NCLEX Questions, NCLEX Trainer Test 4 Questions, NCLEX-PN Questions, Nurselytic

Questions 157

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Extract:

A 25-year-old woman after a vaginal delivery.


Question 1 of 5

Which of the following is the FIRST nursing action that should be implemented for a 25-year-old woman after a vaginal delivery?

Correct Answer: A

Rationale: Strategy: 'FIRST' indicates that this is a priority question. Remember the ABCs. (1) correct-complication of hemorrhage assessed by observing lochial flow (2) done to assist its natural clamping-down action, assessed as firm or boggy (3) must meet physical needs first (4) not first action, hemorrhage most important complication

Extract:


Question 2 of 5

A client is being discharged following insertion of a permanent set pacemaker. A client with a permanent set pacemaker should be taught:

Correct Answer: C

Rationale: Modern pacemakers adjust their rate based on activity (rate-responsive pacing), so the client should understand that increased activity may require pacemaker adjustments.

Question 3 of 5

The nurse is caring for a client who is receiving IV fluids at 125 mL/hour. Which of the following findings should the nurse report immediately?

Correct Answer: C

Rationale: Shortness of breath and crackles suggest fluid overload, a serious complication. Options A, B, and D are normal.

Question 4 of 5

The nurse is teaching a client with asthma about the use of a metered-dose inhaler. Which of the following instructions should the nurse include?

Correct Answer: C

Rationale: Shaking the inhaler ensures proper medication dispersion. Options A, B, and D are incorrect techniques or schedules.

Question 5 of 5

The nurse is caring for a client who is receiving IV ceftriaxone for a urinary tract infection. Which of the following findings would be of GREATest concern to the nurse?

Correct Answer: B

Rationale: A temperature of 100.4°F suggests worsening infection or inadequate antibiotic coverage, requiring immediate evaluation. Options A, C, and D are less concerning: WBC 12,000/mm^3 is expected, urine output 50 mL/hour is normal, and blood pressure 120/80 mmHg is stable.

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