NCLEX Questions, NCLEX RN Practice Test Questions, NCLEX-RN Questions, Nurselytic

Questions 149

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Practice Test Questions

Extract:


Question 1 of 5

The nurse is observing a graduate nurse as she assesses the central venous pressure. Which observation would indicate that the graduate needs further teaching?

Correct Answer: C

Rationale: The Valsalva maneuver falsely elevates CVP; normal breathing is required.

Question 2 of 5

A client pushes his call light and tells the nurse his chest is hurting. The nurse sees his oxygen saturation is 88%. The nurse's first intervention is to

Correct Answer: B

Rationale: Hypoxemia (SpO2 88%) requires immediate oxygen administration to improve oxygenation, which is the priority for chest pain before further assessment or intervention.

Question 3 of 5

What airborne precautions should the nurse anticipate when a client with measles is admitted to the hospital? Select all that apply.

Correct Answer: C,D

Rationale: Measles requires airborne precautions, including a negative pressure room (
C) and an N-95 respirator (
D). Surgical masks (
A) are insufficient, and dedicated entrances (E) are not standard. Client masking during transport (
B) is recommended but not always mandatory.

Question 4 of 5

The nurse is caring for a manic client in the seclusion room, and it is time for lunch. It is MOST appropriate for the nurse to take which of the following actions?

Correct Answer: D

Rationale: should eat at regular time; remain in the seclusion room for client’s safety

Question 5 of 5

The nurse identifies ventricular tachycardia on the heart monitor. The nurse should immediately:

Correct Answer: C

Rationale: Ventricular tachycardia requires immediate treatment with an antiarrhythmic like lidocaine to restore normal rhythm.

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