NCLEX-RN
NCLEX RN High-Yield Questions Questions
Extract:
Question 1 of 5
The nurse is performing a physical assessment on a client with rheumatoid arthritis. The nurse assesses the client's hands and notes which characteristic deformities? Refer to the figure.
Correct Answer: A
Rationale: Ulnar drift occurs when synovitis stretches and damages the tendons, and eventually the tendons become shortened and fixed. This damage causes subluxation (drift) of the joints. All of the conditions that are identified in the options can occur in rheumatoid arthritis; however, the figure pictures ulnar drift.
Question 2 of 5
You are caring for a client who has been taking illicit amphetamines and states that they continue to use this illicit drug because they 'suffer and feel lousy' when they try to stop taking it. Which nursing diagnosis is the most appropriate for this client?
Correct Answer: D
Rationale: The client's symptoms of feeling 'lousy' when stopping the drug indicate physical dependence, as the body has adapted to the presence of amphetamines, leading to withdrawal symptoms upon cessation.
Question 3 of 5
The nurse is assessing a client suspected of having a rib fracture. Which typical signs/symptoms should the nurse observe for?
Correct Answer: D
Rationale: The client with fractured ribs typically has pain over the fracture site with inspiration and to palpation. Respirations are shallow, and guarding of the area is often noted. Bruising may or may not be present.
Therefore, the remaining options are incorrect.
Question 4 of 5
The nurse is assessing a client with suspected diverticulitis. Which finding supports this diagnosis?
Correct Answer: A
Rationale: Left lower quadrant pain is characteristic of diverticulitis, as diverticula commonly form in the sigmoid colon, causing localized inflammation.
Question 5 of 5
A client with a history of heart failure is prescribed sacubitril/valsartan (Entresto). The nurse should monitor the client for which of the following side effects?
Correct Answer: A
Rationale: Sacubitril/valsartan can cause hyperkalemia, requiring monitoring of potassium levels.