NCLEX-PN
NCLEX PN Prep Questions Questions
Extract:
Question 1 of 5
The nurse is preparing to administer phenytoin oral suspension via nasogastric tube to a client with a seizure disorder. The client is receiving continuous enteral feedings. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Phenytoin binds to enteral feedings, reducing absorption. Holding feedings for 1 hour before and after administration ensures efficacy. Tube placement should be verified before, not after, administration. Blood pressure and pancreatic enzymes are unrelated.
Question 2 of 5
A woman who comes in for prenatal care has a history of herpes with outbreaks that occur every six months to a year. She asks if this means she will have a cesarean delivery. How should the nurse respond?
Correct Answer: A
Rationale: Active herpes lesions at labor necessitate a cesarean to prevent neonatal herpes transmission; otherwise, vaginal delivery may be possible.
Question 3 of 5
The nurse is caring for a client with type 1 diabetes mellitus who is reporting abdominal pain and weakness. The client has a fruity odor to the breath and rapid, deep respirations. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: B,C,D,E
Rationale: Symptoms suggest diabetic ketoacidosis (DK
A). Checking glucose confirms hyperglycemia, cardiac monitoring detects arrhythmias from electrolyte imbalances, IV insulin corrects hyperglycemia, and saline bolus addresses dehydration. Breathing into a paper bag is for hyperventilation from anxiety, not DKA.
Question 4 of 5
Following change-of-shift report on an orthopedic unit, which client should the nurse see first?
Correct Answer: C
Rationale: Look for the client who has the most imminent risks and acute vulnerability. The client who returned from surgery 2 hours ago is at risk for life threatening hemorrhage and should be seen first.
Question 5 of 5
A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding should the nurse expect?
Correct Answer: C
Rationale: Intussusception causes intestinal obstruction, often leading to 'currant jelly' stools (blood and mucus). Black, sticky stools suggest upper GI bleeding. Greasy stools indicate malabsorption. Ribbon-like stools suggest rectal narrowing.