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

Questions 158

NCLEX-RN

NCLEX-RN Test Bank

NCLEX-RN Exam Questions

Extract:


Question 1 of 5

The nurse is caring for a client with a tracheostomy. Which action is a priority to prevent complications?

Correct Answer: A

Rationale: Suctioning as needed prevents airway obstruction from mucus buildup, a priority to maintain patency and prevent respiratory distress. Cuff management, tie changes, and infection monitoring are important but secondary to airway maintenance.

Question 2 of 5

Two weeks after a client's admission for depression, the physician orders a consult for electroconvulsive therapy (ECT). Which of the following conditions, if present, would be a contraindication for ECT?

Correct Answer: A

Rationale: A contraindication for ECT is a space-occupying lesion such as a brain tumor. During ECT, intracranial pressure increases.
Therefore, ECT would not be prescribed for a client whose intracranial pressure is already elevated.

Question 3 of 5

A client with a history of a brain tumor is scheduled for a craniotomy. The nurse should:

Correct Answer: B

Rationale: Antibiotics are often given preoperatively for a craniotomy to prevent infection. Shaving is per protocol, flat positioning may increase ICP, and exercises are taught post-op.

Question 4 of 5

The nurse is preparing to administer a dose of insulin lispro (Humalog). When is the onset of action for this medication?

Correct Answer: A

Rationale: Insulin lispro, a rapid-acting insulin, has an onset of 5–15 minutes, making it ideal for pre-meal administration. Other insulins have slower onsets.

Question 5 of 5

The nurse is caring for a client post-appendectomy. Which finding requires immediate intervention?

Correct Answer: B

Rationale: A temperature of 101.5°F post-appendectomy suggests infection (e.g., abscess), requiring immediate intervention. Pain (
A), serous drainage (
C), and absent bowel sounds (
D) are expected initially.

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