NCLEX Questions, NCLEX RN Practice Tests Questions, NCLEX-RN Questions, Nurselytic

Questions 149

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Extract:


Question 1 of 5

While terminating the therapeutic nurse-client relationship, which action should be avoided?

Correct Answer: A

Rationale: Raising a new issue at termination can disrupt closure and hinder the client’s ability to process the end of the relationship.

Question 2 of 5

The newly licensed nurse has been asked to perform a procedure that he feels unqualified to perform. The nurse's best response at this time is to:

Correct Answer: B

Rationale: Refusing and explaining the lack of qualification ensures patient safety and adheres to ethical standards.

Question 3 of 5

A client has been on prolonged bedrest following surgery. The nurse notes that the patient has pain in the right calf on palpation with dorsiflexion of the ankle. Which of the following causes does the nurse suspect?

Correct Answer: D

Rationale: Calf pain with dorsiflexion (Homan's sign) suggests deep vein thrombosis (
D), common after prolonged bedrest. Arthritis (
A), muscle strain (
B), and compartment syndrome (
C) present differently.

Question 4 of 5

The nurse is caring for a client receiving supplemental oxygen. The effectiveness of the oxygen therapy is best determined by:

Correct Answer: C

Rationale: Arterial blood gases provide a direct measure of oxygenation and are the most accurate way to evaluate the effectiveness of oxygen therapy.

Question 5 of 5

A client on a 72-hour psychiatric hold experiences a panic attack while getting ready for the day. The nurse should provide the following interventions ranked by priority:

Order the Items

Source Container

stay with the client until the panic attack is over
incorporate physical activity into the client's daily routine
instruct the client to take slow, deep breaths
reduce external stimuli in the immediate area
work with the client to develop coping mechanisms

Correct Answer: A,D,C,E,B

Rationale: Priority order: Stay with the client (
A) for safety, reduce stimuli (
D) to calm the environment, instruct deep breathing (
C) to manage symptoms, develop coping mechanisms (E) for future prevention, and incorporate physical activity (
B) as a long-term strategy.

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