NCLEX-RN
NCLEX RN Practice Questions Quizlet Questions
Extract:
Question 1 of 5
When assessing the client with acute arterial occlusion, the nurse would expect to find:
Correct Answer: B
Rationale: Acute arterial occlusion causes ischemia, leading to cyanosis or blackened areas (gangrene) in distal areas like the toes due to lack of blood flow.
Question 2 of 5
The nurse is caring for a client with a history of stroke who has dysphagia. Which of the following interventions should the nurse implement to prevent aspiration?
Correct Answer: C
Rationale: thickening liquids to a nectar-like consistency reduces the risk of aspiration in clients with dysphagia
Question 3 of 5
The nurse begins administration of blood to a client on a medical unit. The nurse knows that which of the following activities is inappropriate to delegate to the unlicensed assistive personnel (UAP)?
Correct Answer: C
Rationale: Explaining the reason for a transfusion requires clinical knowledge and is outside the UAP’s scope. Other tasks are appropriate for delegation.
Question 4 of 5
A client is scheduled for a CT with and without contrast to rule out diverticulitis. Which medication on the client's medication list would be of concern to the nurse?
Correct Answer: C
Rationale: Metformin should be held before and after contrast CT due to the risk of lactic acidosis if renal function is impaired by contrast dye.
Question 5 of 5
A client arrives in the emergency room after a motor vehicle accident. Witnesses tell the nurse that they observed the client's head hit the side of the car door. Nursing assessment findings include BP 70/34, heart rate 130, and respirations 22. Which is the client's most appropriate priority nursing diagnosis?
Correct Answer: B
Rationale: Hypotension (BP 70/34) and tachycardia (HR 130) indicate hypovolemic shock, likely from blood loss. Fluid volume deficit is the priority diagnosis to address life-threatening hypovolemia.