NCLEX Questions, NCLEX Practice Questions PN Questions, NCLEX-PN Questions, Nurselytic

Questions 176

NCLEX-PN

NCLEX-PN Test Bank

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Extract:


Question 1 of 5

The nurse is collecting data from a 10-year-old client during a routine physical examination. Which of the following actions should the nurse take? Select all that apply.

Correct Answer: A, C, D

Rationale: Using anatomical terminology (
A) promotes understanding. Explaining equipment and procedures (
C) reduces anxiety. Offering a gown and allowing underwear (
D) respects privacy. Adult examination sequences (
B) may not suit pediatric needs, and parents rating pain (E) may not accurately reflect the child's experience.

Question 2 of 5

A client is admitted with Parkinson's disease. The client has been taking Carbidopa/levodopa (Sinemet) for 1 year. Which clinical manifestation would be the most important to report?

Correct Answer: B

Rationale: Spasmodic eye winking could indicate a toxicity or overdose and should be reported to the physician. Other signs of toxicity include involuntary twitching of muscles, facial grimaces, and severe tongue protrusion. Answers A, C, and D are incorrect because they are side effects of the drug.

Question 3 of 5

The nurse is reinforcing teaching for a client with atrial fibrillation who has a new prescription for warfarin. Which of the following statements by the client would require follow-up?

Correct Answer: B

Rationale: Avoiding all green leafy vegetables (
B) is incorrect; consistent intake is needed to maintain stable INR. Avoiding aspirin (
A), caffeine (
C), and consulting about supplements (
D) are correct.

Question 4 of 5

The nurse is caring for an ambulatory client who has a new order for continuous cardiac monitoring via a portable unit. It would require follow-up if the nurse

Correct Answer: D

Rationale: Placing electrodes on extremities (
D) is incorrect for cardiac monitoring, which requires chest placement. Verifying gel (
A), cleansing skin (
B), and clipping hair (
C) are appropriate.

Question 5 of 5

A nurse is reinforcing fall-prevention teaching to the spouse of a 78-year-old client who recently experienced a stroke. What suggestion by the nurse is most effective in preventing falls?

Correct Answer: C

Rationale: Removing rugs and installing grab bars (
C) directly addresses environmental hazards, the most effective fall prevention strategy. Rising slowly (
A), using a walker (
B), or hiring an aide (
D) are helpful but less comprehensive.

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