NCLEX-RN
Reduction of Risk Potential RN Nursing Questions
Extract:
Question 1 of 5
A nurse is teaching a client with left-sided hemiparesis to walk with a cane. The nurse should include which points about safe cane use when teaching the client? Select all that apply.
Correct Answer: A,C
Rationale: For left-sided hemiparesis, the cane is held in the stronger right hand (
A), and the cane moves with the weaker right leg (
C) for support. Left hand (
B) and left leg (
D) are incorrect.
Question 2 of 5
The nurse is performing discharging instruction for a female client with cystitis. Which statement by the client indicates a need for further teaching?
Correct Answer: C
Rationale: Spermicides can irritate the urethra and increase UTI risk, requiring further teaching. Other statements align with cystitis prevention and management.
Question 3 of 5
A client is having a tonic-clonic seizure. Which of the following should the nurse do first?
Correct Answer: D
Rationale: During a tonic-clonic seizure, the priority is to provide a safe environment (
D) by removing hazards to prevent injury. Restraining (
B) is unsafe, and turning (
C) or calling (
A) follow safety measures.
Question 4 of 5
The nurse is educating a client who has been ordered to wear a Holter monitor. Which statement by the client indicates a need for further education by the nurse?
Correct Answer: A
Rationale: Holter monitors are not waterproof and should not be worn while showering, indicating a need for further teaching.
Question 5 of 5
The nurse is caring for an adult client with a total bilirubin of 2.1 mg/dL. Which signs and symptoms would the nurse expect to find? Select all that apply.
Correct Answer: A,C
Rationale: Elevated bilirubin (2.1 mg/dL, normal 0.1-1.2) causes itchy skin (
A) and pale stools (
C) due to biliary obstruction or liver dysfunction. Nausea (
B) is less specific, and urine is typically dark, not colorless (
D).