NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
The nurse is caring for a patient with suspected diverticulitis. The nurse would be most prudent in questioning an order for which of the following diagnostic tests?
Correct Answer: B
Rationale: A barium enema is contraindicated in suspected diverticulitis due to the risk of perforation and peritonitis. Ultrasound, CT scans, and CBC are appropriate for diagnosing diverticulitis or assessing complications.
Question 2 of 5
A client is being discharged after lithotripsy for removal of a kidney stone. Which statement by the client indicates understanding of the nurse's instructions?
Correct Answer: C
Rationale: Straining urine and saving stone fragments post-lithotripsy allows analysis and confirms stone passage. Starting in the morning (
A) is incorrect, saving all urine (
B) is unnecessary, and not straining (
D) misses stone collection.
Question 3 of 5
A client is pregnant for the fourth time and has had three normal vaginal deliveries. She is in active labor and fully dilated. Suddenly she calls, 'Nurse, the baby is coming.' As the nurse responds to her call, which one of the following observations should the nurse make first?
Correct Answer: A
Rationale: The nurse must assess the labor status to determine if birth is imminent. The nurse may note perineal bulging, crowning, or birth of the head to ascertain labor status. Assessing uterine contractions is one intervention to ascertain labor status. Based on the client's cry, it is not the intervention of choice. If delivery of the infant is imminent, preparing a clean or sterile area for delivery is appropriate, but labor status must be established, whether delivery is imminent, by perineal assessment. Assessing FHR is one intervention to ascertain fetal well-being. Based on the client's cry, this is not the intervention of choice.
Question 4 of 5
After a 10-year-old child with insulin-dependent diabetes mellitus receives her dinner tray, she tells the nurse that she hates broccoli and wants some corn on the cob. The nurse's appropriate response is:
Correct Answer: B
Rationale: Vegetable exchanges are allowed within the same group to maintain nutritional balance. Corn is classified as a starchy vegetable and counts as a bread exchange due to its carbohydrate content, which affects blood glucose levels. Not all vegetables are interchangeable; starchy vegetables like corn have different nutritional impacts than non-starchy ones like broccoli. Limiting to half an ear does not address the dietary classification and could confuse the child about proper exchanges.
Question 5 of 5
The nurse is caring for a client with a diagnosis of gestational trophoblastic disease. Which intervention is most appropriate?
Correct Answer: A
Rationale: Gestational trophoblastic disease requires monitoring hCG levels to assess for resolution or progression to malignancy (e.g. choriocarcinoma).
Tocolytics fetal monitoring and vaginal delivery are not indicated as there is no viable fetus.