NCLEX-PN
Health Promotion and Maintenance NCLEX Questions Questions
Extract:
Question 1 of 5
A pregnant client asks a nurse about the use of noninvasive acupressure as a complementary alternative therapy to relieve nausea. The nurse provides which instruction?
Correct Answer: C
Rationale: The correct answer is 'Devices that apply pressure alone are available over the counter.' Acupressure over the Neiguan acupuncture point can be used as a complementary alternative therapy to relieve nausea during pregnancy. It can be performed with devices that apply pressure alone, which are available over the counter. Acupressure devices that apply electrical impulses over this point require a prescription. It is not safe to try any type of complementary alternative therapy during pregnancy, as some may be harmful to the mother and fetus.
Therefore, the nurse should instruct the client about the availability of over-the-counter pressure devices for acupressure, which are generally safe to use.
Question 2 of 5
The home health nurse has made a visit to an 85-year-old female client's home who has recently had surgery to replace her left knee. The client has been discharged from a rehab facility and has been able to walk on her own. The nurse assesses the need for teaching related to fall prevention. What should the nurse include in this teaching plan?
Correct Answer: A
Rationale: Rugs and clutter are a primary cause of falls in the home and should be eliminated if possible to decrease the risk of a fall.
Question 3 of 5
An Rh-negative woman with previous sensitization has delivered an Rh-positive fetus. Which of the following nursing actions should be included in the client's care plan?
Correct Answer: A
Rationale: In this scenario, the Rh-negative woman has been sensitized, posing a risk to any Rh-positive fetus she delivers. The most appropriate nursing action is to provide emotional support to help the family cope with the infant's condition. This includes addressing potential outcomes like death or neurological damage. Administering MICRhoGam (
Choice
B) to a sensitized woman is not recommended; it is only given post-abortion or ectopic pregnancy to prevent sensitization. Rh-immune globulin is not administered to the newborn (
Choice
C) in this case. Analyzing the maternal Direct Coombs' test (
Choice
D) is unnecessary; instead, an Indirect Coombs' test is used to assess sensitization.
Therefore, the correct nursing action is to offer emotional support to the family, acknowledging the challenges they may face.
Question 4 of 5
Which of the following arterial blood gas values indicates a patient may be experiencing a condition of metabolic acidosis?
Correct Answer: B
Rationale: The bicarbonate value is below normal (15, normal range 22-26 mEq/L), indicating a condition of metabolic acidosis.
Question 5 of 5
A client has a 10 % dextrose in water IV solution running. He is scheduled to receive his antiepileptic drug, phenytoin (Dilantin), at this time. The nurse knows that the phenytoin:
Correct Answer: D
Rationale: Phenytoin and dextrose will precipitate. Normal saline is used to flush before and after phenytoin administration. The administration of an antiepileptic drug cannot be delayed to maintain a therapeutic blood level.