NCLEX Questions, NCLEX RN Practice Test Questions, NCLEX-RN Questions, Nurselytic

Questions 149

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Extract:


Question 1 of 5

The nurse is assessing the heart sounds of a client with mitral stenosis following a history of rheumatic fever. To hear a mitral murmur, the nurse should place the stethoscope at:

Correct Answer: D

Rationale: Mitral stenosis murmurs are best heard at the fourth intercostal space midclavicular line, the mitral valve area.

Question 2 of 5

The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about energy conservation techniques. Which of the following statements by the client indicates understanding?

Correct Answer: B

Rationale: pacing activities and resting as needed conserves energy and reduces fatigue in COPD

Question 3 of 5

A new nurse has just completed orientation and is working on the medical unit. The new nurse is shadowing the charge nurse as they both care for a client with a potassium level of 6.3 mEq/L. Which action by the new nurse requires intervention by the charge nurse?

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic and could worsen hyperkalemia (potassium 6.3 mEq/L). The other actions are appropriate for managing hyperkalemia or general care.

Question 4 of 5

The nurse working in an outpatient clinic has the opportunity to teach a client recently diagnosed with irritable bowel syndrome (IBS). Which of the following topics would be most appropriate for the nurse to include? Select all that apply.

Correct Answer: B, D

Rationale: Stress reduction techniques and daily probiotics can help manage IBS symptoms, while limiting fluids is not recommended, and iced tea may exacerbate symptoms due to caffeine.

Question 5 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.

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