NCLEX-RN
NCLEX RN Questions Medical Surgical Nursing Questions
Extract:
Question 1 of 5
Which activity should the nurse encourage the client to avoid when there is a risk for increased intracranial pressure (ICP)?
Correct Answer: C
Rationale: Coughing increases intrathoracic pressure, which can elevate ICP. Deep breathing, turning, and passive ROM are generally safe and may even help prevent complications like atelectasis or contractures if done gently.
Question 2 of 5
What instructions should the nurse provide to a client who develops cellulitis in the right arm after a right modified radical mastectomy?
Correct Answer: A
Rationale: Antibiotics for 1-2 weeks are the primary treatment for cellulitis, a bacterial infection, to prevent complications in a post-mastectomy client with lymphedema risk.
Question 3 of 5
The nurse explains to the client that a biopsy of the enlarged lymph node is important because, if Hodgkin's disease is present, the histologic examination will reveal which of the following?
Correct Answer: B
Rationale: Hodgkin's disease is diagnosed by the presence of Reed-Sternberg cells, large multinucleated cells, in the lymph node biopsy. Tay-Sachs and Duchenne's cells are unrelated to Hodgkin's.
Question 4 of 5
Which activity should the nurse encourage the client to avoid when there is a risk for increased intracranial pressure (ICP)?
Correct Answer: C
Rationale: Coughing increases intrathoracic pressure, which can elevate ICP. Deep breathing, turning, and passive ROM are generally safe and may even help prevent complications like atelectasis or contractures if done gently.
Question 5 of 5
When instructing a client who has been newly diagnosed with vasospastic disorder (Raynaud's phenomenon) about management of care, the nurse should discuss which of the following topics?
Correct Answer: C
Rationale: Raynaud's phenomenon is often associated with connective tissue diseases (e.g., scleroderma, lupus), especially secondary Raynaud's. Discussing follow-up monitoring for these conditions is essential for early detection and management. Sympathectomy, beta blockers, and angioplasty are not first-line or relevant interventions.