NCLEX-PN
Best NCLEX Next Gen Prep Questions
Question 1 of 5
When a woman is receiving postpartum epidural morphine, the nurse should plan to observe for which of the following side effects to occur within the first 3 hours?
Correct Answer: B
Rationale: A side effect of postpartum epidural morphine is the onset of itching within 3 hours of injection and lasting up to 10 hours. Nausea and vomiting might occur 4-7 hours after injection. While urinary retention is a side effect of postpartum epidural morphine, it is not typically assessed within the first 3 hours. Somnolence is a rare side effect and not commonly observed within the first 3 hours. Therefore, itching is the most likely side effect to be observed within the initial 3 hours after administering postpartum epidural morphine.
Question 2 of 5
A client with Kawasaki disease has bilateral congestion of the conjunctivae, dry cracked lips, a strawberry tongue, and edema of the hands and feet followed by desquamation of fingers and toes. Which of the following nursing measures is most appropriate to meet the expected outcome of positive body image?
Correct Answer: C
Rationale: Educating the client and their family about the progression of Kawasaki disease is crucial for promoting a positive body image. By explaining when symptoms are expected to improve and resolve, the client and family can better understand that there will be no permanent disruption in physical appearance that could negatively impact body image. Administering immune globulin intravenously is a treatment for Kawasaki disease but does not directly address body image concerns. Assessing the extremities for edema, redness, and desquamation every 8 hours is important for monitoring the disease but does not directly address body image concerns. Assessing heart sounds and rhythm is essential for evaluating cardiac effects of Kawasaki disease but is not the most direct measure for promoting a positive body image.
Question 3 of 5
The goals of palliative care include all of the following except:
Correct Answer: C
Rationale: The goals of palliative care include choices A, B, and D. Choice C, 'no interventions are needed because the client is near death,' is not part of palliative care. Palliative care involves giving clients with life-threatening illnesses the best quality of life possible, taking care of the whole person"?body, mind, spirit, heart, and soul, and supporting the needs of the family and client. Interventions are crucial in palliative care to ensure the comfort and well-being of the client until the end of life. Therefore, the correct answer is that no interventions are needed because the client is near death.
Question 4 of 5
The nurse is teaching parents of a newborn about feeding their infant. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: The correct answer is to use the defrost setting on microwave ovens to warm bottles. It is essential for parents to be cautious when warming bottles in a microwave oven to prevent superheating of the milk. Choosing the defrost setting and checking the formula temperature before giving it to the baby helps avoid burns. Discarding partially used bottles after 24 hours when refrigerating formula is crucial as it reduces the risk of harmful bacterial growth. Mixing formula concentrate with water in a 1:1 ratio of one part concentrate to one part water ensures proper dilution of the formula. On the other hand, powdered formula should be mixed following the package instructions, typically using two parts water to one part powder. This accurate mixing ratio provides the necessary balance of nutrients for the baby. Adding fresh formula to partially used bottles can introduce pathogens that may harm the infant, underscoring the importance of discarding partially used bottles and preparing formula correctly. Therefore, options B, C, and D are incorrect as they do not address the safe and proper ways to feed a newborn effectively.
Question 5 of 5
A client with Kawasaki disease has bilateral congestion of the conjunctivae, dry cracked lips, a strawberry tongue, and edema of the hands and feet followed by desquamation of fingers and toes. Which of the following nursing measures is most appropriate to meet the expected outcome of positive body image?
Correct Answer: C
Rationale: Explaining the progression of the disease to the client and their family is the most appropriate nursing measure to promote a positive body image. By educating them about when symptoms are expected to improve and resolve, they can understand that there will be no permanent disruption in physical appearance that could negatively impact body image. While administering immune globulin intravenously may be part of the treatment for Kawasaki disease, it does not directly address body image concerns. Assessing the extremities for edema, redness, and desquamation every 8 hours is important for monitoring the disease but does not directly impact body image. Assessing heart sounds and rhythm is crucial for monitoring cardiac effects of Kawasaki disease but is not directly related to promoting a positive body image.