NCLEX-RN
NCLEX RN High-Yield Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client with chronic renal failure. Knowing that the client is a candidate for development of hypermagnesemia, for which of the following signs and symptoms should the nurse assess the client?
Correct Answer: B
Rationale: Hypermagnesemia can cause lethargy due to its depressive effects on the central nervous system.
Question 2 of 5
The nurse is teaching a client with hypertension about lifestyle modifications. Which of the following should the nurse include? Select all that apply.
Correct Answer: A, B, D, E
Rationale: Reducing sodium, regular aerobic exercise, maintaining healthy weight, and stress management help control hypertension. Moderate alcohol is acceptable, not total avoidance.
Question 3 of 5
The nurse is preparing to give an I.M. injection. Which of the following sites has the least amount of blood vessels and major nerves located in the area?
Correct Answer: C
Rationale: The vastus lateralis has fewer blood vessels and nerves compared to the deltoid, dorsogluteal, or triceps, making it a safer site for I.M. injections.
Question 4 of 5
A client with a history of peptic ulcer disease is prescribed ranitidine (Zantac). The nurse should instruct the client to:
Correct Answer: A
Rationale: Ranitidine is most effective at bedtime to reduce nighttime acid production.
Question 5 of 5
The nurse is monitoring for the presence of pitting edema in the prenatal client. The nurse presses the fingertips of the middle and index fingers against the shin in 4 different locations and holds pressure for 2 to 3 seconds. The nurse notes that the indentation is approximately 1-inch deep. The nurse should document that the client has which level of pitting edema?
Correct Answer: D
Rationale: When evaluating the presence of pitting edema, the nurse presses the fingertips of the index and middle fingers against the shin and holds pressure for 2 to 3 seconds. An indentation approximately 1-inch deep would be indicative of +4 edema. A slight indentation would indicate +1 edema. An indentation approximately 1/4-inch deep indicates +2 edema. An indentation approximately 1/2-inch deep indicates +3 edema.