NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
The mother of a 7-year-old mental health center client reports that the client has refused to attend gymnastics for the past 2 weeks. Prior to that time, the child liked going to this class and was attending 3 times a week. In talking with the client, the nurse would:
Correct Answer: B
Rationale: Asking 'why' questions may put the child on the defensive and may not elicit useful information, especially in a young child who may struggle to articulate reasons. This approach is open-ended and encourages the child to describe her experiences in a non-confrontational way, which may reveal underlying issues while building trust. This question is too specific and may feel confrontational, potentially causing the child to shut down. While encouraging expression of feelings is appropriate, it is less specific and may not help uncover the specific event or change that led to her refusal to attend.
Question 2 of 5
A client with a history of a total hip replacement is being discharged. The nurse should teach the client to avoid:
Correct Answer: B
Rationale: Crossing legs after a total hip replacement risks hip dislocation by adducting the femur. Sleeping, walking, or lying prone (if tolerated) are generally safe with proper precautions.
Question 3 of 5
The nurse working with a client who is out of control should follow a model of intervention that includes which of the following?
Correct Answer: A
Rationale: Approaching a client's aggressive behavior on a continuum of least restrictive care is in agreement with his or her rights (i.e., verbal methods to help maintain control, medication, seclusion, and restraints, as necessary). Approaching a client in a challenging manner is threatening and inappropriate. A non-challenging and calm approach reflects staff in control and may increase client's internal control. It is inappropriate to leave an aggressive client who is acting out alone. The nurse should acquire qualified help to prevent client from harm or injury to self or others. Moving a client to seclusion immediately for shouting is inappropriate. The nurse should offer the client an opportunity to control self with limit setting. The client should understand that the staff will assist with control if necessary (i.e., quietly accompany out of environment to decrease stimulation and allow for verbalization) employing the least restrictive care model of intervention.
Question 4 of 5
A post-operative client has an order for Demerol (meperidine) 75 mg and Phenergan (promethazine) 25 mg IM every 3-4 hours as needed for pain. The combination of the two medications produces a/an:
Correct Answer: B
Rationale: Meperidine (opioid) and promethazine (antihistamine) together produce a synergistic effect, enhancing pain relief and sedation. Promethazine potentiates meperidine’s effects.
Question 5 of 5
The nurse has just received the change of shift report. Which client should the nurse assess first?
Correct Answer: B
Rationale: A suspected subdural hematoma is a medical emergency due to potential brain compression, requiring immediate assessment.