Basic Care and Comfort NCLEX Questions | Nurselytic

Questions 42

NCLEX-PN

NCLEX-PN Test Bank

Basic Care and Comfort NCLEX Questions Questions

Extract:


Question 1 of 5

The nurse is turning a client who has a new prosthetic hip. Which position should be avoided to prevent injury to the new prosthetic hip?

Correct Answer: B

Rationale: New prosthetic hips should have an abduction pillow in place to avoid adduction.

Question 2 of 5

The goals of palliative care include all of the following except:

Correct Answer: C

Rationale: The goals of palliative care include choices A, B, and D.
Choice C is not part of palliative care. All aspects of medical, emotional, social, and spiritual needs of the dying client should be focused on until the end of life.

Question 3 of 5

A client with major head trauma is receiving bolus enteral feeding. The most important nursing order for this client is:

Correct Answer: A

Rationale: Measuring intake and output assesses fluid balance, critical in enteral feeding to prevent dehydration or fluid overload due to hyperosmotic feedings.

Question 4 of 5

A client is on a clear liquid diet. She drinks half of a 12-ounce juice, 4 ounces of soup, and has a 6-ounce JELLO0. How many milliliters of fluid did the patient ingest?

Correct Answer: B

Rationale: 1 ounce = 30 ml, so Juice, 6 ounces (half of 12 oz) × 30 = 180 ml (Remember that oz is an abbreviation for ounces.) Soup, 4 ounces × 30 = 120 ml JELL-OB, 6 ounces × 30 = 180 ml 180 + 120 + 180 = 480 ml Note that gelatin, ice cream, and other things that are liquid at room temperature are counted as fluids.

Question 5 of 5

Before ambulating the client for the first time, the nurse obtains the client's BP with an automatic BP machine. Which actions should the nurse take first when obtaining a BP reading of 86/56 mm Hg and pulse rate of 64 bpm?

Correct Answer: A

Rationale: A: Assessing for hypotension symptoms like dizziness or cold extremities is priority. B: Retaking BP follows assessment. C: Ambulating risks falls with hypotension. D: Reviewing records is secondary.

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