NCLEX-RN
RN NCLEX Practice Test Questions
Extract:
Question 1 of 5
The nurse is observing the ambulation of a client recently fitted for crutches. Which observation requires nursing intervention?
Correct Answer: D
Rationale: Bearing weight on the axilla can cause nerve damage (e.g., brachial plexus injury); crutches should support weight on the hands.
Question 2 of 5
A patient refuses to take his dose of oral medication. The nurse tells the patient that if he does not take the medication that she will administer it by injection. The nurse's comments can result in a charge of:
Correct Answer: B
Rationale: Threatening to administer medication by injection against the patient's will constitutes assault, as it involves a threat of unwanted contact.
Question 3 of 5
A client with sickle cell disease is admitted in active labor. Which nursing intervention would be most helpful in preventing a sickling crisis?
Correct Answer: D
Rationale: IV fluids at 200 mL/hr prevent dehydration, a trigger for sickling crises, by maintaining hydration and blood flow. BP monitoring (
A), pain medication (
B), and ABGs (
C) are supportive but less directly preventive.
Question 4 of 5
A client is admitted with symptoms of vertigo and syncope.
Correct Answer: C
Rationale: Left subclavian artery obstruction can cause subclavian steal syndrome, leading to vertigo, syncope, and radial pulse differences (>10 bpm) due to blood flow reversal. Memory loss (
A), numbness (
B), and headache (
D) are unrelated.
Question 5 of 5
Following a gastric resection, a 70-year-old client is admitted to the postanesthesia care unit. He was extubated prior to leaving the suite. On arrival at the postanesthesia care unit, the nurse should:
Correct Answer: A
Rationale: Adequate air exchange and tissue oxygenation depend on competent respiratory function. Checking the airway is the nurse's priority action. Obtaining the vital signs is an important action, but it is secondary to airway management. Reorienting a client to time, place, and person after surgery is important, but it is secondary to airway and vital signs. Airway management takes precedence over physician's orders unless they specifically relate to airway management.