NCLEX-PN
NCLEX Trainer Test 6 Questions
Extract:
A 35-year-old woman one-day postpartum receiving butorphanol tartrate (Stadol) 1 mg IM.
Question 1 of 5
Which of the following actions is MOST important for the nurse to take after administering the medication?
Correct Answer: B
Rationale: Strategy: Determine the cause of each answer choice and how it relates to Stadol. (1) causes sedation, but not most important (2) correct-decreases rate and depth of respirations (3) diplopia and blurred vision are side effects, but not most important (4) not side effect of medication
Extract:
Question 2 of 5
A 78-year-old client is admitted in heart failure. Which assessment is essential for the nurse to make because the client is in heart failure? Select all that apply.
Correct Answer: B,D,E
Rationale: Persons who are in heart failure are at risk for developing pulmonary edema. The nurse should listen for lung sounds, check legs for pitting edema, which is common in heart failure, and observe respirations for severe dyspnea. Pedal pulses, upper extremity neuro checks, and gait disturbances are not related to heart failure or to pulmonary edema.
Question 3 of 5
The nurse is teaching the mother of a 5 month-old about nutrition for her baby. Which statement by the mother indicates the need for further teaching?
Correct Answer: C
Rationale: I dip his pacifier in honey so he'll take it.' Honey has been associated with infant botulism and should be avoided. Older children and adults have digestive enzymes that kill the botulism spores.
Extract:
A client with a diagnosis of a ruptured lumbar disc.
Question 4 of 5
The nurse should anticipate which of the following in assessing a client with a diagnosis of a ruptured lumbar disc?
Correct Answer: C
Rationale: Strategy: Think about each answer choice. (1) results from cervical lesions (2) can occur in a person who has been paralyzed from a spinal cord injury (3) correct-lumbar lesions can cause paresthesia, pain, muscle weakness, and atrophy in the lower extremities (4) is a sign of Huntington chorea, resulting from atrophy of parts of the brain
Extract:
Question 5 of 5
Which of the following findings is consistent with a diagnosis of congestive heart failure?
Correct Answer: A
Rationale: Jugular vein distention reflects increased fluid volume and right-sided heart failure, a hallmark of congestive heart failure. Other options are not specific to this condition.