Questions 150

NCLEX-RN

NCLEX-RN Test Bank

Free NCLEX RN Exam Practice Questions Questions

Extract:


Question 1 of 5

You are serving as the supervisory nurse for a home healthcare agency in the community. You are doing an admission assessment for a 76 year old male client who resides with his elderly wife. Which of the following assessments would indicate that the couple needs some education relating to home safety?

Correct Answer: B

Rationale: The absence of scatter rugs is a safety feature, not a concern requiring education. Labeled foods , FIFO method , and annual smoke alarm battery replacement are all safe practices. However, the question implies a need for education, and B is the least directly related to a safety deficit, but no clear safety issue is present in the options provided.

Question 2 of 5

A client admitted in an acute psychotic state says that she hears terrible voices in the head and thinks her neighbor is out to get her. Which of the following is the nurse's best response?

Correct Answer: D

Rationale: Asking about the content of the voices helps assess the nature of the hallucinations and potential risks, guiding therapeutic intervention.

Question 3 of 5

A 13-year-old male was kidnapped and held for ransom by two criminals. His parents asked to have him admitted to the adolescent psychiatric unit. He is sleep-deprived, filthy, alternating between sobbing and making threats to kill his captors, and then asks to go to sleep. What is the best initial plan for this client?

Correct Answer: B

Rationale: Building trust and allowing the client to express feelings addresses immediate emotional needs and trauma, prioritizing mental health support.

Question 4 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 5 of 5

A client with a fractured femur is in skeletal traction. The nurse should assess for which of the following complications?

Correct Answer: A, D

Rationale: Fat embolism is a risk with long bone fractures, and pressure ulcers can develop due to immobility in traction.

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