NCLEX-RN
NCLEX RN Practice Tests Questions
Extract:
Question 1 of 5
When using restraints for an agitated/aggressive patient, which of the following statements should NOT influence the nurse’s actions during this intervention?
Correct Answer: C
Rationale: the need for restraints is based on patient’s behavioral status and condition, not the patient’s voluntary/involuntary status
Question 2 of 5
A client has been on prolonged bedrest following surgery. The nurse notes that the patient has pain in the right calf on palpation with dorsiflexion of the ankle. Which of the following causes does the nurse suspect?
Correct Answer: D
Rationale: Calf pain with dorsiflexion (Homan's sign) suggests deep vein thrombosis (
D), common after prolonged bedrest. Arthritis (
A), muscle strain (
B), and compartment syndrome (
C) present differently.
Question 3 of 5
A woman has undergone a mastectomy of her right breast and has been brought to the recovery unit. The nurse explains that the client should
Correct Answer: A
Rationale: Elevating the arm on a pillow reduces lymphedema risk post-mastectomy by promoting lymphatic drainage.
Question 4 of 5
A home health nurse is making preparations for morning visits. Which one of the following clients should the nurse visit first?
Correct Answer: B
Rationale: Nighttime dyspnea suggests acute heart failure exacerbation, requiring priority.
Question 5 of 5
A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates understanding of phantom limb pain?
Correct Answer: B
Rationale: Phantom limb pain results from peripheral nervous system interruptions, and offering pain medication addresses the client's discomfort appropriately.