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Questions 227

NCLEX-PN

NCLEX-PN Test Bank

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Extract:

John H is a 66-year-old man with a history of heavy smoking presented himself to the ER due to difficulty breathing of 2 years duration. Mr. H was also diagnosed with effusion of the right lung. He is now scheduled for chest tube insertion.


Question 1 of 5

The level of the water in the water-seal chamber is at

Correct Answer: A

Rationale: The water-seal chamber is maintained at 2 cm to prevent air entry.

Extract:

Liquid iron preparation


Question 2 of 5

Liquid iron preparation, which of the following directions would be appropriate for the nurse to teach?

Correct Answer: C

Rationale: Using a straw prevents tooth staining from liquid iron.

Extract:

The nurse on the floor will perform peripheral IV site insertion.


Question 3 of 5

Her performance is based on:

Correct Answer: B

Rationale: Nursing Standards of Practice guide safe and competent IV insertion.

Extract:


Question 4 of 5

The nurse is caring for a client with a tracheostomy. Which of the following actions should the nurse perform to prevent complications?

Correct Answer: B

Rationale: Cleaning the inner cannula with sterile technique prevents infection and ensures airway patency, a priority in tracheostomy care. Suctioning (
A) is as needed, not routine, tie changes (
C) are less frequent, and dressings (
D) should be pre-cut and moisture-resistant.

Question 5 of 5

The client states, 'My discharge plan leaves me with a lot to do. I don't think I can do it. I'm never good at doing things.' The nurse knows the client lacks:

Correct Answer: D

Rationale: Expressing doubt in ability to manage the discharge plan indicates low self-efficacy, a belief in one's capacity to execute tasks.

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