NCLEX-PN
NCLEX Trainer Test 5 Questions
Extract:
Question 1 of 5
Which of the following nursing interventions is MOST important when caring for a client who has just been placed in physical restraints?
Correct Answer: B
Rationale: assessment; while a client is restrained, physiological integrity is important; monitoring positioning, tightness, and peripheral circulation is essential; nurse documents the client's response and clinical status after being restrained
Question 2 of 5
A client is readmitted with a recurrent urinary tract infection. The client is to be discharged home on methenamine mandelate (Mandelamine). The nurse should instruct the client to limit intake of which of the following fluids?
Correct Answer: A
Rationale: should limit intake of alkaline foods and fluids, such as milk
Question 3 of 5
The nurse performs an assessment of an 8-year-old girl diagnosed with scoliosis.
Correct Answer: A
Rationale: Scoliosis causes lateral spinal curvature, leading to thoracic asymmetry. Waddling gait is associated with hip issues, edema with circulatory problems, and a protruding sternum with pectus carinatum, none of which are typical of scoliosis.
Question 4 of 5
The nurse is caring for a client with a history of heart failure who is receiving spironolactone (Aldactone) 25 mg PO daily. Which of the following client statements would be of GREATest concern to the nurse?
Correct Answer: C
Rationale: Muscle cramps suggest hyperkalemia, a serious side effect of spironolactone, a potassium-sparing diuretic, requiring immediate evaluation to prevent arrhythmias. Options A, B, and D are less concerning: fatigue and dry mouth are nonspecific, and taking with food is acceptable.
Question 5 of 5
The nurse is caring for a 1 year-old child who has 6 teeth. What is the best way for the nurse to give mouth care to this child?
Correct Answer: A
Rationale: Using a moist soft brush or cloth to clean teeth and gums. The nurse should use a soft cloth or soft brush to do mouth care so that the child can adjust to the routine of cleaning the mouth and teeth.