NCLEX Questions, NCLEX PN Practice Questions Questions, NCLEX-PN Questions, Nurselytic

Questions 164

NCLEX-PN

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Question 1 of 5

The nurse is to observe the client for shock. The client's admitting vital signs are blood pressure (BP)=116/70, pulse=86, and respirations=24. Which finding, if observed, would be most suggestive of shock?

Correct Answer: B

Rationale: Increased pulse (tachycardia) is a hallmark of shock, compensating for reduced volume. Stable or slightly varied BP and low pulse are less indicative.

Question 2 of 5

A client with a history of renal calculi passes a stone made up of calcium oxalate. Which of the following diet instructions should be given to the client?

Correct Answer: C

Rationale: Dark green, leafy vegetables are high in oxalates, which contribute to calcium oxalate stones. Meats and dairy increase other stone types, and citrus juices are beneficial.

Question 3 of 5

A nurse is caring for a client following the delivery of a stillborn infant. Which of the following actions should the nurse take? Select all that apply.

Correct Answer: A,D,E

Rationale: Bathing, holding, and obtaining mementos support grieving. Naming is a personal choice, and organ donation discussions may be inappropriate at this time.

Question 4 of 5

Following a stroke, an elderly client develops ptosis. When assessing the client, the nurse will note:

Correct Answer: A

Rationale: Ptosis or drooping of the eyelid can occur as the result of a stroke or Bell's palsy. Answer B refers to entropion, and answer C refers to ectropion, so they are incorrect. Answer D refers to chalazion, so it's incorrect. Answers B, C, and D are incorrect because they do not relate to ptosis.

Question 5 of 5

A female client is admitted for a breast biopsy. She says, tearfully to the nurse, 'If this turns out to be cancer and I have to have my breast removed, my partner will never come near me.' The nurse's best response would be which of these statements?

Correct Answer: D

Rationale: This is a general lead-in type of response that encourages further discussion without focusing on an area that the nurse, but possibly not the client, feels is a problem.

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