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Questions 227

NCLEX-PN

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Extract:

Francis' serum K+ level is 3.8 mEq/L. Potassium chloride 40 mEq has been prescribed to be added to the first liter of IV fluid.


Question 1 of 5

The nurse should

Correct Answer: C

Rationale: Ketoacidosis means high blood glucose. Insulin is expected to be administered to lower the blood glucose level. Insulin transports potassium back to the cell, so potassium IV is usually given prophylactically with insulin.

Extract:

The physician orders non-weight bearing with crutches for a patient with a leg injury.


Question 2 of 5

The nurse would recommend which of the following herb to the patient with vomiting and nausea?

Correct Answer: A

Rationale: Ginger root is effective for nausea and vomiting, a safe herbal recommendation.

Extract:


Question 3 of 5

A postpartum mother is unwilling to allow the father to participate in the newborn's care, although he is interested in doing so. She states, 'I am afraid the baby will be confused about who the mother is. Baby raising is for mothers, not fathers.' The nurse's initial intervention should be what focus?

Correct Answer: B

Rationale: Set time aside to get the mother to express her feelings and concerns. This facilitates understanding and resolution of her concerns.

Question 4 of 5

The nurse is assessing a child admitted who has a fractured humerus. The family says the child fell. Which piece of information would cause the nurse to suspect child abuse?

Correct Answer: C

Rationale: Small round burns suggest cigarette burns, a specific sign of abuse. Frequent ER visits or bruising are concerning but less definitive; hand-holding is normal.

Extract:

A 78-year-old client is admitted for open reduction of a wrist fracture. That night she is found wandering in the hallway near the fire alarm. When the nurse calls the client's name, the client says, 'If you come any closer to me I'll pull this fire alarm. You're a drug addict. I saw you taking drugs out of the cabinet.'


Question 5 of 5

The best response by the nurse would be:

Correct Answer: A

Rationale: This response addresses safety calmly without escalating the situation.

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