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

Questions 164

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Question 1 of 5

The nurse enters the room of a woman who had a vaginal hysterectomy three days ago and finds her crying. What is the best initial approach for the nurse?

Correct Answer: A

Rationale: Asking about her concerns opens therapeutic communication, addressing her emotional needs directly and empathetically.

Question 2 of 5

The nurse is caring for a client who has a chest tube connected to a wet suction closed chest drainage system. The nurse should recognize the drainage system is working correctly when gentle, continuous bubbling is present in the

Correct Answer: D

Rationale: Gentle, continuous bubbling in the suction control chamber indicates proper suction in a wet suction system. Bubbling in the water seal suggests an air leak, and the collection chamber does not bubble.

Question 3 of 5

The nurse in the mental health unit observes a client hitting the wall repeatedly with the hands after an upsetting family therapy session. The nurse should recognize that the client is exhibiting which of the following defense mechanisms?

Correct Answer: B

Rationale: Defense mechanisms are unconscious mental processes used to protect individuals from uncomfortable thoughts, internal conflicts, and external stresses. Defense mechanisms may be therapeutic to clients with anxiety. However, with excessive use, defense mechanisms may become notherapeutic because they involve a degree of self-deception and reality distortion that can result in poor interpersonal relationships, irrational behavior, and decreased productivity.

Question 4 of 5

A client at 20 weeks gestation reports 'running to the bathroom all the time,' pain with urination, and foul-smelling urine. Which question is most important for the nurse to ask when assessing the client?

Correct Answer: A

Rationale: Back or flank pain suggests pyelonephritis, a serious complication of UTI in pregnancy, requiring urgent evaluation. Hygiene, frequency, and history are relevant but less critical than assessing for systemic infection.

Question 5 of 5

A primigravida arrives at the labor unit stating that she is having contractions. Which statement describes the presence of true contractions?

Correct Answer: B

Rationale: True contractions have a consistent frequency , becoming regular and stronger. They start in the back or upper abdomen (A is incorrect), intensify with activity (C is incorrect), and are regular (D is incorrect).

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