NCLEX-RN
NCLEX RN Exam Prep Questions
Extract:
Question 1 of 5
Your patient has finished a 12-ounce can of iced tea and 8 ounces of fresh orange juice. What will you record on the Intake and Output form for this patient's intake?
Correct Answer: C
Rationale: You will record 600 cc of fluid intake. There are 600 cc in 20 ounces (12 ounces of iced tea + 8 ounces of orange juice) of fluid intake.
Choice A and B are incorrect as they do not reflect the correct conversion of fluid intake from ounces to cubic centimeters.
Choice D is incorrect as it provides the measurement in cubic centimeters but does not account for the total fluid intake accurately.
Question 2 of 5
Your patient has finished a 12-ounce can of iced tea and 8 ounces of fresh orange juice. What will you record on the Intake and Output form for this patient's intake?
Correct Answer: C
Rationale: You will record 600 cc of fluid intake. There are 600 cc in 20 ounces (12 ounces of iced tea + 8 ounces of orange juice) of fluid intake.
Choice A and B are incorrect as they do not reflect the correct conversion of fluid intake from ounces to cubic centimeters.
Choice D is incorrect as it provides the measurement in cubic centimeters but does not account for the total fluid intake accurately.
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
A client is being instructed on how to use crutches. Which of the following information should be included in the teaching?
Correct Answer: B
Rationale: When instructing a client on how to use crutches for ambulation, it is important to emphasize keeping the crutch tips dry to prevent slipping while bearing weight on them. Moisture on the crutch tips can lead to accidents.
Therefore, the correct answer is to dry the crutch tips with a paper towel if they become wet.
Choice A, placing the majority of body weight on the axilla, is incorrect as the weight should be borne through the hands, not the axilla, to avoid nerve damage.
Choice C, using the crutches to lift both feet simultaneously when ascending stairs, is incorrect as the client should ascend stairs by placing weight on the unaffected leg first, followed by the crutches and then the affected leg. This method provides stability and safety during stair climbing.
Question 5 of 5
When assisting a client with shampooing his hair while he is still in bed, a nurse raises the bed to approximately the level of her waist. What is the rationale for this action?
Correct Answer: C
Rationale: Raising the bed to the level of the nurse's waist while assisting a client with shampooing in bed is done to reduce strain on the nurse's back. This adjustment ensures that the nurse can work comfortably without excessive bending or stooping, thus preventing back injuries.
Choices A, B, and D are incorrect. While preventing shampoo from getting into the client's eyes, allowing excess water to run off the bed, and preventing hair tangles are important considerations, the primary rationale for raising the bed is to prioritize the nurse's ergonomic safety and prevent musculoskeletal strain.