NCLEX-RN
Free NCLEX RN Exam Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a diagnosis of rheumatoid arthritis who is receiving methotrexate. Which laboratory value would be most concerning?
Correct Answer: A
Rationale: Methotrexate can cause bone marrow suppression. A WBC of 4,000/mm3 (
A) indicates leukopenia, increasing infection risk, and is most concerning. Platelets (
B), hemoglobin (
C), and creatinine (
D) are within normal limits.
Question 2 of 5
A client with a history of ovarian cancer is admitted with complaints of abdominal swelling. The nurse should give priority to:
Correct Answer: A
Rationale: Abdominal swelling in ovarian cancer often indicates ascites, so monitoring for ascites is the priority to guide treatment.
Question 3 of 5
A client with a history of renal failure is admitted with complaints of shortness of breath. The nurse should expect the client to have:
Correct Answer: A
Rationale: Renal failure impairs acid excretion, leading to metabolic acidosis, which can cause compensatory hyperventilation and shortness of breath.
Question 4 of 5
A client is admitted to the hospital for an induction of labor owing to a gestation of 42 weeks confirmed by dates and ultrasound. When she is dilated 3 cm, she has a contraction of 70 seconds. She is receiving oxytocin. The nurse's first intervention should be to:
Correct Answer: C
Rationale: FHT should be monitored continuously with an induction of labor; this is an accepted standard of care. The physician should be notified, but this is not the first intervention the nurse should do. The standard of care for an induction according to the Association of Women's Health, Obstetric, and Neonatal Nurses and American College of Obstetrics and Gynecology is that contractions should not exceed 60 seconds in an induction. Inductions should simulate normal labor; 70-second contractions during the latent phase (3 cm) are not the norm. The next contractions can be longer and increase risks to the mother and fetus. Contractions lasting 60-90 seconds during transition are typical; this provides a good distractor. The nurse needs to be knowledgeable of the phases and stages of labor.
Question 5 of 5
The client is prescribed methotrexate for rheumatoid arthritis. Which instruction should the nurse include?
Correct Answer: B
Rationale: Methotrexate causes immunosuppression, increasing infection risk, so reporting signs of infection is critical. Milk does not prevent GI upset, photosensitivity is not a primary concern, and methotrexate is taken regularly, not as needed.