NCLEX-PN
PN NCLEX Practice Exam Questions
Extract:
Question 1 of 5
The nurse is caring for an older adult client who is confused and has a high risk for falls. The client is incontinent of urine and frequently attempts to get out of bed unassisted to use the restroom. Which nursing interventions are appropriate when caring for this client? Select all that apply.
Correct Answer: A,B,D
Rationale: Bed alarms (
A), hourly rounding (
B), and proximity to the nurses' station (
D) enhance safety and monitoring. Catheters (
C) increase infection risk and are not first-line, and raising all side rails (E) is a restraint and unsafe.
Question 2 of 5
A 24-year-old female client is prescribed isotretinoin for severe cystic acne. Which instruction is most important for the nurse to reinforce?
Correct Answer: D
Rationale: Isotretinoin is highly teratogenic, so using two forms of contraception (
D) is critical to prevent pregnancy. Sunscreen (
C) is important for photosensitivity, but contraception is the priority.
Question 3 of 5
An adult is admitted to the long-term care facility. She had a cerebrovascular accident and no longer needs acute care. The client has left side hemiplegia. Because of the type of deficit the client has, the nurse knows that this woman is at increased risk for which of the following?
Correct Answer: C
Rationale: Left hemiplegia from a right brain CVA increases risk for visual-spatial deficits, as the right hemisphere processes spatial awareness, unlike speech (left hemisphere), behavior, or hearing.
Question 4 of 5
A 62-year-old client admitted to the telemetry unit after an acute myocardial infarction 3 days ago reports that the left calf is very tender and warm to the touch. Which nursing intervention is the priority?
Correct Answer: D
Rationale: Tenderness and warmth suggest deep vein thrombosis, so a neurovascular check (
D) is the priority to assess for complications. History (
A), ECG (
B), and vitals (
C) are secondary.
Question 5 of 5
The nurse is assessing a client's emotional state and coping strategies. Evidence of which behavior is of most concern to the nurse?
Correct Answer: D
Rationale: Self-mutilation indicates severe emotional distress and risk of harm, the most concerning behavior requiring immediate intervention.