NCLEX Questions, NCLEX Trainer Test 1 Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Question 1 of 5

The nurse is preparing to discharge a client after an abdominal cholecystectomy for treatment of cholelithiasis. The client will go home with a T-tube in place. Which of the following statements, if made by the client to the nurse, indicates a need for further teaching?

Correct Answer: C

Rationale: Swimming submerges the T-tube, risking infection, indicating a need for further teaching. Options A, B, and D are correct: showering is allowed, increased drainage requires reporting, and daily skin checks prevent complications.

Question 2 of 5

Following surgery for placement of a ventriculoperitoneal (VP) shunt as treatment for hydrocephalus, the parents question why the infant has a small abdominal incision. The best response by the nurse would be to explain that the incision was made in order to

Correct Answer: A

Rationale: Pass the catheter into the abdominal cavity. The VP shunt drains cerebrospinal fluid into the peritoneal cavity via a catheter inserted through an abdominal incision.

Question 3 of 5

The home health care nurse is caring for a 30-year-old woman with type I diabetes mellitus.

Correct Answer: B

Rationale: Elevated morning blood glucose levels suggest the dawn phenomenon, where blood sugar rises in the early morning due to hormonal changes. Adding 3 units of NPH insulin at 10 PM addresses this by providing longer-acting insulin coverage. Reducing the diet, adding regular insulin, or eliminating the snack does not target the dawn phenomenon effectively.

Question 4 of 5

The nurse is teaching a client with hypertension about lifestyle modifications. Which of the following recommendations is MOST appropriate?

Correct Answer: C

Rationale: Weight loss reduces blood pressure in hypertensive clients. Options A, B, and D worsen hypertension.

Question 5 of 5

The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:

Correct Answer: B

Rationale: Hypersomnolence is an expected side effect of magnesium sulfate due to its sedative properties, so B is correct. Decreased urinary output , absence of knee jerk reflex , and decreased respiratory rate are signs of toxicity, not expected effects.

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