NCLEX-RN
NCLEX RN Exam Prep Questions
Extract:
Question 1 of 5
Which of the following interventions is most appropriate for a client with a diagnosis of Risk for Activity Intolerance?
Correct Answer: C
Rationale: The most appropriate intervention for a client diagnosed with Risk for Activity Intolerance is to minimize environmental noise. Environmental noise can increase the energy demand on the client as they try to manage their responses to stimuli. By reducing excess noise, the nurse helps promote rest and conserves the client's energy, which is crucial in managing activity intolerance.
Choice A is incorrect because increasing nursing activities may exacerbate the client's intolerance to activity.
Choice B is incorrect as assessing for signs of increased muscle tone does not directly address the issue of activity intolerance.
Choice D is incorrect as teaching the Valsalva maneuver is not relevant to managing activity intolerance in this scenario.
Question 2 of 5
A client is being assisted to lie in the Sims' position. In what position does the nurse arrange the client?
Correct Answer: A
Rationale: The Sims' position is a side-lying position used for examinations or comfort. In the Sims' position, the client lies on their side with the upper leg flexed. The abdomen is slightly downward, and the lower arm is positioned behind the body. A pillow can be used to support the leg.
Choice B is incorrect as it describes a position with the client lying on their back with the head lower than the feet.
Choice C is incorrect as it describes a prone position, not the Sims' position.
Choice D is incorrect as it describes a sitting position, not the Sims' position.
Question 3 of 5
A client is undergoing range of motion exercises, and the nurse moves the leg in a pattern of circumduction. Which movement is the nurse performing?
Correct Answer: C
Rationale: Circumduction involves moving a limb in a circular pattern. In this scenario, the nurse is performing circumduction by moving the leg in a circular motion, engaging the muscles of the gluteus maximus and gluteus medius.
Choice A, 'Bending the leg at the knee,' is incorrect as it describes flexion and extension movements.
Choice B, 'Turning the foot inward and outward,' refers to inversion and eversion movements of the foot, not circumduction.
Choice D, 'Moving the leg forward and up,' describes flexion and abduction movements, not circumduction.
Question 4 of 5
Which of the following signs or symptoms indicates a possible nutritional deficiency?
Correct Answer: D
Rationale: A client with poor nutritional intake may have pale mucous membranes surrounding the eye, or the conjunctiva. This area should normally be pink, indicating good circulation and a lack of irritation or dryness. Improper nutrition can manifest as numerous signs in the body, including bowed legs, pale mucous membranes, a smooth or beefy tongue, and poor muscle tone. Subcutaneous fat at the waist and abdomen is not a sign of nutritional deficiency but rather of excess fat deposition. The presence of papillae on the surface of the tongue is normal and not indicative of a nutritional deficiency. Straight arms and legs are also typical anatomical features and not specifically related to nutritional deficiencies.
Question 5 of 5
A client is complaining of pain that starts in the shoulder and travels down the length of his arm. This type of pain is referred to as:
Correct Answer: C
Rationale: Radiating pain is the correct term for pain that originates in one part of the body and extends to other related areas. In this scenario, the pain starting in the shoulder and traveling down the arm describes radiating pain. Referred pain (
Choice
A) is pain felt at a site different from the actual origin of the pain. Superficial pain (
Choice
B) is pain that arises from the skin or tissues just beneath it. Precipitating pain (
Choice
D) refers to pain that is triggered by specific actions or events, not the characteristic described in the question.