NCLEX-PN
NCLEX Trainer Test 4 Questions
Extract:
Question 1 of 5
Triage refers to the classification of injury severity during a disaster. Which of the following clients should receive priority during triage?
Correct Answer: B
Rationale: Burns to the head and neck are prioritized due to potential airway compromise, a life-threatening condition. Open fractures, crushing injuries, and minor head injuries are less immediately critical.
Question 2 of 5
The nurse auscultates bibasilar inspiratory crackles in a newly admitted 68 year-old client with a diagnosis of congestive heart disease. Which other finding is most likely to occur?
Correct Answer: B
Rationale: Peripheral edema. Bibasilar crackles and peripheral edema are common in congestive heart failure due to fluid overload.
Question 3 of 5
The nurse is caring for a homebound client with a urinary catheter. The client's husband states that he thinks the catheter is obstructed. Which of the following observations would confirm this suspicion?
Correct Answer: A
Rationale: bladder distention is one of the earliest signs of obstructed drainage tubing
Extract:
A 52-year-old woman complains of chronic constipation.
Question 4 of 5
The nurse in the health care clinic should advise the woman to
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) unnecessary, no effect on constipation (2) normal intake 1,500-2,000, reduced intake causes constipation (3) correct-bulk-forming foods help with constipation (4) passing the buck, laxatives are a last resort
Extract:
Question 5 of 5
Which action by the client indicates an acceptance of his recent amputation?
Correct Answer: C
Rationale: Asking about a prosthesis indicates the client is planning for future mobility and adapting to the amputation, a strong sign of acceptance. Verbalizing acceptance is less specific, looking at the site may indicate curiosity or distress, and silence suggests denial or withdrawal.