NCLEX-PN
NCLEX Trainer Test 3 Questions
Extract:
A client with an obsessive-compulsive disorder manifested by the compulsion of handwashing.
Question 1 of 5
The nurse knows that which of the following BEST describes the client's need for the repetitive acts of handwashing?
Correct Answer: C
Rationale: Strategy: Think about each answer choice. (1) not a manipulation on the client's part (2) not an accurate statement regarding the compulsive behavior of this client (3) correct-compulsive behavior is an unconscious attempt to control and/or relieve the tension and anxiety the client is experiencing (4) client is not subject to depression but to high levels of anxiety
Extract:
Question 2 of 5
An 80 year-old nursing home resident has a temperature of 101.6 degrees Fahrenheit rectally. This is a sudden change in an otherwise healthy client. Which should the nurse assess first?
Correct Answer: C
Rationale: Level of alertness. Assessing the level of consciousness (alert vs. lethargic vs. unresponsive) will help the provider determine the severity of the acute episode. If the client is alert, responses to questions about complaints can be followed-up quickly.
Question 3 of 5
The nurse is caring for a client who is in the late stage of multiple myeloma. Which of the following should be included in the plan of care?
Correct Answer: C
Rationale: Precautions with position changes. Multiple myeloma causes osteoporosis, increasing the risk of pathological fractures, necessitating careful positioning.
Question 4 of 5
The doctor has ordered chlorpromazine (Thorazine) to control an alcoholic client's restlessness, agitation, and irritability following surgery. The nurse should check the order with the doctor based on which of the following rationales?
Correct Answer: A
Rationale: medication is contraindicated for the treatment of alcohol withdrawal symptoms; medication will lower client's seizure threshold and BP, causing potentially serious medical consequences
Extract:
A client has a nasogastric tube in place after extensive abdominal surgery. The client complains of nausea. His abdomen is distended, and there are no bowel sounds.
Question 5 of 5
The FIRST nursing action should be to
Correct Answer: C
Rationale: Strategy: Answers are a mix of assessments and implementations. Is this a situation that requires assessment? Yes. (1) implementation, may be carried out after the patency of the tube is determined (2) implementation, patency should be checked first (3) correct-should first assess if the tube is open and draining to determine if there is a problem with the nasogastric tube; if it is patent and draining it does not need to be irrigated (4) assessment, patency should be checked first by aspirating stomach contents, not by auscultation