NCLEX-PN
NCLEX-PN Free Practice Questions Questions
Extract:
The nurse assesses a patient's IV site and finds that it is red, hot, and tender to touch.
Question 1 of 5
The most appropriate first action is:
Correct Answer: A
Rationale: Signs of phlebitis or infection require stopping the infusion and removing the IV to prevent complications.
Extract:
Ms. Wilson has undergone total thyroidectomy.
Question 2 of 5
Following surgery, the patient should be observed for signs and symptoms of thyroid storm. Which of the following is consistent with thyroid storm?
Correct Answer: A
Rationale: Tachycardia, such as a heart rate of 180 bpm, is one of the manifestations of thyroid storm, a life-threatening condition.
Extract:
Question 3 of 5
The nurse is monitoring the fluid status of a 63-year-old woman receiving IV fluids following surgery. Which of the following symptoms would suggest to the nurse that the patient has fluid volume overload?
Correct Answer: B
Rationale: Fluid volume overload is characterized by symptoms such as bounding pulse, elevated blood pressure, respiratory crackles (due to pulmonary edema), distended neck veins, edema, headache, polyuria, diarrhea, and liver enlargement.
Choice B includes respiratory crackles and a bounding pulse, which are hallmark signs.
Choice A suggests dehydration, choice C could have other causes, and choice D shows normal CVP and unrelated nystagmus.
Question 4 of 5
A 65-year-old female is planning for retirement. Which statement indicates that the client has achieved ego integrity?
Correct Answer: A
Rationale: Ego integrity, per Erikson, involves acceptance of one's life and finding meaning, as shown by planning to join a travel club .
Choices B, C, and D reflect uncertainty or despair.
Question 5 of 5
A nurse has just started on the 7PM surgical unit shift. Which of the following patients should the nurse check on first?
Correct Answer: B
Rationale: The new onset of urinary incontinence may require additional medical assessment, and the physician needs to be notified.