NCLEX-PN
NCLEX PN Exam Practice Test Questions
Extract:
Question 1 of 5
The nurse is monitoring a newborn with skin discoloration in the buttock and lumbar area. Which action by the nurse is appropriate? Click the exhibit button for additional information.
Correct Answer: B
Rationale: Skin discoloration in the buttock and lumbar area of a newborn is often due to Mongolian spots (also called congenital dermal melanocytosis). These are benign, flat, bluish-gray patches typically found on the lower back or buttocks. They are more common in infants with darker skin tones and are not harmful, but they can be mistaken for bruises, which raises concern for abuse later on.
The appropriate nursing action is to measure and document the size, shape, and location of the spots in the medical record. This ensures that there is a clear, dated record of the findings to avoid confusion in the future.
Question 2 of 5
The nurse is providing diet instruction to the parents of a child with cystic fibrosis. The nurse would emphasize that the diet should be
Correct Answer: C
Rationale: High protein, high calorie, unrestricted fat. The child with Cystic Fibrosis needs a well balanced diet that is high in protein and calories. Fat does not need to be restricted.
Question 3 of 5
The nurse is talking to a group of clients who are postmenopause. Which of the following statements would be appropriate for the nurse to make? Select all that apply.
Correct Answer: A,B,D,E
Rationale: Monitoring cholesterol, increasing nutrient-rich foods, seeking emotional support, and weight-bearing exercise are appropriate for postmenopausal health. Vaginal bleeding is not normal and requires evaluation.
Question 4 of 5
Which of the following should the nurse teach the client to avoid when taking chlorpromazine HCL (Thorazine)?
Correct Answer: A
Rationale: Direct sunlight. Phenothiazines increase sensitivity to the sun, making clients especially susceptible to sunburn.
Question 5 of 5
The client has a chest tube attached to a portable water seal drainage system. Four hours after the chest tube is inserted, the nurse notes that there is no bubbling in the water seal compartment. What is the most likely explanation for this?
Correct Answer: A
Rationale: No bubbling in the water seal four hours post-insertion suggests the lung has reexpanded, resolving the pneumothorax. Obstruction, air leaks, or inactive suction would typically cause other signs.