NCLEX-PN
NCLEX Question of The Day Questions
Question 1 of 5
A child with newly diagnosed leukemia is receiving chemotherapy. Which would be included in his plan of care by the nurse?
Correct Answer: D
Rationale: The correct answer is to teach family and visitors handwashing techniques. Any client on chemotherapy should have good infection control measures in place, such as handwashing by all who they encounter. Placing the child in a negative pressure isolation room (
Choice
A) is not necessary unless specifically indicated for a certain condition. Administering prophylactic IV antibiotics (
Choice
B) may not be part of the standard care plan for a child with leukemia receiving chemotherapy. Avoiding high protein food intake (
Choice
C) is not directly related to infection control and may not be necessary unless there are specific dietary restrictions.
Question 2 of 5
The nurse is preparing for a dressing change on a full thickness burn to the flank area. The orders include irrigating the wound with each dressing change. To irrigate the wound, what will the nurse use?
Correct Answer: A
Rationale: When irrigating a wound, especially in the case of a full-thickness burn, it is crucial to use a solution that is gentle and non-irritating to the tissues. Sterile saline is the preferred choice for wound irrigation as it is isotonic and does not cause additional damage to the already compromised tissue. Distilled water lacks the electrolytes present in saline, Betadine scrub is not used for irrigation due to its potential to be cytotoxic, and tap water may introduce contaminants and microorganisms to the wound.
Question 3 of 5
While Fluorouracil (5FU®) is being infused, a client complains of burning at the IV site. What should the nurse do first?
Correct Answer: C
Rationale: The correct first action for the nurse is to inspect the IV site. This is important to assess for any signs of infiltration or extravasation, which could be causing the burning sensation. Aspirating the IV site for blood return (
Choice
A) may not be the initial priority as it does not directly address the client's complaint of burning. Slowing the infusion (
Choice
B) may help alleviate discomfort but should not be done before inspecting the site. Stopping the infusion (
Choice
D) may be necessary, but inspecting the site should come first to determine the appropriate course of action.
Question 4 of 5
What should the nurse do while caring for a client with an eating disorder?
Correct Answer: D
Rationale: The correct answer is to monitor food intake and behavior for one hour after meals. This is crucial in caring for a client with an eating disorder as it helps in assessing any immediate risks related to the disorder. Option A is incorrect as it may trigger additional stress for the client and distract from the main focus of managing the disorder. Option B, weighing the client daily, could lead to an unhealthy focus on weight and potentially worsen the client's mental health. Option C, restricting access to mirrors, although it may be beneficial for body image concerns, does not directly address the core issue of monitoring food intake and behavior, which is essential in managing eating disorders.
Question 5 of 5
The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?
Correct Answer: D
Rationale: The correct answer is 'Anxiety.' Anxiety is not a typical sign of right-sided heart failure. Right-sided heart failure usually presents with symptoms such as muscle tetany, syncope, and numbness. Muscle tetany can occur due to electrolyte imbalances seen in heart failure. Syncope can result from decreased cardiac output, leading to decreased perfusion to the brain. Numbness can occur due to poor circulation. While anxiety can be present in patients with various medical conditions, it is more commonly associated with respiratory acidosis or other psychological factors rather than right-sided heart failure.