NCLEX-PN
2023 NCLEX-PN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is assessing for side effects from the administration of a dose of penicillin (Bicillin). Which assessment finding best justifies withholding the I.M. administration of penicillin until consulting the prescribing physician?
Correct Answer: B
Rationale: A red, itchy rash is a sign of a possible allergic reaction to penicillin, which could progress to anaphylaxis, necessitating immediate consultation with the physician.
Question 2 of 5
A nurse is caring for a client with a total hip replacement. Which position should the nurse avoid to prevent dislocation?
Correct Answer: A
Rationale: Crossing the legs after hip replacement increases the risk of dislocation by adducting and rotating the hip joint.
Question 3 of 5
A nurse is caring for a client with a urinary catheter. Which action prevents catheter-associated urinary tract infections?
Correct Answer: B
Rationale: Daily perineal cleaning with soap and water reduces bacterial colonization around the catheter insertion site, preventing infection.
Question 4 of 5
A nurse is caring for a client with a temporary pacemaker. Which observation requires immediate intervention?
Correct Answer: A
Rationale: A heart rate of 60 beats/min may indicate pacemaker failure to capture or sense, requiring immediate intervention to prevent bradycardia.
Question 5 of 5
The nurse is completing a care plan for an immobile client. Which nursing measure for preventing contractures is best to include in the care plan?
Correct Answer: B
Rationale: Range-of-motion exercises maintain joint flexibility and muscle length, directly preventing contractures in immobile clients.