NCLEX-PN
NCLEX Trainer Test 5 Questions
Extract:
At an inpatient psychiatric unit, a 40-year-old woman insists on staying in her room and repeatedly comments to the nurse: 'Special agents are here. Maybe you are one.'
Question 1 of 5
Which of the following responses, if made by the nurse, is BEST?
Correct Answer: B
Rationale: Strategy: Remember therapeutic communication. (1) nontherapeutic, fails to respond to feeling tone, trust builds through interactions (2) correct-patient experiencing delusion (persistent false belief), responds to feeling tone, acknowledges that patient believes it to be true, represents reality (3) statement of reassurance, but denies acceptance of patient's feelings (4) should not encourage patient to explain delusions, would serve to reinforce them
Extract:
Question 2 of 5
The nurse is caring for a client who is postoperative day 1 after a thyroidectomy. Which of the following findings should the nurse report immediately?
Correct Answer: B
Rationale: A temperature of 100.8°F suggests infection, a serious post-thyroidectomy complication. Options A, C, and D are normal or expected.
Question 3 of 5
The nurse is caring for an adult who has kidney stones. Which action is essential for the nurse to take?
Correct Answer: D
Rationale: Straining urine captures kidney stones for analysis, guiding treatment. Blood pressure, bed rest, or positioning are not primary.
Question 4 of 5
The nurse has just returned to the desk and has four phone messages to return.
Correct Answer: B
Rationale: Heartburn radiating to the jaw in a man indicates possible chest pain, which could be a symptom of a myocardial infarction, a life-threatening condition requiring immediate medical attention. The other conditions (pregnancy-related heartburn, menopausal symptoms, and knee pain) are less urgent and can be addressed after ruling out a cardiac emergency.
Question 5 of 5
Which of the following instructions should be included in the pre-op teaching of a client scheduled for a transphenoidal hypophysectomy for the removal of a pituitary tumor?
Correct Answer: D
Rationale: Post-transphenoidal hypophysectomy, clients avoid brushing teeth for about a week to prevent disruption of the surgical site in the nasal cavity.