NCLEX Questions, NCLEX Trainer Test 8 Questions, NCLEX-PN Questions, Nurselytic

Questions 156

NCLEX-PN

NCLEX-PN Test Bank

NCLEX Trainer Test 8 Questions

Extract:

A client has severe second- and third-degree burns over 75% of his body.


Question 1 of 5

The nurse would be MOST concerned if which of the following was observed?

Correct Answer: C

Rationale: Strategy: Determine how each answer relates to burns. (1) insignificant for burn client (2) may be due to pain (3) correct-body responds to early hypovolemic shock by adrenergic stimulation; vasoconstriction compensates for the loss of fluid, resulting in cool clammy skin, tachycardia, tachypnea, and pale color (4) may be due to pain

Extract:


Question 2 of 5

The nurse is caring for a client with a history of schizophrenia who is receiving haloperidol (Haldol) 5 mg PO bid. Which of the following client statements would be of GREATest concern to the nurse?

Correct Answer: A

Rationale: Stiffness when walking suggests extrapyramidal symptoms (EPS), a serious side effect of haloperidol, requiring evaluation for possible dose adjustment or antiparkinsonian medication. Options B, C, and D are common, less urgent side effects: dry mouth, sedation, and headaches.

Extract:

The triage nurse for a women's health center receives a phone call from each of the following women.


Question 3 of 5

Which woman should be directed to come to the health care facility IMMEDIATELY?

Correct Answer: A

Rationale: Strategy: Determine the least stable client. (1) correct-needs to be evaluated for an ectopic pregnancy (2) expect during first trimester of pregnancy (3) symptomatic of threatened abortion; instruct to decrease activity (4) symptoms of spontaneous abortion; instruct client to save and count pads

Extract:


Question 4 of 5

A client on chemotherapy has a WBC count of 1,200/mm^3. Which of the following nursing actions should the nurse take FIRST?

Correct Answer: A

Rationale: A WBC count of 1,200/mm^3 indicates severe neutropenia, increasing infection risk. Checking temperature every 4 hours detects fever early, a priority. Options B, C, and D are secondary: urine output is unrelated, bleeding gums suggest thrombocytopenia, and blood cultures require fever.

Question 5 of 5

A woman comes to the antepartum clinic for a routine prenatal examination. She is 12 weeks pregnant with her second child. Which of the following shows proper documentation of the client's obstetric history by the nurse?

Correct Answer: D

Rationale: Gravida 2, Para 1. Gravida describes a woman who is or has been pregnant, regardless of pregnancy outcome. Para describes the number of babies born past a point of viability.

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