NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
The nurse is performing discharge teaching on a client with polycythemia vera. Which would be included in the teaching plan?
Correct Answer: D
Rationale: Polycythemia vera increases blood viscosity, raising thrombosis risk. Teaching to recognize thrombosis symptoms (e.g., pain, swelling) is critical. Avoiding crowds (
A) is for neutropenia, elevating the bed (
B) is for reflux, and socks/gloves (
C) are for Raynaud’s.
Question 2 of 5
The nurse is caring for a client with a history of a mastectomy who is receiving radiation therapy. The nurse should teach the client to:
Correct Answer: C
Rationale: Avoiding sun exposure to the radiated area prevents further skin damage and irritation. Lotion, air exposure, and heating pads can worsen skin integrity.
Question 3 of 5
The client is admitted with a possible myocardial infarction. The nurse would anticipate an order from the physician for which laboratory test?
Correct Answer: A, C, D
Rationale: Creatine kinase (
A), myoglobin (
C), and troponin T (
D) are cardiac biomarkers elevated in myocardial infarction. Ammonia (
B), gamma-glutamyl transferase (E), and bilirubin (F) are unrelated to acute cardiac events.
Question 4 of 5
A burn client's care plan reveals an expected outcome of no localized or systemic infection. Which assessment by the nurse supports this outcome?
Correct Answer: A
Rationale: Minimal bacteria in wound cultures indicates no localized infection, supporting the outcome. Cloudy urine (
B), elevated WBC (
C), and fever (
D) suggest possible infection.
Question 5 of 5
The nurse is in the hallway and one of the visitors faints. The nurse should:
Correct Answer: B
Rationale: Sitting the client up defeats the goal of re-establishing cerebral blood flow. Elevating the legs anatomically redirects blood flow to the cerebral area. This strategy is a nice general comfort measure after the victim has regained consciousness. This strategy is not as effective a strategy in helping the client to regain consciousness as elevating the legs.