NCLEX Questions, PN NCLEX Practice Test Questions, NCLEX-PN

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Question 1 of 5

The nurse is reinforcing teaching to a client being discharged on enoxaparin therapy following total knee replacement surgery. Which statement made by the nurse is most appropriate?

Correct Answer: B

Rationale: Mild bruising or redness at the injection site is a common side effect of enoxaparin, a low-molecular-weight heparin. Vitamin K restriction applies to warfarin, ibuprofen increases bleeding risk, and PT/INR monitoring is not required for enoxaparin.

Question 2 of 5

An adult is admitted for surgery today. Immediately after administering the preoperative medications of meperidine and atropine, the nurse notes that the operative permit has not been signed. Which action should the nurse take?

A. Have the client sign the operative permit immediately before the medications take effect B. Have the client's next of kin sign the permission form C. Ask the client if he/she is willing to undergo surgery, sign the form for the client, and indicate the nurse's name as witness to the client's verbal consent D. Report it to the physician so the surgery can be delayed until the client can legally sign a consent form

Correct Answer: D

Rationale: Preoperative medications like meperidine impair judgment, making consent invalid post-administration. Reporting to the physician to delay surgery ensures legal and ethical consent.

Question 3 of 5

The nurse is assessing a client with portal hypertension. Which of the following findings would the nurse expect?

A. Expiratory wheezes B. Blurred vision C. Ascites D. Dilated pupils

Correct Answer: C

Rationale: Ascites. Portal hypertension can occur in a client with right-sided heart failure or cirrhosis of the liver. Portal hypertension can lead to ascites due to the increased portal pressure as well as a lowered colloid osmotic pressure because of low albumin. When liver functioning deteriorates, protein metabolism suffers.

Question 4 of 5

The nurse is assisting with an education conference for graduate nurses about infant CPR. Which of the following statements are appropriate to include in the teaching? Select all that apply.

A. A single rescuer responding to an unwitnessed infant arrest should perform 2 minutes of CPR before retrieving a defibrillator B. Depth of chest compressions for infants should be half the depth of the anterior-posterior chest diameter C. Rescuers should place the heel of one hand on the lower sternum when delivering chest compressions to infants D. The ratio of chest compressions to breaths during CPR by a single rescuer is 15:2 for infants E. You should assess the infant’s brachial pulse for no longer than 10 seconds

Correct Answer: A,E

Rationale: Two minutes of CPR before defibrillator retrieval and assessing the brachial pulse for ≤10 seconds align with infant CPR guidelines. Compression depth is about one-third the chest, two fingers are used, and the ratio is 30:2 for a single rescuer.

Question 5 of 5

The nurse should initiate discharge planning for a client

A. When the client or family demonstrate readiness to learn self care modalities B. When informed that a date for discharge has been determined C. Upon admission to a hospital unit or the emergency room D. When the client's condition is stabilized on the assigned unit

Correct Answer: C

Rationale: Upon admission to a hospital unit or the emergency room. Early discharge planning ensures continuity of care with shorter hospital stays.

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