NCLEX-RN
Free NCLEX RN Exam Practice Questions Questions
Extract:
Question 1 of 5
When infusing total parenteral nutrition (TPN), the nurse should assess the client for which of the following complications?
Correct Answer: C,D
Rationale: TPN can cause hyperglycemia due to high glucose content and infection due to catheter use, both requiring vigilant monitoring.
Question 2 of 5
The nurse receives a client from the postanesthesia care unit who has had skeletal traction applied in the operating room. The nurse should take immediate action to correct which problem with the traction setup when it is noted?
Correct Answer: C
Rationale: The traction setup is checked to ensure that weights are hanging freely from the ropes and knots are tied securely. The weights should not be resting on the bed. Countertraction is commonly supplied by the client's body weight or by weights pulling in the opposite direction.
Therefore, there can be weights at both ends of the bed. Pin-site care varies but usually includes regularly removing exudate with half-strength hydrogen peroxide, rinsing pin sites with sterile saline, and drying the area with sterile gauze; the pin site is left open to air. If any problems are noted, they should be fixed immediately.
Question 3 of 5
Which of the following responses would be most appropriate for the nurse when comforting a primiparous client whose critically ill neonate delivered at 25 weeks dies while the mother is present?
Correct Answer: C
Rationale: Allowing the mother to stay with her baby and express herself supports grieving and closure, which is most appropriate in this situation.
Question 4 of 5
A neonate is to receive an I.V. infusion of normal saline solution at 3 mL/hour. The nurse is setting the alarms on an I.V. infusion pump. How should the nurse set the alarms?
Correct Answer: D
Rationale: For precise low-rate infusions like 3 mL/hour, the alarm should be set at the exact rate to ensure accuracy and detect deviations promptly. Infiltration alarms are not standard on most pumps.
Question 5 of 5
Which neurological complication can occur when a vest restraint is too tight around the client's body?
Correct Answer: A
Rationale: A too-tight vest restraint can cause strangulation, a life-threatening complication, by restricting breathing or neck movement.