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

Questions 164

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Question 1 of 5

To maintain Bryant's traction, the nurse must make certain that the child's:

Correct Answer: B

Rationale: Bryant's traction requires hips slightly elevated and legs at a right angle to the bed to align the femur properly and reduce pressure on the pelvis.

Question 2 of 5

The nurse is performing rounding on clients in restraints. Which situation would require immediate intervention by the nurse?

Correct Answer: D

Rationale: A vest restraint in the high-Fowler position (
D) poses a risk of strangulation or asphyxiation due to the restraint slipping upward, requiring immediate intervention. Belt restraint in semi-Fowler (
A), mitten restraints in side-lying (
B), and wrist restraints in supine (
C) are safer positions, assuming proper application and monitoring.

Question 3 of 5

The office nurse receives 4 telephone messages from clients. Which client does the nurse anticipate as the priority for treatment?

Correct Answer: C

Rationale: Headaches and gait disturbance in a 78-year-old on warfarin post-fall (
C) suggest a possible subdural hematoma, a life-threatening condition requiring immediate evaluation. Bull’s-eye rash (
A) suggests Lyme disease, vaginal discharge (
B) indicates yeast infection, and diarrhea (
D) is a colchicine side effect, all less urgent.

Question 4 of 5

The emergency room nurse admits a child who experienced a seizure at school. The parent comments that this is the first occurrence and denies any family history of epilepsy. What is the best response by the nurse?

Correct Answer: B

Rationale: The seizure may or may not mean your child has epilepsy. A single seizure has multiple potential causes, not necessarily epilepsy.

Question 5 of 5

A client is being discharged after receiving an implantable cardioverter defibrillator. Which statement by the client indicates that teaching has been effective?

Correct Answer: B

Rationale: Avoiding hair-fixing (
B) prevents arm movement that could dislodge leads, showing effective teaching. Device firing (
A) can be uncomfortable, driving (
C) is restricted temporarily, and air travel (
D) is generally safe with precautions.

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