NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a closed head injury. Which finding should be reported to the doctor immediately?
Correct Answer: D
Rationale: Unequal pupils suggest increased intracranial pressure or neurological deterioration in a head injury, requiring immediate reporting. The other findings are within normal or less urgent ranges.
Question 2 of 5
The physician has ordered 50 mEq of potassium chloride for a client with a potassium level of 2.5 mEq/L. The nurse should administer the medication:
Correct Answer: C
Rationale: Potassium chloride for hypokalemia (2.5 mEq/L) should be administered via controlled IV infusion over several hours (e.g., five hours) to prevent rapid shifts that could cause arrhythmias.
Question 3 of 5
The nurse is caring for a client with a history of a spinal cord injury who is experiencing autonomic dysreflexia. The nurse should:
Correct Answer: C
Rationale: Autonomic dysreflexia is often triggered by bladder distension. Inserting a Foley catheter relieves the trigger. Vasodilators and positioning are secondary, and prone position is unsafe.
Question 4 of 5
The client with a history of preterm labor is being monitored at 28 weeks gestation. The physician orders betamethasone (Celestone). The rationale for administering betamethasone is to:
Correct Answer: C
Rationale: Betamethasone a corticosteroid is given to women in preterm labor (24-34 weeks) to enhance fetal lung maturity by promoting surfactant production reducing the risk of respiratory distress syndrome. It does not prevent infection stimulate labor or prevent bleeding.
Question 5 of 5
The nurse is performing discharge teaching on a client with polycythemia vera. Which would be included in the teaching plan?
Correct Answer: D
Rationale: Polycythemia vera increases blood viscosity, raising thrombosis risk. Teaching to recognize thrombosis symptoms (e.g., pain, swelling) is critical. Avoiding crowds (
A) is for neutropenia, elevating the bed (
B) is for reflux, and socks/gloves (
C) are for Raynaud’s.