NCLEX-RN
NCLEX RN Exam Questions Questions
Extract:
Question 1 of 5
The nurse is preparing to administer both regular and NPH insulin to a client with diabetes. Place in sequence the correct method for completing this task.
Correct Answer: C, D, B, A
Rationale:
To prevent contamination: Inject air into regular insulin vial (
C), then NPH vial (
D). Withdraw regular insulin (
B), then NPH insulin (
A). Regular insulin is clear, drawn first to avoid clouding with NPH.
Question 2 of 5
A client is diagnosed with stage II Hodgkin's lymphoma. The nurse recognizes that the client has involvement:
Correct Answer: B
Rationale: Stage II Hodgkin's lymphoma involves two or more lymph nodes or a single organ on the same side of the diaphragm, per the Ann Arbor staging system.
Question 3 of 5
A 47-year-old client has been admitted to the general surgery unit for bowel obstruction. The doctor has ordered that an NG tube be inserted to aid in bowel decompression. When preparing to insert a NG tube, the nurse measures from the:
Correct Answer: D
Rationale: This measurement is ~50 cm (48-49 cm). Fifty centimeters is considered the length necessary for the distal end of the tube to be in place in the stomach. This measurement is too short. This measurement is ~50 cm (47-48 cm). Fifty centimeters is considered the length necessary for the distal end of the tube to be in place in the stomach. This measurement is too short. This measurement gives an approximate indication of the length necessary for the distal end of the tube to be in place in the stomach, but it is not as accurate as actually measuring the client (nose-ear-xiphoid). This is the correct measurement of 50 cm from the tip of the client's nose to the tip of the earlobe to the xiphoid process (called the NEX [nose-ear-xiphoid] measurement). It is approximately equal to the distance necessary for the distal end of the tube to be located in the correct position in the stomach.
Question 4 of 5
The client is admitted with a diagnosis of ectopic pregnancy. Which symptom is most characteristic of this condition?
Correct Answer: A
Rationale: Ectopic pregnancy often presents with sudden sharp abdominal pain due to tubal stretching or rupture. Painless bleeding is more typical of placenta previa and fever or edema are not characteristic.
Question 5 of 5
A client with a history of a colostomy is being discharged. The nurse should teach the client to:
Correct Answer: B
Rationale: High-fiber foods can cause blockages or excessive output in a colostomy. Bag changes depend on output, alcohol irritates the stoma, and irrigation is not always required.