NCLEX-PN
NCLEX Trainer Test 5 Questions
Extract:
Question 1 of 5
When assessing a client who has just undergone a cardioversion, the practical nurse (LPN) finds the respirations are 12/minute. Which action should the nurse take first?
Correct Answer: D
Rationale: Continue to monitor respirations. A rate of 12/minute is acceptable post-cardioversion, requiring no immediate intervention.
Question 2 of 5
A client with MRSA is receiving Vanomycin (Vancocin) IV. If the client experiences 'red man' syndrome, the nurse should:
Correct Answer: A
Rationale: Red man syndrome is caused by rapid vancomycin infusion, leading to histamine release. Slowing the infusion and monitoring blood pressure manage symptoms. It's not normal, and discontinuing is unnecessary.
Question 3 of 5
Which playroom activities should the nurse organize for a small group of 7 year-old hospitalized children?
Correct Answer: A
Rationale: Sports and games with rules. The purpose of play for the 7 year-old is developing cooperation. Rules are very important. Logical reasoning and social skills are developed through play.
Question 4 of 5
An obstetrical client elects to have epidural anesthesia with Marcaine. After the epidural anesthesia is given, the nurse should monitor the client for signs of:
Correct Answer: C
Rationale: Marcaine (bupivacaine) can cause vasodilation, leading to postural hypotension. Seizures, respiratory depression, and hematuria are less common.
Extract:
A client with a new tracheotomy with a small amount of serosanguineous drainage on the dressing. A client who is responsive with a moderate amount of clear fluid draining from the NG tube. A client with a chest tube and dark red drainage in the collection chamber. A client who is unresponsive to verbal stimuli with the oral airway out of place.
Question 5 of 5
The nurse is caring for clients in the postanesthesia care unit (PACU). Which of the following clients require IMMEDIATE attention by the nurse?
Correct Answer: D
Rationale: Strategy: Remember the ABCs. (1) expected outcome, patient is stable (2) no indication of complications, stable client (3) expected outcome, gently 'milk' tubing in the direction of the drainage, if needed (4) correct-reinsert airway to maintain patent airway