NCLEX Questions, Free NCLEX RN Practice Questions Questions, NCLEX-RN Questions, Nurselytic

Questions 148

NCLEX-RN

NCLEX-RN Test Bank

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Extract:


Question 1 of 5

The nurse has just received a report from the previous shift. Which of the following clients should the nurse visit first?

Correct Answer: B

Rationale: Shortness of breath post-MVA suggests potential trauma (e.g., pneumothorax), requiring immediate assessment. The other clients' conditions are less acute.

Question 2 of 5

A 4-year-old male is admitted to the unit with nephrotic syndrome. He is extremely edematous. To decrease the discomfort associated with scrotal edema, the nurse should:

Correct Answer: B

Rationale: Elevating the scrotum reduces edema by promoting fluid drainage, decreasing discomfort.

Question 3 of 5

The nurse is caring for a client who is having surgery the next morning. The client says, 'I'm really scared about surgery. I've never been put to sleep before and I'm afraid I might not wake up.' Which response by the nurse is the most therapeutic?

Correct Answer: C

Rationale: Acknowledging fear as normal and inviting the client to express feelings is therapeutic, fostering trust and emotional support.

Question 4 of 5

The nurse is caring for a postcholecystectomy client who had the T-tube removed this AM. Two hours after removal of the T-tube, the nurse notes that the 4x4 dressing covering the stab site is saturated with dark, greenish-yellow drainage. It is MOST appropriate for the nurse to take which of the following actions?

Correct Answer: A

Rationale: expected that a stab wound will continue to drain until the wound seals; nurse should keep wound clean and dry

Question 5 of 5

A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client's cervix is 5cm dilated with 75% effacement. Based on the nurse's assessment the client is in which phase of labor?

Correct Answer: A

Rationale: A cervix dilated to 5 cm with 75% effacement indicates the active phase of labor.

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