NCLEX Questions, ATI NCLEX-PN Practice Questions Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Extract:


Question 1 of 5

The elderly female client of Mexican heritage is upset and tells the nurse the unlicensed assistive personnel (UAP) complimented her grandchild's hair. Which intervention should the nurse implement?

Correct Answer: D

Rationale: In Mexican culture, complimenting a child may be linked to 'mal de ojo' (evil eye), causing distress. Educating the UAP about this belief prevents further upset. Asking why, ignoring, or notifying a psychologist does not address cultural sensitivity.

Question 2 of 5

The 85-year-old client diagnosed with severe end-stage chronic obstructive pulmonary disease has a chest x-ray incidentally revealing an eight (8)-cm abdominal aortic aneurysm (AAA). Which intervention should the nurse implement?

Correct Answer: A

Rationale: An 8-cm AAA in an elderly COPD patient has high rupture risk; end-of-life discussions are appropriate given surgical risks.

Question 3 of 5

The telemetry nurse is monitoring the following clients. Which client should the telemetry nurse instruct the primary nurse to assess first?

Correct Answer: C

Rationale: Multifocal PVCs post-MI indicate higher arrhythmia risk, requiring urgent assessment, per ACLS guidelines.

Question 4 of 5

The client comes to the emergency department complaining of pain in the right forearm. The nurse notes a large area of redness and edema over the forearm, and the client has an elevated temperature. Which condition should the nurse suspect?

Correct Answer: A

Rationale: Redness, edema, and fever suggest cellulitis, a bacterial skin infection, the most likely diagnosis.

Question 5 of 5

The nurse is admitting the client to a medical unit. Which questions should the nurse specifically ask the client about the current use of medications? Select all that apply.

Correct Answer: A,B,C,D,E

Rationale: All questions are essential for a comprehensive medication history: herbs (drug interactions), OTC meds (side effects), allergies (safety), timing (dosing), and prescriptions (treatment plan).

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