NCLEX Questions, Mock NCLEX RN Exam Questions, NCLEX-RN Ques

Extract:

Question 1 of 5

The nurse is caring for a client with a cerebrovascular accident (CVA) who is complaining of being nauseated and is requesting an emesis basin. Which action would the nurse take first?

Correct Answer: C

Rationale: Turning the client to one side prevents aspiration, a priority in a nauseated CVA client with potential swallowing deficits. Administering an antiemetic (
A) or notifying the physician (
D) is secondary, and ice (
B) is ineffective.

Question 2 of 5

The client is prescribed digoxin (Lanoxin) for heart failure. Which instruction should the nurse include in the teaching plan?

A. Take the medication with meals to prevent nausea.' B. Report a pulse below 60 beats per minute.' C. Increase potassium-rich foods in your diet.' D. Take an extra dose if you miss one.'

Correct Answer: B

Rationale: Digoxin toxicity is increased with bradycardia, so a pulse below 60 beats per minute should be reported. It can be taken with or without food, potassium monitoring is important but not increasing, and extra doses are dangerous.

Question 3 of 5

The nurse is caring for a client after a motor vehicle accident. The client has a fractured tibia, and bone is noted protruding through the skin. Which action is of priority?

A. Provide manual traction above and below the leg. B. Cover the bone area with a sterile dressing. C. Apply an ACE bandage around the entire lower limb. D. Place the client in the prone position.

Correct Answer: B

Rationale: Covering an open fracture with a sterile dressing prevents infection, a priority. Traction (
A) is secondary, an ACE bandage (
C) may contaminate the wound, and prone positioning (
D) is inappropriate.

Question 4 of 5

A client is having a pneumonectomy done today, and the nurse is planning her postoperative care. Nursing interventions for a postoperative left pneumonectomy would include:

A. Monitoring the chest tubes B. Positioning the client on the right side C. Positioning the client in semi-Fowler position with a pillow under the shoulder and back D. Monitoring the right lung for an increase in rales

Correct Answer: D

Rationale: Monitoring the right lung for an increase in rales is essential to detect early signs of fluid accumulation or infection in the remaining lung.

Question 5 of 5

Forty-eight hours after a thyroidectomy, a female client complains of numbness and tingling of the toes and fingers. The nurse notes upper arm and facial twitching. The nurse needs to:

A. Report the findings to the physician B. Assist the client to do range of motion exercises C. Check the client's potassium level D. Administer the as-needed dose of phenytoin (Dilantin)

Correct Answer: A

Rationale: Muscular hyperactivity and parasthesias may indicate hypocalcemic tetany and require immediate administration of calcium gluconate. Tetany can occur if the parathyroid glands were erroneously excised during surgery. Range of motion exercises are not appropriate to presenting symptoms. These characteristics are not usual signs of potassium imbalance, but of calcium imbalance. Phenytoin is indicated for seizure activity mainly of neurological origin.