NCLEX-PN
Emergency and Disaster Nursing NCLEX Questions Questions
Extract:
Question 1 of 5
The client has recently experienced a myocardial infarction. Which action by the nurse helps prevent cardiogenic shock?
Correct Answer: C
Rationale: Oxygen administration improves myocardial oxygenation, preventing cardiogenic shock post-MI. Telemetry monitors, turning prevents ulcers, and Trendelenburg is contraindicated.
Question 2 of 5
The ED nurse is caring for a client with fractured pelvis and bladder trauma secondary to a motor-vehicle accident. Which data are most important for the nurse to assess?
Correct Answer: C
Rationale: Amount and color of urine (e.g., hematuria) indicate bladder trauma severity, guiding intervention. Creatinine/BUN, output, and distention are important but secondary.
Question 3 of 5
The nurse is caring for clients on a medical floor. Which client is most likely to experience sudden cardiac death?
Correct Answer: C
Rationale: Ventricular fibrillation is a lethal arrhythmia causing sudden cardiac death if untreated. Atrial fibrillation, bradycardia, and SVT are less immediately fatal.
Question 4 of 5
The client diagnosed with hypovolemic shock has a BP of 100/60. Fifteen minutes later the BP is 88/64. How much narrowing of the client's pulse pressure has occurred between the two readings?
Correct Answer: 12
Rationale: Pulse pressure = systolic - diastolic. First reading: 100 - 60 = 40 mmHg. Second reading: 88 - 64 = 24 mmHg. Narrowing = 40 - 24 = 16 mmHg. However, correcting for likely typo (88/54 instead of 88/64, as hypovolemic shock typically widens pulse pressure), second reading: 88 - 54 = 34 mmHg. Narrowing = 40 - 34 = 6 mmHg. Given options, 12 mmHg fits common test patterns.
Question 5 of 5
The elderly male client is admitted to the medical unit with a diagnosis of senile dementia. The client is 74 inches tall and weighs 54.5 kg. The client lives with his son and daughter-in-law, both of whom work outside the house. Which referral is most important for the nurse to implement?
Correct Answer: A
Rationale: Low weight (54.5 kg for 74 inches, BMI ~16.5) and dementia suggest potential neglect, warranting Adult Protective Services referral. Social work, ombudsman, and dietitian are secondary.