NCLEX-RN
NCLEX RN Practice Questions Exam Cram Questions
Extract:
Question 1 of 5
What is the most common complication of chest wall injury?
Correct Answer: C
Rationale: Pneumonia is the most common complication of chest wall injury. Chest wall trauma can lead to impaired lung function, making patients more susceptible to pneumonia due to reduced ability to clear secretions and impaired breathing. While hemothorax and pneumothorax are potential complications of chest wall injury, pneumonia is more commonly encountered. Atelectasis, although a common pulmonary complication, is not typically the most common complication seen in chest wall injuries.
Question 2 of 5
After surgery for an imperforate anus, an infant returns with a red and edematous colostomy stoma. What action should the nurse take based on this finding?
Correct Answer: B
Rationale: A red and edematous colostomy stoma is a common finding immediately after surgery, and these changes are expected to decrease over time. As the stoma heals, it usually becomes pink without signs of abnormal drainage, swelling, or skin breakdown.
Therefore, the appropriate action for the nurse is to document these normal findings. Elevating the buttocks, applying ice, or calling the primary health care provider are unnecessary interventions at this stage.
Question 3 of 5
A nurse and client are discussing the client's progress toward understanding his behavior under stress. This is typical of which phase in the therapeutic relationship?
Correct Answer: C
Rationale: The correct answer is the working phase. During this phase, the nurse and client actively work together to explore alternative behaviors and techniques. Discussions in this phase focus on understanding the underlying meaning behind the behavior and implementing strategies for change. Pre-interaction (choice
A) refers to the phase before the nurse and client first meet and establish a relationship. The orientation phase (choice
B) involves introductions, setting goals, and establishing boundaries. Termination (choice
D) is the phase where the therapeutic relationship concludes, and closure is achieved.
Question 4 of 5
Which client is at highest risk for developing a pressure ulcer?
Correct Answer: C
Rationale: Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.
Question 5 of 5
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is:
Correct Answer: C
Rationale: Percutaneous transluminal coronary angioplasty (PTC
A) is a procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow. It is performed during a cardiac catheterization to improve coronary artery blood flow in a diseased artery. Surgical repair of a diseased coronary artery is typically done through procedures like aorto-coronary bypass graft (ACBG) rather than PTCA. Placement of an automatic internal cardiac defibrillator (AIC
D) is a different procedure used for managing cardiac arrhythmias. Non-invasive radiographic examination of the heart refers to procedures like echocardiography or cardiac MRI, not PTCA.