NCLEX-RN
NCLEX RN Practice Questions Questions
Extract:
Question 1 of 5
The family of a hospice client wishes to visit at midnight. Which of the following actions by the nurse would be the most appropriate?
Correct Answer: D
Rationale: In hospice care, allowing family visits at any time supports the client’s and family’s emotional needs, especially near end-of-life.
Question 2 of 5
A client seen in the doctor's office for complaints of nausea and vomiting is sent home with directions to follow a clear-liquid diet for the next 24-48 hours. Which of the following is not permitted on a clear-liquid diet?
Correct Answer: C
Rationale: Ice cream is not a clear liquid, as it is opaque and contains dairy.
Question 3 of 5
An adolescent client is seen by the nurse at a school where a fatal shooting incident occurred on campus 3 months earlier. The nurse documents that the client is experiencing flashbacks, avoiding the location of the shooting, having angry outbursts, and experiencing a loss of interest in playing his favorite musical instrument. The nurse suspects the client is experiencing post-traumatic stress disorder. Which intervention would be the best for the nurse to implement?
Correct Answer: B
Rationale: Referring to the multidisciplinary crisis team ensures comprehensive, coordinated care for suspected PTSD, leveraging expertise beyond the nurse’s scope.
Question 4 of 5
The client who is 2 weeks post-burn with a 40% deep partial-thickness injury still has open wounds. The nurse's assessment reveals the following findings: temperature 96.5°F, BP 87/40, and severe diarrhea stools. What problem does the nurse most likely suspect?
Correct Answer: C
Rationale: Hypothermia, hypotension, and diarrhea suggest systemic gram-negative infection, likely sepsis, due to bacterial translocation from open wounds or the gut in a burn patient.
Question 5 of 5
The nurse is caring for a client with staphylococcus epidermidis. The client is on a vancomycin IV. What nursing consideration should the nurse be aware of regarding this medication?
Correct Answer: C
Rationale: Vancomycin requires monitoring trough levels (drawn before a dose) to ensure therapeutic efficacy and prevent toxicity.