NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
Which set of vital signs would best indicate to the nurse that a client has an increase in intracranial pressure?
Correct Answer: A
Rationale: Increased ICP is indicated by Cushing’s triad: hypertension (BP 180/70), bradycardia (pulse 50), and irregular respirations. Option A best matches this, with fever as a possible secondary sign. Options B, C, and D lack this combination.
Question 2 of 5
The nurse is caring for a client with a diagnosis of postpartum endometritis. Which intervention is most appropriate?
Correct Answer: A
Rationale: Postpartumndometritis require es antibiotics to treat the uterine infection. Fetal heart tones are irrelevant postpartum cesarean delivery is not indicated and tocolytics are for preterm labor.
Question 3 of 5
The client is diagnosed with a pneumothorax. Which finding is most expected on auscultation?
Correct Answer: B
Rationale: A pneumothorax causes collapsed lung tissue, resulting in diminished or absent breath sounds on the affected side. Crackles, wheezing, and rhonchi are not typical.
Question 4 of 5
Why is Phytonadione (vitamin K) administered to a newborn shortly after birth?
Correct Answer: D
Rationale: Newborns have low vitamin K levels, necessary for clotting factor synthesis. Phytonadione is given to facilitate clotting and prevent hemorrhagic disease of the newborn. It does not stop active hemorrhage, treat infections, or replace electrolytes.
Question 5 of 5
On the third postpartum day, the nurse would expect the lochia to be:
Correct Answer: A
Rationale: This discharge occurs from delivery through the 3rd day. There is dark red blood, placental debris, and clots. This discharge occurs from days 4-10. The lochia is brownish, serous, and thin. This discharge occurs from day 10 through the 6th week. The lochia is yellowish white. This is not a classification of lochia but relates to the amount of discharge.