NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a history of breast cancer who is receiving Tamoxifen (Nolvadex). The nurse should monitor the client for:
Correct Answer: A
Rationale: Tamoxifen, an anti-estrogen, commonly causes hot flashes due to hormonal changes. Blood pressure, appetite, and hair loss are not primary side effects.
Question 2 of 5
A 5-year-old has just had a tonsillectomy and adenoidectomy. Which of these nursing measures should be included in the postoperative care?
Correct Answer: D
Rationale: The nurse should discourage the child from coughing, clearing the throat, or putting objects in his mouth. These may induce bleeding. Cool, clear liquids may be given when child is fully alert. Warm liquids may dislodge a blood clot. The nurse should avoid red- or brown-colored liquids to distinguish fresh or old blood from ingested liquid should the child vomit. Gargles and vigorous toothbrushing could initiate bleeding. Postoperative hemorrhage, though unusual, may occur. The nurse should observe for bleeding by looking directly into the throat and for vomiting of bright red blood, continuous swallowing, and changes in vital signs.
Question 3 of 5
In assessing a person after experiencing spousal abuse, which need has the highest priority?
Correct Answer: C
Rationale: Assessing the level of anxiety, coping responses, and support systems is very important, but not of highest priority at this time. A history of physical abuse is an important part of assessment. The nurses must also always ask if there is abuse of the children. Although all of these answers are very important in assessment, the highest priority is assessment of suicide potential, because this could cause the greatest harm to the client. Feeling there is no other way out, abused spouses may consider suicide. The spouse may be self-medicating herself with alcohol or drugs to escape an awful situation. The abuser may also be abusing drugs or alcohol. If this is so, the nurse should encourage the spouse to seek counseling and not to return to the home.
Question 4 of 5
A client is diagnosed with organic brain disorder. The nursing care should include:
Correct Answer: A
Rationale: An organized, safe environment minimizes confusion and ensures safety for clients with organic brain disorders.
Question 5 of 5
As a postoperative cholecystectomy client completes tomorrow's dinner menu, the nurse knows that one of the following meal choices will best provide the essential vitamin(s) necessary for proper tissue healing?
Correct Answer: D
Rationale: This meal choice provides more of the vitamins A, D, and K than of vitamin C. This meal choice provides more of the vitamins A, B12, and D than of vitamin C. This meal choice provides more of the vitamins A, B1 (thiamine), niacin, and microminerals than of vitamin C. This meal choice provides foods rich in vitamin C, which are essential in tissue healing.