NCLEX Questions, NCLEX RN Practice Test Questions, NCLEX-RN Questions, Nurselytic

Questions 149

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Practice Test Questions

Extract:


Question 1 of 5

The nurse is caring for a manic client in the seclusion room, and it is time for lunch. It is MOST appropriate for the nurse to take which of the following actions?

Correct Answer: D

Rationale: should eat at regular time; remain in the seclusion room for client’s safety

Question 2 of 5

Where is the best site for examining for the presence of petechiae in an African American client?

Correct Answer: C

Rationale: The earlobes are a reliable site to assess petechiae in dark-skinned individuals, as they are less pigmented and allow easier visualization of small hemorrhages.

Question 3 of 5

Which task is included in the working phase of the nurse-client relationship?

Correct Answer: C

Rationale: The working phase involves evaluating progress toward goals, building on strengths identified earlier.

Question 4 of 5

The nurse is observing a graduate nurse as she assesses the central venous pressure. Which observation would indicate that the graduate needs further teaching?

Correct Answer: C

Rationale: The Valsalva maneuver falsely elevates CVP; normal breathing is required.

Question 5 of 5

The nurse is assessing a 6-year-old following a tonsillectomy. Which one of the following signs is an early indication of hemorrhage?

Correct Answer: A

Rationale: Drooling of bright red secretions indicates active bleeding, a critical sign of post-tonsillectomy hemorrhage requiring immediate attention.

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