NCLEX-PN
Quizlet NCLEX PN 2023 Questions
Extract:
Question 1 of 5
When assessing a client with early impairment of oxygen perfusion, such as a pulmonary embolus, the nurse should expect to find restlessness and which of the following symptoms?
Correct Answer: C
Rationale: When a client has early impairment of oxygen perfusion, such as in a pulmonary embolus, the nurse should expect to find restlessness, diaphoresis, tachycardia, and cool skin. Tachycardia is a compensatory mechanism to increase oxygen delivery to tissues. Cool, clammy skin (choice
A) is more indicative of impaired oxygen perfusion compared to warm, dry skin. Bradycardia (choice
B) is less likely to occur in the early stages and is more common in severe cases. Eupnea (choice
D) refers to normal respirations in rate and depth, which may not be altered in early impairment of oxygen perfusion.
Question 2 of 5
A healthcare professional is reviewing a patient's medical record. The record indicates the patient has limited shoulder flexion on the left. Which plane of movement is limited?
Correct Answer: B
Rationale: The correct answer is 'Sagittal.' The sagittal plane divides the body into left and right halves, and movements in this plane involve flexion and extension. In this case, limited shoulder flexion on the left indicates a restriction in the forward and backward movement of the arm, which occurs in the sagittal plane.
Choice A, 'Horizontal,' is incorrect as it refers to movements parallel to the ground.
Choice C, 'Frontal,' is incorrect as it involves side-to-side movements.
Choice D, 'Vertical,' is incorrect as it typically refers to up and down movements.
Question 3 of 5
A nurse is returning phone calls in a pediatric clinic. Which of the following reports most requires the nurse's immediate attention and phone call?
Correct Answer: A
Rationale: The correct answer is the 8-year-old boy with vomiting, slower movements, and a history of an atrioventricular shunt placement. This report requires immediate attention because the symptoms could indicate a blocked shunt, which is a serious medical condition needing urgent evaluation and intervention. Slower movements in the context of an atrioventricular shunt history could suggest increased intracranial pressure. The other choices involve less urgent issues: choice B describes post-exercise pain, choice C presents with a low-grade fever and headache that could be due to a mild infection, and choice D reports itching associated with a cast, which is a common issue and less critical compared to a potentially blocked shunt.
Question 4 of 5
A healthcare professional is screening patients for immunizations. Which of the following is not a contraindication for immunization?
Correct Answer: D
Rationale: The correct answer is D, 'Illness lasting more than 6 months.' Chronic conditions lasting more than 6 months are not considered a contraindication for immunization.
Choice A, 'Seizures,' can be a contraindication in certain situations, especially if linked to a specific vaccine component.
Choice B, 'Fever lasting more than 3 days,' can be a temporary precaution but not a general contraindication.
Choice C, 'Malignancy within the past 3 months,' is a contraindication due to the compromised immune system in cancer patients.
Question 5 of 5
When giving an intramuscular injection to an infant, which of the following sites is preferred?
Correct Answer: C
Rationale: The correct answer is the Vastus lateralis when giving an intramuscular injection to an infant. The Vastus lateralis muscle, located in the thigh, is the preferred site for infants as it has a larger muscle mass and is well-developed, making it suitable for injections. The Ventrogluteal region and Dorsogluteal region are not recommended for infants due to their smaller muscle mass and potential risk of damaging nearby structures. The Deltoid muscle is typically used for older children and adults, not infants.