NCLEX-PN
NCLEX PN Exam Practice Test Questions
Extract:
Question 1 of 5
The nurse is talking with a 74-year-old client with previously well-controlled hypertension. The client currently has a blood pressure of 190/88 mm Hg and has had a cold with nasal congestion for the past 3 days. Which of the following questions would be most important for the nurse to ask?
Correct Answer: B
Rationale: OTC cold medications (e.g., decongestants) can elevate blood pressure, explaining the sudden increase, making this the most important question.
Question 2 of 5
An adult is receiving intermittent tube feedings. When the nurse aspirates and measures the gastric contents, the client's wife asks the nurse what she is doing. What information is most important to include in the response?
Correct Answer: B
Rationale: Aspirating gastric contents verifies tube placement, the most critical step to prevent aspiration during feedings.
Question 3 of 5
The nurse is checking the client's central venous pressure. The nurse should place the zero of the manometer at the:
Correct Answer: A
Rationale: The phlebostatic axis is the reference point for accurate central venous pressure measurement, as it corresponds to the right atrium's level. The point of maximum impulse, Erb's point, and Tail of Spence are not used for this purpose, so answers B, C, and D are incorrect.
Question 4 of 5
A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client's temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is
Correct Answer: C
Rationale: Manage pain. The immediate goal of therapy is to alleviate the client's pain, which can be quite severe with kidney stones.
Question 5 of 5
Which actions by a nurse are reportable to the state board of nursing? Select all that apply.
Correct Answer: A,C,D
Rationale: Administering medication without a prescription, falsifying documentation, and stealing narcotics are reportable to the state board. Tardiness and leaving a shift are not typically reportable.