NCLEX-PN
Free NCLEX-PN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a postcholecystectomy client who had the T-tube removed this AM. Two hours after removal of the T-tube, the nurse notes that the 4x4 dressing covering the stab site is saturated with dark, greenish-yellow drainage. It is MOST appropriate for the nurse to take which of the following actions?
Correct Answer: A
Rationale: Dark, greenish-yellow drainage is expected bile post-T-tube removal, and a saturated dressing indicates ongoing drainage until the wound seals. Replacing with a more absorbent dressing keeps the site clean and dry, preventing infection. Culturing (
B) is unnecessary without infection signs, dehiscence (
C) is unlikely, and reinforcing (
D) risks infection.
Question 2 of 5
The physician has ordered thiamine 100 mg IM for a client with chronic alcoholism. The primary reason for giving thiamine is:
Correct Answer: C
Rationale: Thiamine is given to treat or prevent neurological symptoms, such as Wernicke's encephalopathy, caused by thiamine deficiency in chronic alcoholism.
Question 3 of 5
A young adult who was in a motorcycle accident is brought to the emergency room with a closed head injury with suspected subdural hematoma. Although the client complains of a severe headache, he is alert and answers questions appropriately. The nurse would question which of the following orders?
Correct Answer: B
Rationale: Morphine sulfate, a narcotic analgesic, causes central nervous system (CNS) and respiratory depression. In patients with head injuries, it is contraindicated because it masks signs of increased intracranial pressure (ICP), such as changes in level of consciousness, which are critical for monitoring neurological status. Promethazine is an antiemetic, docusate is a stool softener, and ranitidine prevents stress ulcers, none of which pose the same risk in this context.
Question 4 of 5
The nurse is caring for a client with a history of heart failure who is receiving furosemide (Lasix). Which of the following laboratory values should the nurse monitor?
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, increasing the risk of arrhythmias in heart failure patients, so serum potassium must be monitored closely. Glucose (
B), cholesterol (
C), and hemoglobin (
D) are not directly affected by furosemide.
Extract:
Rosemarie is 24 years old, G1P0, admitted with a diagnosis of Multiple Sclerosis.
Question 5 of 5
The nurse observes indications of positive response from treatments and signs that the patient is recovering from the disease by which of the following assessment data?
Correct Answer: D
Rationale: Multiple Sclerosis temporarily affects both sensory and motor functions. Being able to walk with a stable gait is a sign that the motor function is returning to normal.