NCLEX-RN
Best NCLEX RN Question Bank Questions
Extract:
Question 1 of 5
The mother of a 28-year-old client who is taking clozapine [Clozaril] states, 'Something is wrong. My son is drooling like a baby.' Which of the following responses by the nurse would be most helpful?
Correct Answer: B
Rationale: Excess salivation is a common side effect of clozapine. Providing a practical solution like a cup supports the client's comfort and addresses the mother's concern.
Question 2 of 5
The nurse is assessing a client with suspected hypovolemic shock. Which finding is most indicative?
Correct Answer: A
Rationale: Tachycardia is an early sign of hypovolemic shock as the body compensates for reduced blood volume by increasing heart rate.
Question 3 of 5
You are caring for an acute care adult client in the medical unit who has no history of a psychiatric mental health disorder. This 76 year old client has suddenly and abruptly started to exhibit episodic and intermittent periods of time vacillating between periods of impaired cognition and periods of mental clarity. The client reports to you that they are seeing clowns in their room. This client is dehydrated and has just begun taking an anticholinergic medication. Which of the following is the most appropriate nursing diagnosis for this client?
Correct Answer: D
Rationale: The sudden onset of impaired cognition, fluctuating mental status, and visual hallucinations in the context of dehydration and anticholinergic medication use strongly suggests delirium, not dementia or psychosis.
Question 4 of 5
The nurse is caring for a client with a new colostomy. Which statement by the client indicates a need for further teaching?
Correct Answer: B
Rationale: High-fiber foods may cause blockages in a new colostomy. The client should start with a low-residue diet and gradually introduce fiber, indicating a need for further teaching.
Question 5 of 5
An infant is born with facial abnormalities, growth retardation, mental retardation, and vision abnormalities. These abnormalities are probably caused by maternal:
Correct Answer: A
Rationale: These symptoms are characteristic of fetal alcohol syndrome, caused by maternal alcohol consumption during pregnancy, which affects fetal development.