NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, 'It's not so easy for me to just go right to the hospital like that.' After acknowledging her feelings, which of these approaches by the nurse would probably be best?
Correct Answer: B
Rationale: This answer does not hold the client accountable for her own health. The nurse should explore potential reasons for the client's anxiety: are there small children at home, is the husband out of town? The nurse should aid the client in seeking support or interventions to decrease the anxiety of hospitalization. Repeating the physician's reason for recommending hospitalization may not aid the client in dealing with her reasons for anxiety. The concern for self and welfare of baby may be secondary to a woman who is in a crisis situation. The nurse should explore the client's potential reasons for anxiety. For example, is there another child in the home who is ill, or is there a husband who is overseas and not able to return on short notice?
Question 2 of 5
The nurse is caring for a client with a history of rheumatoid arthritis who is receiving Methotrexate (Rheumatrex). The nurse should monitor the client for:
Correct Answer: A
Rationale: Methotrexate can cause hepatotoxicity, requiring monitoring of liver enzymes. Hypotension, hyperglycemia, and thrombocytosis are not common side effects.
Question 3 of 5
A client with cancer who is receiving chemotherapeutic drugs has been given injections of pegfilgastrim (Neulasta). Which laboratory value reveals that the drug is producing the desired effect?
Correct Answer: B
Rationale: Pegfilgastrim stimulates neutrophil production, increasing white blood cell counts. A WBC of 6,000/mm (
B) indicates effectiveness. Hemoglobin (
A), platelets (
C), and hematocrit (
D) are not directly affected.
Question 4 of 5
A client scheduled for disc surgery tells the nurse that she frequently uses the herbal supplement kava-kava (piper methysticum). The nurse should notify the doctor because kava-kava:
Correct Answer: A
Rationale: Kava-kava can potentiate the effects of anesthesia and analgesics, increasing the risk of excessive sedation or respiratory depression, necessitating physician awareness.
Question 5 of 5
While caring for a client in the second stage of labor, the nurse notices a pattern of early decelerations. The nurse should:
Correct Answer: D
Rationale: Early decelerations are benign, caused by fetal head compression during labor, and require only documentation, as they do not indicate fetal distress.