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Questions 148

NCLEX-RN

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Extract:


Question 1 of 5

The nurse is caring for a client with a history of schizophrenia, alcohol abuse, bipolar disorder, and noncompliance with treatment and medications. The client has also been arrested in the past for violent behavior. Which action by the nurse is the most important when caring for a potentially violent client?

Correct Answer: B

Rationale: Maintaining an open pathway to the door ensures the nurse’s safety if the client becomes violent, prioritizing personal safety.

Question 2 of 5

A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client's cervix is 5cm dilated with 75% effacement. Based on the nurse's assessment the client is in which phase of labor?

Correct Answer: A

Rationale: A cervix dilated to 5 cm with 75% effacement indicates the active phase of labor.

Question 3 of 5

The nurse is caring for a 36-year-old female recently diagnosed with Addison's disease. The nurse recognizes further teaching is needed if the client states,

Correct Answer: A

Rationale: Addison’s disease requires increased salt intake due to aldosterone deficiency. Lifelong hormone therapy, medical alert bracelets, and monitoring for adrenal crisis are correct.

Question 4 of 5

The physician has prescribed Synthroid (levothyroxine) for a client with myxedema. Which statement indicates that the client understands the nurse's teaching regarding the medication?

Correct Answer: C

Rationale: Reporting visual disturbances is important, as they may indicate levothyroxine overdose or other complications, reflecting proper understanding.

Question 5 of 5

What is the responsibility of the nurse in obtaining an informed consent for surgery?

Correct Answer: D

Rationale: The nurse's role is to witness the client's signature and ensure the consent form is completed, not to explain the procedure.

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