NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a diagnosis of hepatitis who is experiencing pruritis. Which would be the most appropriate nursing intervention?
Correct Answer: B
Rationale: Adding baby oil to bath water moisturizes skin, relieving pruritus in hepatitis. Warm showers (
A) and hot rinses (
D) may worsen itching, and powder (
C) can dry skin further.
Question 2 of 5
A 74-year-old obese man who has undergone open reduction and internal fixation of the right hip is 8 days postoperative. He has a history of arthritis and atrial fibrillation. He admits to right lower leg pain, described as 'a cramp in my leg.' An appropriate nursing action is to:
Correct Answer: B
Rationale: Calf pain with dorsiflexion of the foot (Homans' sign) can be a sign of a deep venous thrombosis; however, it is not diagnostic of the condition. Swelling and warmth along the affected vein are commonly observed clinical manifestations of a deep venous thrombosis as a result of inflammation of the vessel wall. Rubbing or massaging of the affected leg is contraindicated because of the risk of the clot breaking loose and becoming an embolus. A pillow behind the knee can be constricting and further impair blood flow.
Question 3 of 5
A male client has experienced low back pain for several years. He is the primary support of his wife and six children. Although he would qualify for disability, he plans to continue his employment as long as possible. His back pain has increased recently, and he is unable to control it with non-steroidal anti-inflammatory agents. He refuses surgery and cannot take narcotics and remain alert enough to concentrate at work. His physician has suggested application of a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following is an appropriate rationale for using a TENS unit for relief of pain?
Correct Answer: C
Rationale: TENS units do not have this effect, but whirlpool therapy does. TENS units do not produce endogenous opioids, only the body can do that. TENS units do work based on the gate-control theory of pain control. TENS units do not have this effect, but possibly changing the client's position would.
Question 4 of 5
The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?
Correct Answer: A
Rationale: Prothrombin time (PT/INR) measures Coumadin's anticoagulant effect by assessing clotting time. PTT monitors heparin, and clot retraction or bleeding time are unrelated.
Question 5 of 5
Which ECG finding is most likely to be present in the client with a potassium of 6.0 mEq/L?
Correct Answer: C
Rationale: Hyperkalemia (potassium 6.0 mEq/L) typically causes peaked T waves on an ECG due to altered cardiac repolarization. Depressed S-T segments and U waves are more associated with hypokalemia and T/U wave fusion is less common.