NCLEX-RN
NCLEX RN Practice Test Questions
Extract:
Question 1 of 5
The nurse identifies ventricular tachycardia on the heart monitor. The nurse should immediately:
Correct Answer: C
Rationale: Ventricular tachycardia requires immediate treatment with an antiarrhythmic like lidocaine to restore normal rhythm.
Question 2 of 5
The home health nurse is planning for the day's visits. Which client should be seen first?
Correct Answer: C
Rationale: The client with a decubitus ulcer is at risk for infection and complications, making them the priority for assessment.
Question 3 of 5
While performing a neurological assessment on a client with a closed head injury, the nurse notes a positive Babinski reflex. The nurse should:
Correct Answer: D
Rationale: A positive Babinski reflex in an adult with a head injury suggests neurological damage, warranting immediate physician notification.
Question 4 of 5
A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include:
Correct Answer: D
Rationale: Sterile pin care is essential to prevent infection at the site of cervical tongs, while altering traction or bed position could compromise spinal alignment.
Question 5 of 5
Where is the best site for examining for the presence of petechiae in an African American client?
Correct Answer: C
Rationale: The earlobes are a reliable site to assess petechiae in dark-skinned individuals, as they are less pigmented and allow easier visualization of small hemorrhages.