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 with a history of a kidney transplant is receiving Prednisone. The nurse should monitor the client for:
Correct Answer: A
Rationale: Prednisone, a corticosteroid, suppresses immunity, increasing infection risk. Hypotension, hyperkalemia, and weight loss are not primary concerns; weight gain is more common.
Question 3 of 5
The nurse is caring for a client with a history of Rh sensitization. The physician orders a Kleihauer-Betke test. The purpose of this test is to:
Correct Answer: A
Rationale: The Kleihauer-Betke test quantifies fetal blood in maternal circulation critical in Rh sensitization to determine the dose of RhoGAM needed to prevent maternal antibody formation. It does not assess lung maturity antibodies or amniotic fluid volume.
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
A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include:
Correct Answer: D
Rationale: Sterile pin care prevents infection at the cervical tong insertion sites, a critical nursing responsibility. Releasing traction, loosening pins, or elevating the bed risks spinal instability.