Questions 150

NCLEX-RN

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Question 1 of 5

The nurse notices drops of a liquid on the hallway floor of a health care facility. The nurse should do which of the following first?

Correct Answer: C

Rationale: Posting 'wet floor' signs first ensures immediate safety by alerting others to the hazard, preventing slips.
Then, the nurse can proceed with cleanup or notify appropriate personnel.

Question 2 of 5

Which of the following baseline laboratory data should be established before a client is started on tissue plasminogen activator or alteplase recombinant (Activase)?

Correct Answer: C

Rationale: These tests assess bleeding risk, critical before administering thrombolytics like alteplase, which can cause hemorrhage.

Question 3 of 5

A 1-year-old is brought to the clinic with failure to thrive. Which assessment should the nurse prioritize?

Correct Answer: A

Rationale: Dietary intake history is critical in failure to thrive to identify inadequate caloric intake or feeding issues, guiding intervention.

Question 4 of 5

Which clinical manifestations are consistently observed in infants who have been diagnosed with congenital hypothyroidism? Select all that apply.

Correct Answer: B,C,D,F

Rationale: The infant with congenital hypothyroidism may display the following signs: skin mottling, a large fontanel, a large tongue, hypotonia, slow reflexes, bradycardia, and a distended abdomen. Other signs and symptoms include prolonged jaundice, lethargy, constipation, feeding problems, coldness to touch, umbilical hernia, hoarse cry, and excessive sleeping.

Question 5 of 5

The Joint Commission on the Accreditation of Healthcare Organizations mandates standardized 'hand off' change of shift reporting. Which of the following is a standardized 'hand off' change of shift reporting system that you may want to consider for implementation on your nursing care unit?

Correct Answer: C

Rationale: ISBAR is a standardized hand-off reporting system (Introduction, Situation, Background, Assessment, Recommendation) recommended by The Joint Commission for effective communication during shift changes.

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