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

Questions 157

NCLEX-RN

NCLEX-RN Test Bank

NCLEX-RN Exam Practice Questions

Extract:


Question 1 of 5

The nurse is caring for a client with a history of a ventricular septal defect. Which finding should be reported to the doctor immediately?

Correct Answer: D

Rationale: Cyanosis in a ventricular septal defect indicates significant shunting and hypoxemia, a critical finding requiring immediate reporting. Murmurs, tachycardia, and fatigue are expected but less urgent.

Question 2 of 5

The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?

Correct Answer: A

Rationale: MRSA (methicillin-resistant Staphylococcus aureus) requires contact precautions and a private room to prevent transmission. Diabetes pancreatitis and Addison’s disease do not require isolation unless other infectious conditions are present.

Question 3 of 5

A 2-month-old infant is receiving IV fluids with a volume control set. The nurse uses this type of tubing because it:

Correct Answer: C

Rationale: A volume control set allows the nurse to control the amount of fluid administered over a set period.

Question 4 of 5

A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the GTPAL system to record her obstetrical history, the nurse should record:

Correct Answer: C

Rationale: G=3 (current pregnancy), T=1 (term birth), P=1 (preterm birth), A=0 (no abortions), L=2 (living children).

Question 5 of 5

A 4 days postpartum client who is gravida 3, para 3, is examined by the home health nurse during her first postpartum home visit. The nurse notes that she has a pink vaginal discharge with a serosanguineous consistency. The nurse would most accurately chart the client's lochia as:

Correct Answer: C

Rationale: Lochia rubra is bloody with clots and occurs 1-3 days postpartum. There is no such term as lochia rosa. Lochia serosa is a pink-brown discharge with a serosanguineous consistency that occurs 4-9 days postpartum. Lochia alba is yellow to white in color and occurs approximately 10 days postpartum.

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