NCLEX Questions, NCLEX PN Test Questions Questions, NCLEX-PN Questions, Nurselytic

Questions 164

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Question 1 of 5

The nurse receives the handoff of care report on four clients. Which client should the nurse see first?

Correct Answer: D

Rationale: Restlessness in a pneumonia client with low SpO2 (
D) suggests worsening hypoxia, requiring immediate assessment. Severe pain (
A) is urgent but stable. Pleural effusion (
B) and fever (
C) are less critical.

Question 2 of 5

The nurse is reinforcing skin care guidelines for a client who is receiving external radiation therapy. Which of the following statements by the client would indicate a correct understanding of the teaching?

Correct Answer: C,D,E

Rationale: Sun protection (
C), gentle washing (
D), and loose clothing (E) are correct for radiation therapy skin care. Ice packs (
A) can damage skin, and baby oil (
B) may irritate or trap radiation.

Question 3 of 5

The nurse is caring for a child newly diagnosed with cystic fibrosis. What interventions does the nurse expect to be included in the client's multidisciplinary plan of care?

Correct Answer: A,B,E

Rationale: Chest physiotherapy (
A) clears mucus, genetic counseling (
B) addresses hereditary aspects, and spiritual support (E) aids coping. A high-calorie diet, not low-calorie (
C), is needed for nutrition. Fluid restriction (
D) is inappropriate, as hydration is encouraged.

Question 4 of 5

A 31-year-old client is admitted to the psychiatric unit after cutting both wrists with a kitchen knife. The client has a diagnosis of borderline personality disorder. The most therapeutic approach by the nurse is one that is:

Correct Answer: C

Rationale: A firm and consistent approach provides structure and boundaries, which are therapeutic for clients with borderline personality disorder who often test limits.

Question 5 of 5

The client with a colostomy does not feel that the irrigating solution has drained completely. The nurse can enhance the effectiveness of the colostomy irrigation by telling the client to:

Correct Answer: A

Rationale: Gentle abdominal massage can stimulate peristalsis and help the irrigation solution drain completely from the colostomy. Reducing solution or using a heating pad is not standard, and increasing oral intake is unrelated.

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