NCLEX Questions, NCLEX PN Test Questions Questions, NCLEX-PN Questions, Nurselytic

Questions 164

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Extract:


Question 1 of 5

The nurse caring for a terminally ill client asks if the client has an advance directive. The client states, 'I already have a power of attorney.' What is the best response by the nurse?

Correct Answer: D

Rationale: Clarifying if the POA includes healthcare decisions (
D) ensures proper advance directive planning. Vague affirmations (A,
B) or suggesting a lawyer (
C) do not address the need for a healthcare-specific POA.

Question 2 of 5

The intensive care nurse is caring for a client who has just been extubated. Which interventions are appropriate at this time?

Correct Answer: B,C,D,E

Rationale: Post-extubation, warmed, humidified oxygen (
B) prevents mucosal drying, ice chips (
C) moisten the mouth, oral sponges (
D) maintain hygiene, and incentive spirometry (E) promotes lung expansion. Oral narcotics (
A) are risky due to potential airway compromise.

Question 3 of 5

The nurse is caring for a newborn with patent ductus arteriosus. Which finding would be consistent with the condition?

Correct Answer: C

Rationale: Patent ductus arteriosus causes a loud, machine-like murmur (
C) due to continuous blood flow. Other murmurs (A, B,
D) are associated with different cardiac conditions.

Question 4 of 5

The best position for the client with a right total hip replacement is:

Correct Answer: C

Rationale: Supine with pillows supporting the leg prevents dislocation while maintaining alignment. Flexion or adduction risks complications.

Extract:

Vital signs
Temperature 98.7 F (37.05 C)
Blood pressure 110/64 mm Hg
Heart rate 92/min
Respirations 22/min
O2 saturation or SpO2 90% on room air


Question 5 of 5

An 81-year-old client is admitted to a rehabilitation facility 3 days after total hip replacement. The next morning, the unlicensed assistive personnel (UAP) takes the client's vital signs, but when the UAP returns to assist the client with a shower, the client curses at and tries to hit the UAP. Which is the most appropriate response by the practical nurse?

Correct Answer: A

Rationale: Observing the client (
A) allows assessment of the behavior's cause. Assuming dissatisfaction (
B) or dementia (
D) is premature. Leaving the client (
C) delays intervention.

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