NCLEX Questions, NCLEX Trainer Test 8 Questions, NCLEX-PN Questions, Nurselytic

Questions 156

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Question 1 of 5

The nurse is caring for a client who is receiving IV fluids at 125 mL/hour. Which of the following findings would be of GREATest concern to the nurse?

Correct Answer: C

Rationale: Jugular vein distension suggests fluid overload, a serious complication of IV fluids, potentially leading to heart failure. Options A, B, and D are normal: blood pressure 130/80 mmHg, heart rate 80 bpm, and urine output 50 mL/hour indicate stability.

Question 2 of 5

An adult is admitted with histoplasmosis. What is most likely to be in the client's history because he has histoplasmosis?

Correct Answer: A

Rationale: Histoplasmosis is caused by inhaling Histoplasma spores, often found in bird or bat droppings, common in chicken farming environments, unlike shellfish, water, or milk.

Question 3 of 5

Which of the following positions is best for a client with preeclampsia who is in labor?

Correct Answer: A

Rationale: The left Sims position promotes placental perfusion and reduces pressure on the vena cava in preeclampsia, improving maternal and fetal outcomes. Other positions are less optimal.

Question 4 of 5

The nurse is caring for a client who had a transurethral resection of the prostate yesterday.

Correct Answer: A

Rationale: A urine output of 150 cc over 8 hours is critically low, indicating possible obstruction, bleeding, or renal impairment, requiring immediate intervention. Bladder spasms, bright red urine with clots, and burning are expected post-procedure but should be monitored.

Question 5 of 5

The nurse is caring for a client with a history of depression who is receiving venlafaxine (Effexor) 75 mg PO bid. Which of the following symptoms should the nurse report immediately?

Correct Answer: C

Rationale: Suicidal thoughts are a medical emergency with venlafaxine. Options A, B, and D are common side effects.

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