NCLEX-RN
NCLEX RN Reduction of Risk Potential Questions
Extract:
Question 1 of 5
The nurse is caring for a homeless client brought to the emergency department with a diagnosis of heat stroke. Which key features of heat stroke would the nurse expect to note upon assessment? Select all that apply.
Correct Answer: A,B,E
Rationale: Heat stroke presents with hyperthermia (>104°F,
A), tachycardia and hypotension (B, E) due to dehydration and vasodilation. Bradycardia (
C) and low respiratory rate (
D) are not typical.
Question 2 of 5
The nurse is preparing the client for a liver biopsy. Which statement by the client indicates a need for further instruction regarding the procedure?
Correct Answer: A
Rationale: Strenuous activity should be avoided for 1-2 weeks post-liver biopsy to prevent bleeding, indicating a need for further teaching.
Question 3 of 5
A 10-year-old is sent home from school with a report of having lice. The nurse should instruct the parent on which intervention?
Correct Answer: C
Rationale: An approved pediculicide (
C) is the standard treatment for head lice, following package directions. Dandruff shampoo (
A) is ineffective, isolation alone (
B) is insufficient, and shaving (
D) is unnecessary.
Question 4 of 5
A student nurse is discussing fluid overload with the staff nurse. Which statement by the student nurse indicates a need for further explanation by the staff nurse?
Correct Answer: A
Rationale: Pitting edema is one indicator, but not the best, as fluid overload is assessed holistically (e.g., crackles, distended veins). Other statements are accurate.
Question 5 of 5
The nurse is assisting the health care provider to perform a renal biopsy. Which position should the nurse place the client in?
Correct Answer: D
Rationale: The prone position with a pillow under the abdomen (
D) provides optimal access to the kidney and stabilizes the client during a renal biopsy.