NCLEX-PN
Nclex Practice Questions 2024 Questions
Extract:
Question 1 of 5
The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?
Correct Answer: C
Rationale: The most crucial assessment during the preoperative period for a client with a sacular abdominal aortic aneurysm scheduled for surgical repair is the identification of peripheral pulses. During surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities.
Therefore, it is essential for the nurse to assess peripheral pulses and monitor the return of circulation to the lower extremities postoperatively. Assessing the client's level of anxiety (
Choice
A) is important but not as crucial as ensuring adequate circulation. Evaluating exercise tolerance (
Choice
B) is not recommended preoperatively for this situation. Assessing bowel sounds and activity (
Choice
D) is of lesser concern compared to the critical need to monitor peripheral circulation.
Question 2 of 5
If the client is receiving peritoneal dialysis and the dialysate returns cloudy, what should the nurse do?
Correct Answer: B
Rationale: When the dialysate returns cloudy, it could indicate the presence of infection, and sending a specimen to the lab for evaluation is crucial to determine the cause. Documenting the finding alone, as in choice A, may not provide enough information for proper intervention. Straining the dialysate, as in choice C, is not a standard practice and may not help identify the underlying issue. Obtaining a complete blood count, as in choice D, is not directly related to addressing cloudiness in the dialysate. However, the healthcare provider might order a white blood cell count to assess for infection.
Question 3 of 5
After the client discusses her relationship with her father, the nurse says, "Tell me whether I am understanding your relationship with your father. You feel dominated and controlled by him?"? This is an example of:
Correct Answer: B
Rationale: Seeking consensual validation is the correct answer. Consensual validation is a technique used to check one's understanding of what the client has said. It involves confirming with the client whether the nurse's interpretation aligns with the client's feelings or thoughts. This process helps build rapport, trust, and a shared understanding between the nurse and the client. Verbalizing the implied (choice
A) refers to expressing the underlying or implicit meaning of a client's statement. Encouraging evaluation (choice
C) involves prompting the client to assess or judge a situation. Suggesting collaboration (choice
D) entails proposing working together with the client on a shared goal, which is not the primary focus in the scenario provided.
Question 4 of 5
The client with cirrhosis of the liver is receiving Lactulose. The nurse is aware that the rationale for the order for Lactulose is:
Correct Answer: C
Rationale: Lactulose is administered to the client with cirrhosis to lower ammonia levels, as it works by acidifying the colon, trapping ammonia for elimination in the stool.
Choices A, B, and D are incorrect because Lactulose does not have an effect on blood glucose, uric acid, or creatinine levels.
Therefore, the correct answer is to lower the ammonia level.
Question 5 of 5
A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?
Correct Answer: D
Rationale: The correct answer is a fresh peach. It is the most suitable snack for a client with sodium restriction as it is naturally low in sodium. Peanut butter cookies (choice
A), grilled cheese sandwich (choice
B), and cottage cheese and fruit (choice
C) contain higher amounts of sodium, making them unsuitable choices for someone on a low-sodium diet. Fresh fruits like peaches are excellent options for individuals on a low-sodium diet as they are not only low in sodium but also provide essential nutrients and hydration.