gestational trophoblastic disease can cause maternal tachycardia due to elevated hCG or bleeding. Fetal bradycardia is not relevant (no viable fetus) and hypotension is less common unless hemorrhage occurs.
Question 2 of 5
A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:
Correct Answer: A
Rationale: A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. Proper identification of the recipient and the blood product must be validated by at least two people.
Question 3 of 5
What is the most effective method to identify early breast cancer lumps?
Correct Answer: D
Rationale: Mammograms are less effective than breast self-examination for the diagnosis of abnormalities in younger women, who have denser breast tissue. They are more effective for women older than 40. Up to 15% of early-stage breast cancers are detected by physical examination; however, 95% are detected by women doing breast self-examination. Ultrasound is used primarily to determine the location of cysts and to distinguish cysts from solid masses. Monthly breast self-examination has been shown to be the most effective method for early detection of breast cancer. Approximately 95% of lumps are detected by women themselves.
Question 4 of 5
A 66-year-old female client has smoked 2 packs of cigarettes per day for 20 years. Her arterial blood gases on room air are as follows: pH 7.35; PO2 70 mm Hg; PCO2 55 mm Hg; HCO3 32 mEq/L. These blood gases reflect:
Correct Answer: B
Rationale: Normal pH with elevated PCO2 and HCO3 indicates compensated respiratory acidosis, common in chronic smokers due to CO2 retention.
Question 5 of 5
The nurse is assessing a client with suspected rheumatoid arthritis. Which finding is most characteristic of this condition?
Correct Answer: A
Rationale: Morning stiffness lasting over 30 minutes is a hallmark of rheumatoid arthritis, reflecting synovial inflammation. Joint pain is symmetrical, fever and weight loss are less specific, and nodules are subcutaneous, not spinal.