NCLEX Questions, NCLEX RN Practice Tests Questions, NCLEX-RN Questions, Nurselytic

Questions 149

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Question 1 of 5

The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:

Correct Answer: C

Rationale: Repositioning the client can relieve umbilical cord compression, the common cause of variable decelerations.

Question 2 of 5

The physician has inserted an esophageal balloon tamponade in a client with bleeding esophageal varices. The nurse should maintain the esophageal balloon at a pressure of:

Correct Answer: D

Rationale: A pressure of 20-25 mmHg effectively compresses varices to control bleeding without causing tissue damage.

Question 3 of 5

The client using a diaphragm should be instructed to:

Correct Answer: D

Rationale: Surgery, especially pelvic or abdominal, can alter pelvic anatomy, requiring the diaphragm to be resized for effective contraception.

Question 4 of 5

The nurse is conducting an aphasia assessment of a client who has suffered a stroke. Which of the following observations should the nurse include in the assessment? Select all that apply.

Correct Answer: A,B,C,D,E

Rationale: Aphasia assessment post-stroke includes evaluating spontaneous speech (
A), comprehension (
B), naming objects (
C), describing objects (
D), and writing (E). Memory recall (F) is not specific to aphasia.

Question 5 of 5

The home health nurse is visiting a 30-year-old with sickle cell disease. Assessment findings include spleenomegaly. What information obtained on the visit would cause the most concern? The client:

Correct Answer: D

Rationale: Working as a furniture mover involves heavy physical exertion, which can trigger a sickle cell crisis due to increased oxygen demand and dehydration, posing a significant risk.

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