NCLEX-RN
NCLEX-RN Exam Practice Questions
Question 1 of 5
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
Correct Answer: A
Rationale: Positive inotropic agents should not be administered owing to their action of increasing myocardial contractility. Increased ventricular contractility would increase outflow tract obstruction in the client with hypertrophic cardiomyopathy. Vasodilators are not typically prescribed but are not contraindicated. Diuretics are used with caution to avoid causing hypovolemia. Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.
Question 2 of 5
A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:
Correct Answer: A
Rationale: A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. Proper identification of the recipient and the blood product must be validated by at least two people.
Question 3 of 5
A 3-year-old female client is brought into the pediatric clinic because she limps. She has not been to the clinic since she was 9 months old. The nurse practitioner describes the limp as a 'Trendelenburg gait.' This gait is characteristic of:
Correct Answer: B
Rationale: (A, C,
D) A Trendelenburg gait is not characteristic of any of these disorders. The downward slant of one hip is a positive sign of dislocation in the weight-bearing hip. If one hip is dislocated, the child walks with a characteristic limp known as the Trendelenburg gait.
Question 4 of 5
A client with a history of asthma is admitted with an acute exacerbation. The nurse should give priority to:
Correct Answer: A
Rationale: Bronchodilators are the first-line treatment for an acute asthma exacerbation to relieve bronchospasm and improve airflow.
Question 5 of 5
A client is pregnant for the fourth time and has had three normal vaginal deliveries. She is in active labor and fully dilated. Suddenly she calls, 'Nurse, the baby is coming.' As the nurse responds to her call, which one of the following observations should the nurse make first?
Correct Answer: A
Rationale: The nurse must assess the labor status to determine if birth is imminent. The nurse may note perineal bulging, crowning, or birth of the head to ascertain labor status. Assessing uterine contractions is one intervention to ascertain labor status. Based on the client's cry, it is not the intervention of choice. If delivery of the infant is imminent, preparing a clean or sterile area for delivery is appropriate, but labor status must be established, whether delivery is imminent, by perineal assessment. Assessing FHR is one intervention to ascertain fetal well-being. Based on the client's cry, this is not the intervention of choice.