NCLEX-RN
Free NCLEX RN Exam Practice Questions Questions
Extract:
Question 1 of 5
You are caring for a client who has been assessed as having a past history of violent and dangerous behaviors towards others. You, as the nurse, are concerned about this client's past history and the dangers that may adversely affect others including staff, visitors and other clients on the unit. What is the first thing that you should do to prevent violence towards others?
Correct Answer: D
Rationale: Establishing trust is the first step in de-escalating potential violence, as it fosters a therapeutic relationship and reduces the client's anxiety or agitation, which could otherwise escalate into violent behavior.
Question 2 of 5
You are asked by your supervisor to take photographs of the residents and their family members who are attending a holiday dinner and celebration at your long term care facility. What should you do?
Correct Answer: C
Rationale: Taking photographs without the explicit consent of all residents and family members violates their privacy rights under HIPAA . Consent must be obtained to ensure compliance with privacy regulations.
Question 3 of 5
The nurse is caring for a client with a history of burns covering 30% of the body. Which of the following interventions should be prioritized?
Correct Answer: A
Rationale: I.V. fluids are the priority to replace fluid loss and prevent hypovolemic shock in burn injuries.
Question 4 of 5
A client with a suspected stroke is admitted to the emergency department. What is the nurse's priority action?
Correct Answer: B
Rationale: Assessing neurological status is the priority to establish a baseline and detect changes in a suspected stroke, guiding urgent interventions.
Question 5 of 5
Which of the following laboratory tests should the nurse monitor when the client is receiving warfarin sodium (Coumadin) therapy?
Correct Answer: D
Rationale: Warfarin therapy requires monitoring prothrombin time (PT) to assess anticoagulation effectiveness.