NCLEX-PN
NCLEX Practice Questions PN Questions
Extract:
Question 1 of 5
The nurse is preparing to administer ear drops to a 5-year-old client. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Pulling the pinna upward and back (
A) straightens the ear canal in children over 3. Sitting with chin down (
B), touching the canal (
C), or cold drops (
D) are incorrect.
Question 2 of 5
The nurse observes an ambulating client begin to experience a tonic-clonic seizure. Which nursing actions should be implemented immediately? Select all that apply.
Correct Answer: A, C, E, F
Rationale: Guiding to the floor (
A), clearing objects (
C), positioning laterally (E), and observing (F) ensure safety.
Tongue blades (
B) are dangerous, and restraining (
D) increases injury risk.
Question 3 of 5
The nurse has reinforced teaching with a client with newly diagnosed polycythemia vera. Which of the following statements by the client would require follow-up?
Correct Answer: A
Rationale: Iron supplements (
A) can worsen polycythemia vera by increasing red blood cell production, requiring follow-up. Increased fluids (
B), phlebotomy (
C), and aspirin (
D) are appropriate.
Question 4 of 5
The nurse is reviewing laboratory test results for an 80-year-old client who has a methicillin-resistant Staphylococcus aureus infection and is receiving vancomycin. Which of the following test results would require immediate follow-up?
Correct Answer: A
Rationale: Elevated BUN (
A) may indicate nephrotoxicity, a serious side effect of vancomycin requiring immediate follow-up. Decreased iron (
B) or triglycerides (
C) are not directly related to vancomycin toxicity. Elevated glucose (
D) may need monitoring but is less urgent.
Question 5 of 5
While planning care for a 2 year-old hospitalized child, which situation would the nurse expect to most likely affect the behavior?
Correct Answer: B
Rationale: Separation from parents. Separation anxiety is the greatest stress for a toddler during hospitalization.