NCLEX-RN
NCLEX RN Exam Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a history of ectopic pregnancy. Which risk factor is most likely to be present?
Correct Answer: A
Rationale: Pelvic inflammatory disease (PI
D) is a major risk factor for ectopic pregnancy as it can scar the fallopian tubes impairing embryo transport. Gestational diabetes hypertension and multiple gestations are not strongly associated.
Question 2 of 5
A terrorist attack has left hundreds of patients with injuries determined to be in the immediate category as defined by NATO. The color to designate this group is:
Correct Answer: C
Rationale: In NATO triage the immediate category (requiring urgent intervention to survive) is designated by red. Black indicates deceased or expectant yellow is delayed and green is minimal.
Question 3 of 5
The nurse is teaching a client with type 1 diabetes about insulin administration. Which statement by the client indicates a need for further teaching?
Correct Answer: D
Rationale: In type 1 diabetes, insulin requirements may change during illness, and skipping doses without medical guidance can lead to ketoacidosis. The other statements are correct: rotating sites prevents lipodystrophy, checking blood sugar guides dosing, and mixing insulins is allowed.
Question 4 of 5
When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to breathe. This behavior is most indicative of:
Correct Answer: C
Rationale: Pericarditis can cause dyspnea but primarily causes chest pain. Anxiety can cause dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. The inability to oxygenate well without being upright is most indicative of congestive heart failure, due to alveolar drowning. Angina causes primarily chest pain; any SOB associated with angina is not influenced by body position.
Question 5 of 5
A 4-year-old boy is brought to the emergency room with bruises on his head, face, arms, and legs. His mother states that he fell down some steps. The nurse suspects that he may have been physically abused. In accordance with the law, the nurse must:
Correct Answer: B
Rationale: Although the nurse probably would talk to the physician about these concerns, the nurse is not required by law to do so. All healthcare workers are required by the Federal Child Abuse Prevention and Treatment Act of 1974 to report suspected and actual cases of child abuse and/or neglect. Talking to the child's father may or may not help the child, and the nurse is not required by law to do so. Confrontation may not be indicated; the nurse is not required by law to confront the child's mother with these suspicions.