NCLEX Questions, NCLEX-RN Exam Questions, NCLEX-RN Questions, Nurselytic

Questions 158

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Extract:


Question 1 of 5

The nurse is caring for a client with a history of a fractured ankle who is in a cast. The client complains of numbness and tingling. The nurse should:

Correct Answer: C

Rationale: Numbness and tingling suggest neurovascular compromise (e.g., compartment syndrome), requiring immediate physician notification. Ice, elevation, and massage are insufficient.

Question 2 of 5

The nurse is caring for a client with a history of a fractured ankle who is in a cast. The client complains of numbness and tingling. The nurse should:

Correct Answer: C

Rationale: Numbness and tingling suggest neurovascular compromise (e.g., compartment syndrome), requiring immediate physician notification. Ice, elevation, and massage are insufficient.

Question 3 of 5

When assessing the client with acute arterial occlusion, the nurse would expect to find:

Correct Answer: B

Rationale: Acute arterial occlusion causes ischemia, leading to tissue necrosis, which may present as minute blackened areas on the toes, indicating severe ischemia.

Question 4 of 5

A client who has sustained a basilar skull fracture exhibits blood-tinged drainage from his nose. After establishing a clear airway, administering supplemental O2, and establishing IV access, the next nursing intervention would be to:

Correct Answer: D

Rationale: Testing the fluid from the nares would determine the presence of CSF. Basilar skull fractures may cause dural lacerations, leading to CSF leakage. Insertion of a tube, tamponading, or suctioning could worsen the problem or increase brain damage.

Question 5 of 5

The client at 30 weeks gestation is admitted with a diagnosis of preterm labor. The nurse should prepare to administer which medication?

Correct Answer: D

Rationale: In preterm labor at 30 weeks betamethasone is given for fetal lung maturity terbutaline or magnesium sulfate may be used as tocolytics to halt contractions and magnesium sulfate may also provide fetal neuroprotection. All are appropriate.

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