NCLEX-RN
NCLEX RN Practice Questions with Answers Questions
Extract:
Question 1 of 5
The nurse is teaching a client with a new tracheostomy about home care. Which of the following instructions should be included? Select all that apply.
Correct Answer: A, B, D, E
Rationale: Daily cleaning, suctioning, keeping a spare tube, and using a humidifier are essential for tracheostomy care. Tube changes are typically done by professionals.
Question 2 of 5
Methylergonovine maleate is prescribed for a woman who has just delivered a healthy newborn. Which is the priority assessment to complete before administering the medication?
Correct Answer: C
Rationale: Methylergonovine maleate, an oxytocic, is an agent used to prevent or control postpartum hemorrhage by contracting the uterus. The immediate dose is administered intramuscularly, and then, if still needed, it is administered orally. It causes uterine contractions and may elevate the blood pressure. A priority assessment before administration of methylergonovine maleate is blood pressure. Methylergonovine maleate is to be administered cautiously in the presence of hypertension, and the primary health care provider should be notified if hypertension is present. Options 1 and 2 are general components of care in the postpartum period. Option 4 is most specifically related to the administration of magnesium sulfate.
Question 3 of 5
The nurse is assessing a client with a suspected spinal cord injury. Which of the following findings is most indicative of this condition?
Correct Answer: A
Rationale: Loss of sensation below the injury site is a hallmark sign of spinal cord injury due to disrupted nerve pathways.
Question 4 of 5
A client with a history of stroke is at risk for aspiration. Which of the following interventions should the nurse include in the plan of care? Select all that apply.
Correct Answer: A, C, D, E
Rationale: Upright positioning, assessing gag reflex, small frequent meals, and thickened liquids reduce aspiration risk. Thin liquids increase risk.
Question 5 of 5
The nurse is teaching a client with a new diagnosis of celiac disease about dietary management. Which of the following foods should the client avoid?
Correct Answer: B
Rationale: Wheat contains gluten, which must be avoided in celiac disease.