NCLEX Questions, NCLEX Trainer Test 4 Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Question 1 of 5

The parents of a child who is in for a 1-year well-baby check ask what immunizations the child needs. The nurse checks the child's record and determines that the child has had immunizations as recommended during the first year. What should the nurse reply?

Correct Answer: C

Rationale: At 1 year, per CDC guidelines, children typically receive MMR, varicella, and HiB (final dose), assuming prior vaccinations are complete. Rotavirus, hepatitis B, polio, pneumococcal, and meningococcal are given at other ages.

Question 2 of 5

An adult is admitted in diabetic ketoacidosis. What observation by the nurse is consistent with the diagnosis?

Correct Answer: A

Rationale: Deep, rapid (Kussmaul) respirations are a compensatory mechanism in diabetic ketoacidosis to eliminate excess CO2, correcting acidosis.

Question 3 of 5

During the admission assessment on a client with chronic bilateral glaucoma, which statement by the client would the nurse anticipate since it is associated with this problem?

Correct Answer: C

Rationale: I have to turn my head to see my room. Intraocular pressure becomes elevated, producing a progressive loss of the peripheral visual field in the affected eye.

Question 4 of 5

A pregnant diabetic client, who is 37 weeks gestation, is scheduled for an amniocentesis. The client asks the nurse the purpose of the test. The nurse should explain that the primary reason for performing an amniocentesis is:

Correct Answer: C

Rationale: At 37 weeks, amniocentesis primarily assesses fetal lung maturity via lecithin/sphingomyelin ratio, critical for delivery planning. Diabetes effects , skeletal age , and genetic issues are less common indications.

Question 5 of 5

The nurse is caring for a client with a history of type 1 diabetes who is receiving insulin detemir (Levemir) 15 units SC daily. Which of the following symptoms should the nurse report immediately?

Correct Answer: B

Rationale: Sweating and shakiness indicate hypoglycemia, a medical emergency with insulin detemir. Options A, C, and D are less urgent: fatigue is nonspecific, thirst is expected, and headache is common.

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