NCLEX-RN
NCLEX RN Practice Tests Questions
Extract:
Question 1 of 5
The nurse is caring for a client with full thickness burns to the lower half of the torso and lower extremities. During the emergent phase of injury, the primary nursing diagnosis would focus on:
Correct Answer: C
Rationale: In the emergent phase of burns, fluid volume deficit is the priority due to massive fluid loss from damaged skin, risking hypovolemic shock.
Question 2 of 5
The physician has ordered intravenous fluid with potassium for a client admitted with gastroenteritis and dehydration. Before adding potassium to the intravenous fluid, the nurse should:
Correct Answer: A
Rationale: Adequate urinary output (at least 30 mL/hr) must be confirmed before adding potassium to IV fluids to prevent hyperkalemia.
Question 3 of 5
A mother tells the nurse that her daughter has become quite a collector, filling her room with Beanie babies, dolls, and stuffed animals. The nurse recognizes that the child is developing:
Correct Answer: C
Rationale: Collecting items reflects concrete operational thinking, where children (ages 7-11) organize and categorize objects systematically, per Piaget's stages.
Question 4 of 5
A student nurse is developing a care plan for a 23-year-old woman with Meniere's disease. Which of the following would NOT be an expected intervention?
Correct Answer: A
Rationale: Meniere’s disease causes vertigo and hearing loss, not typically requiring narcotic pain medication. Low-sodium diets, assistance with mobility, and balanced meals help manage symptoms.
Question 5 of 5
A client in restraints is assigned to a newly graduated nurse. The nurse understands that which of the following are true regarding restraints? Select all that apply.
Correct Answer: A, C, F
Rationale: Restraints include chemical, mechanical, or physical methods; bed rails are restraints if used to restrict movement; and non-restraint alternatives like active listening are preferred. Pediatric time limits and reassessment frequency vary by policy, and reapplication requires new orders.