NCLEX-RN
NCLEX RN High-Yield Questions Questions
Extract:
Question 1 of 5
The nurse is administering a subcutaneous injection of heparin. Which technique ensures safe administration?
Correct Answer: D
Rationale: Pinching the skin creates a fold for subcutaneous injection, ensuring heparin is delivered into the correct tissue layer without damaging underlying structures.
Question 2 of 5
The nurse is monitoring for the presence of pitting edema in the prenatal client. The nurse presses the fingertips of the middle and index fingers against the shin in 4 different locations and holds pressure for 2 to 3 seconds. The nurse notes that the indentation is approximately 1-inch deep. The nurse should document that the client has which level of pitting edema?
Correct Answer: D
Rationale: When evaluating the presence of pitting edema, the nurse presses the fingertips of the index and middle fingers against the shin and holds pressure for 2 to 3 seconds. An indentation approximately 1-inch deep would be indicative of +4 edema. A slight indentation would indicate +1 edema. An indentation approximately 1/4-inch deep indicates +2 edema. An indentation approximately 1/2-inch deep indicates +3 edema.
Question 3 of 5
A client with a history of rheumatoid arthritis is admitted with a flare-up. The nurse should include which of the following in the plan of care?
Correct Answer: A
Rationale: NSAIDs reduce inflammation and pain during rheumatoid arthritis flare-ups.
Question 4 of 5
A nurse is caring for a child with diabetes mellitus at camp. The child is irritable and has a headache. Which of the following should the nurse do first?
Correct Answer: C
Rationale: Checking the blood glucose level determines whether the symptoms are due to hypo- or hyperglycemia, guiding treatment.
Question 5 of 5
While preparing to provide neonatal care instructions to a primiparous client who delivered a term neonate 24 hours ago, which of the following should the nurse include in the client's teaching plan?
Correct Answer: C
Rationale: Milia are benign and disappear spontaneously, requiring no treatment, and should be included in teaching.