NCLEX Questions, NCLEX Trainer Test 2 Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Question 1 of 5

The nurse is assigned to care for a client who has a leaking intracranial aneurysm. To minimize the risk of rebleeding, the nurse should plan to

Correct Answer: A

Rationale: restrict visitors to immediate family. Maintaining a quiet environment will assist in minimizing cerebral rebleeding. When family visit, the client should not be disturbed. If the client is awake, topics of a general nature are better choices for discussion than topics that result in emotional or physiological stimulation.

Question 2 of 5

The LPN/LVN is caring for an adult who has pneumonia. The nurse should instruct the nursing assistant to report which information immediately?

Correct Answer: A

Rationale: Restlessness may indicate hypoxia in pneumonia, a critical symptom requiring immediate reporting to assess oxygenation status.

Question 3 of 5

The nurse is making assignments for the day. The staff consists of an RN, an LPN, and a nursing assistant. Which client should be assigned to the nursing assistant?

Correct Answer: B

Rationale: A nursing assistant can provide basic care such as hygiene and vital signs for stable clients. A client with viral pneumonia, if stable, requires less complex care compared to post-surgical , potential emergency , or cardiac clients, which require licensed staff.

Question 4 of 5

The nurse prepares a 25-year-old woman for a cesarean section.

Correct Answer: C

Rationale: Preoperative medication for a cesarean section includes reduced amounts of narcotics to minimize respiratory depression in the newborn due to placental transfer. Sedatives and hypnotics are typically used in similar doses as in general surgery, and the overall dosage is not necessarily lower.

Question 5 of 5

At 10:00 A.M., the nurse discovers a 75-year-old woman who is hospitalized with congestive heart failure on the floor beside the bed. She has a bruise on her leg, but x-rays reveal no fractures. How should the nurse record the incident in the client's chart?

Correct Answer: B

Rationale: Accurate documentation includes specific details: time, client status, mechanism of fall, assessment findings (bruise size, orientation), and actions taken (physician notification, x-rays). This option is thorough and objective, unlike the others, which are vague or incomplete.

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