NCLEX-PN
Reduction of Risk Potential NCLEX Questions
Extract:
Question 1 of 5
The nurse is caring for a client with a newly applied long leg cast. Which of these actions should the nurse take first to prevent complications from the cast?
Correct Answer: A
Rationale: Checking pedal pulses bilaterally is the first action to ensure adequate circulation and detect potential complications like compartment syndrome early.
Question 2 of 5
After a client has an enteral feeding tube inserted, the most accurate method for verification of placement is
Correct Answer: A
Rationale: abdominal x-ray. Placement should be verified by radiograph to determine that the tube is in the stomach or intestine rather than in the airways.
Question 3 of 5
A patient asks a nurse the following question. Exposure to TB can be identified best with which of the following procedures? Which of the following tests is the most definitive of TB?
Correct Answer: B
Rationale: The Mantoux is the most accurate test to determine the presence of TB.
Question 4 of 5
A nurse is reviewing a patient's ECG report. The patient exhibits a flat T wave, depressed ST segment and short QT interval. Which of the following medications can cause all of the above effects?
Correct Answer: D
Rationale: Digitalis can cause all of the listed ECG changes, including flat T waves, depressed ST segments, and shortened QT intervals, due to its effects on cardiac electrophysiology.
Question 5 of 5
A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia (MRSA). What type of isolation is most appropriate for this client?
Correct Answer: D
Rationale: Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected.