NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a history of a fractured pelvis who is in skeletal traction. The nurse should:
Correct Answer: D
Rationale: Monitoring for infection at pin sites prevents osteomyelitis in skeletal traction. Turning is limited, weights must hang freely, and lotion is unnecessary.
Question 2 of 5
A child is to receive heparin sodium five units per kilogram of body weight by subcutaneous route every four hours. The child weighs 52.8 lb. How many units should the child receive in a 24 hour period?
Correct Answer: 720
Rationale: Weight: 52.8 lb ÷ 2.2 = 24 kg. Dose: 5 units/kg × 24 kg = 120 units/dose. Frequency: every 4 hours = 6 doses/day.
Total: 120 × 6 = 720 units.
Question 3 of 5
The client is admitted with a diagnosis of molar pregnancy. Which intervention is most appropriate?
Correct Answer: A
Rationale: Molar pregnancy involves abnormal trophoblastic tissue and no viable fetus often causing vaginal bleeding. Monitoring for bleeding is critical.
Tocolytics cesarean delivery and fetal monitoring are not indicated.
Question 4 of 5
The nurse is assessing a client with suspected appendicitis. Which clinical manifestation would the nurse expect to find?
Correct Answer: A
Rationale: Rebound tenderness in the right lower quadrant is a classic sign of appendicitis (e.g., Rovsing’s sign). Left upper quadrant pain (
B), distention (
C), and diarrhea (
D) are not typical.
Question 5 of 5
The nurse is caring for a postoperative client when the client becomes nonresponsive and pale,with a BP of 90/40. The nurse recognizes that the necessary intervention at this time is to:
Correct Answer: B
Rationale: Hypotension (BP 90/40) pallor,and nonresponsiveness suggest hypovolemic shock likely from postoperative bleeding. Increasing the IV infusion rate (e.g. saline) restores volume. Trendelenburg is controversial atropine treats bradycardia,and the emergency cart is secondary to immediate fluid resuscitation.