NCLEX-RN
RN NCLEX Practice Questions Questions
Extract:
Question 1 of 5
The nurse caring for a client with a closed head injury obtains an intracranial pressure (ICP) reading of 17 mmHg. The nurse recognizes that:
Correct Answer: A
Rationale: An ICP of 17 mmHg is elevated (normal is 7-15 mmHg), indicating increased intracranial pressure, which requires immediate notification of the physician.
Question 2 of 5
A client with deep vein thrombosis is receiving a continuous heparin infusion and Coumadin PO. INR lab test result is 8.0. Which intervention would be most important to include in the nursing care plan?
Correct Answer: A
Rationale: An INR of 8.0 is dangerously high, indicating a risk of bleeding. Assessing for abnormal bleeding is the priority to detect and manage potential complications.
Question 3 of 5
The nurse has an order to give 1,000 mL of 0.9% NS with 20 meQ of potassium chloride over 8 hours. The IV set has a drop factor of 15. How many gtts/min should the client receive?
Correct Answer: 31
Rationale: Rate = 1,000 mL ÷ 8 hr = 125 mL/hr. Drops/min = (125 mL/hr × 15 gtts/mL) ÷ 60 min = 31.25 gtts/min, rounded to 31 gtts/min.
Question 4 of 5
If a client with psoriasis is to begin NB-UVB phototherapy, how long should the initial treatment be?
Correct Answer: A
Rationale: Initial NB-UVB phototherapy starts with 30 seconds to 1 minute (
A) to assess skin tolerance and prevent burns. Longer durations (B, C,
D) are used in subsequent sessions.
Question 5 of 5
The nurse is taking the blood pressure of the obese client. If the blood pressure cuff is too small, the results will be:
Correct Answer: A
Rationale: A blood pressure cuff that is too small will result in a false elevation of the blood pressure reading due to increased pressure on the arm.