NCLEX Questions, NCLEX Trainer Test 4 Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Extract:


Question 1 of 5

The nurse is caring for a client who is receiving a continuous IV infusion of insulin for diabetic ketoacidosis. Which of the following findings would be of GREATest concern to the nurse?

Correct Answer: B

Rationale: Hypokalemia (potassium 3.0 mEq/L) is a serious complication in diabetic ketoacidosis treatment, as insulin drives potassium into cells, risking arrhythmias. Options A, C, and D are less urgent: glucose 200 mg/dL is improving, pH 7.30 is near normal, and sodium 135 mEq/L is normal.

Extract:

During auscultation of the fetal heart rate during labor, the nurse assesses a rate of 59 beats per minute.


Question 2 of 5

The FIRST action the nurse should take is

Correct Answer: B

Rationale: Strategy: 'FIRST' indicates that this is a priority question. All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) should be placed on left side to increase blood flow to the uterus (2) correct-persistent fetal bradycardia may indicate cord compression or separation of the placenta, but always indicates fetal distress, left side reduces compression of vena cava and aorta (3) should be done after positioning patient (4) this position is used only if there is cord prolapsed

Extract:


Question 3 of 5

A baby girl is born with a meningomyelocele. To prevent trauma to the sac, the nurse should place the infant:

Correct Answer: B

Rationale: Placing the infant prone with hips slightly elevated protects the meningomyelocele sac from trauma and pressure.

Question 4 of 5

When admitting a client who has acute glomerulonephritis, the nurse expects that the client will report which information?

Correct Answer: C

Rationale: Acute glomerulonephritis is often post-streptococcal, following pharyngitis. Bladder/kidney infections or sexual partners are less directly related.

Question 5 of 5

Which item should be kept at the bedside of a client who has just returned from having a thyroidectomy?

Correct Answer: D

Rationale: A tracheostomy set is essential due to the risk of airway obstruction from swelling or hemorrhage post-thyroidectomy. Options A, B, and C are less critical in this context.

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