NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
Two weeks after a client's admission for depression, the physician orders a consult for electroconvulsive therapy (ECT). Which of the following conditions, if present, would be a contraindication for ECT?
Correct Answer: A
Rationale: A contraindication for ECT is a space-occupying lesion such as a brain tumor. During ECT, intracranial pressure increases.
Therefore, ECT would not be prescribed for a client whose intracranial pressure is already elevated.
Question 2 of 5
A 19-month-old child is admitted to the hospital for surgical repair of patent ductus arteriosus. The child is being given digoxin. Prior to administering the medication, the nurse should:
Correct Answer: C
Rationale: Digoxin should not be given to adults with an apical pulse <60 bpm. Digoxin should be given to children with an apical pulse >100 bpm. With a pulse <100 bpm, the medication should be withheld and the physician notified. Prior to digoxin administration in both children and adults, an apical pulse should be taken for 1 full minute. Aside from the rate per minute, the nurse should note any sudden increase or decrease in heart rate, irregular rhythm, or regularization of a chronic irregular heart rhythm. Early indications of digoxin toxicity, such as visual disturbances, occur rarely as initial signs in children.
Question 3 of 5
A client with a history of epilepsy is admitted with complaints of aura. The nurse should give priority to:
Correct Answer: A
Rationale: An aura signals an impending seizure, so ensuring safety (e.g., padding, side-lying position) is the priority.
Question 4 of 5
A type I diabetic client delivers a male newborn. The newborn is 45 minutes old. What is the primary nursing goal in the nursery during the first hours for this newborn?
Correct Answer: B
Rationale: The infant will be at risk for hypoglycemia because of excess insulin production.
Question 5 of 5
The client is admitted with a diagnosis of molar pregnancy. Which intervention is most appropriate?
Correct Answer: A
Rationale: Molar pregnancy involves abnormal trophoblastic tissue and no viable fetus often causing vaginal bleeding. Monitoring for bleeding is critical.
Tocolytics cesarean delivery and fetal monitoring are not indicated.