NCLEX-RN
Medical Surgical NCLEX RN Questions
Extract:
Question 1 of 5
Which of the following will the nurse observe in the ictal phase of a generalized tonic-clonic seizure?
Correct Answer: D
Rationale: The ictal phase of a generalized tonic-clonic seizure is characterized by loss of consciousness, body stiffening (tonic phase), and violent muscle contractions (clonic phase). The other options describe focal or absence seizures.
Question 2 of 5
Which symptom suggests bladder cancer recurrence?
Correct Answer: C
Rationale: Hematuria is a common sign of bladder cancer recurrence.
Question 3 of 5
The client has a sustained increased intracranial pressure (ICP) of 20 mm Hg. Which client position would be most appropriate?
Correct Answer: A
Rationale: Elevating the head of the bed 30 to 45 degrees promotes venous drainage from the brain, reducing ICP. Trendelenburg's position increases ICP by impeding venous return, Sims position is unrelated to ICP management, and pillows may not ensure consistent elevation or neutral neck alignment.
Question 4 of 5
The nurse monitors the client with pancreatitis for early signs of shock. Which of the following conditions is primarily responsible for making it difficult to manage shock in pancreatitis?
Correct Answer: B
Rationale: Fluid sequestration into the retroperitoneal space (
B) causes significant hypovolemia in pancreatitis, complicating shock management. Intestinal hemorrhage (
A), infection (
C), and cardiac output (
D) are secondary or less common contributors.
Question 5 of 5
The nurse should teach the client who is receiving warfarin sodium that:
Correct Answer: C
Rationale: INR monitors warfarin's anticoagulant effectiveness, guiding dosage adjustments to prevent clotting or bleeding.