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
The primary cause of anemia in a client with chronic renal failure is:
Correct Answer: D
Rationale: Chronic renal failure reduces erythropoietin production, impairing red blood cell production and causing anemia. Iron absorption, RBC destruction, and intrinsic factor are secondary or unrelated.
Question 3 of 5
A 9-month-old infant is being examined in the general pediatric clinic for a routine well-child checkup. His immunizations are up to date, and his mother reports that he has had no significant illnesses or injuries. Which of the following signs would lead the nurse to believe that he has had a cerebral injury?
Correct Answer: D
Rationale: Infants older than 6 months of age should not have significant head lag. This is a sign of cerebral injury and should be referred for further evaluation.
Question 4 of 5
A client with a history of epilepsy is admitted with complaints of aura. The nurse should give priority to:
Correct Answer: A
Rationale: An aura signals an impending seizure, so ensuring safety (e.g., padding, side-lying position) is the priority.
Question 5 of 5
The nurse is caring for a client with a colostomy. Which finding requires immediate intervention?
Correct Answer: D
Rationale: A significantly protruding stoma may indicate prolapse, a complication requiring immediate intervention to prevent ischemia or obstruction. Pink stoma, cramping, and liquid stool are normal or less urgent.