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 schizophrenic client who is experiencing thoughts of having special powers states that 'I am a messenger from another planet and can rule the earth.' The nurse assesses this behavior as:
Correct Answer: D
Rationale: Clients experiencing ideas of reference believe that information from the environment (e.g., the television) is referring to them. Clients experiencing delusions of persecution believe that others in the environment are plotting against them. Clients experiencing thought broadcasting perceive that others can hear their thoughts. Clients experiencing delusions of grandeur think that they are omnipotent and have superhuman powers.
Question 3 of 5
After the fetal activity test (nonstress test) is completed, the RN is looking at the test results on the monitor strip. The RN observes that the fetal heart accelerated 5 beats/min with each fetal movement. The accelerations lasted 15 seconds and occurred 3 times during the 20 minute test. The RN knows that these test results will be interpreted as:
Correct Answer: A
Rationale: A reactive nonstress test requires at least two accelerations of the fetal heart rate of at least 15 bpm, lasting 15 seconds, over a 20-minute period. The described results (5 bpm accelerations) do not meet the criteria, but the correct answer provided is A, indicating a possible error in the question's data. However, based on the provided answer, it is interpreted as reactive.
Question 4 of 5
The nurse has just received a report from the previous shift.
Correct Answer: B
Rationale: Shortness of breath post-MVA suggests potential trauma (e.g., pneumothorax), requiring immediate assessment. COPD with PCO2 50 (
A) is stable, pain (
C) is less urgent, and mild fever (
D) is expected post-op.
Question 5 of 5
The nurse is conducting a physical assessment on a client with mild anemia. Which of the following would the nurse expect to observe?
Correct Answer: C
Rationale: Mild anemia reduces oxygen-carrying capacity leading to fatigue and activity intolerance. Heart murmurs increased respiratory rate or frequent infections are not typical findings in mild anemia unless complications arise.