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Questions 149

NCLEX-RN

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Extract:


Question 1 of 5

The nurse is monitoring a client following postoperative cardiac catheterization and is checking the client's oxygen saturation (SPO2) per pulse oximetry. The nurse recognizes that the SPO2 should be maintained above what percentage in most clients to ensure adequate oxygenation? Record your answer using a whole number.

Correct Answer: 92

Rationale: SPO2 should be maintained above 92% in most clients to ensure adequate oxygenation, especially post-procedure.

Question 2 of 5

The family of a hospice client wishes to visit at midnight. Which of the following actions by the nurse would be the most appropriate?

Correct Answer: D

Rationale: In hospice care, allowing family visits at any time supports the client’s and family’s emotional needs, especially near end-of-life.

Question 3 of 5

A client with paranoid schizophrenia is brought to the hospital by her elderly parents. During the assessment, the client's mother states, 'Sometimes she is more than we can manage.' Based on the mother's statement, the most appropriate nursing diagnosis is:

Correct Answer: B

Rationale: The mother's statement suggests caregiver role strain due to the ongoing stress of managing the client's schizophrenia symptoms.

Question 4 of 5

The nurse is monitoring a client following postoperative cardiac catheterization and is checking the client's oxygen saturation (SPO2) per pulse oximetry. The nurse recognizes that the SPO2 should be maintained above what percentage in most clients to ensure adequate oxygenation? Record your answer using a whole number.

Correct Answer: 92

Rationale: SPO2 should be maintained above 92% in most clients to ensure adequate oxygenation, especially post-procedure.

Question 5 of 5

A nulliparous client has been admitted after 12 hours of mild contractions at home. On examination, the client is found to be fully effaced and dilated to 3 cm. Contractions are every 5 minutes and last approximately 60 seconds. The client asks the nurse approximately how long it should take to get to 10 cm dilation. Which of the following is the most appropriate response?

Correct Answer: D

Rationale: Nulliparous women progress at ~1 cm/hour in active labor. From 3 cm to 10 cm is 7 cm, so ~7 hours (
D) is expected.

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