NCLEX-PN
NCLEX Trainer Test 6 Questions
Extract:
Question 1 of 5
The nurse is teaching a client how to care for a colostomy. Which factor indicates that the client needs more instruction?
Correct Answer: B
Rationale: Irrigating while sitting on the toilet risks contamination; irrigation should be done in a controlled setting, indicating a need for further instruction.
Question 2 of 5
A client was admitted to the psychiatric unit after complaining to her friends and family that neighbors have bugged her home in order to hear all of her business. She remains aloof from other clients, paces the floor and believes that the hospital is a house of torture. Nursing interventions for the client should appropriately focus on efforts to
Correct Answer: C
Rationale: Provide interactions to help the client learn to trust staff. Establishing trust helps clients feel safer and facilitates a therapeutic alliance between staff and client.
Question 3 of 5
A client weighing 76 kg is admitted at 0600 with a TBSA burn of 40%. Using the Parkland formula, the client's 24-hour intravenous fluid replacement should be:
Correct Answer: C
Rationale: The Parkland formula is 4 ml × kg × TBSA = 24-hour fluid requirement, or 4 × 76 × 40 = 12,160 ml. Answer A is the fluid requirement for the first 8 hours after burn injury, so it's incorrect. Answer B is incorrect because it's the fluid requirement for 16 hours after burn injury. Answer D is an excessive amount given the client's weight and TBSA, so it's incorrect.
Question 4 of 5
The nurse is teaching a client how to care for a colostomy. Which factor indicates that the client needs more instruction?
Correct Answer: B
Rationale: Irrigating while sitting on the toilet risks contamination; irrigation should be done in a controlled setting, indicating a need for further instruction.
Question 5 of 5
The nurse is caring for a client with a history of polycystic kidney disease.
Correct Answer: B
Rationale: Flank pain and hematuria are common in polycystic kidney disease due to cyst pressure and rupture. Chest pain, weight loss, and numbness are unrelated.