NCLEX NCLEX-RN
NCLEX RN Practice Questions Exam Cram
1. A client had a closed reduction of a fractured right wrist followed by the application of a fiberglass cast 12 hours ago. Which finding requires immediate attention?
- A. Capillary refill of fingers on right hand is 3 seconds
- B. Skin warm to touch and normally colored
- C. Client reports prickling sensation in the right hand
- D. Slight swelling of fingers of right hand
Correct answer: Client reports prickling sensation in the right hand
Rationale: A prickling sensation in the right hand is indicative of compartment syndrome, a serious condition that can lead to tissue damage and impaired circulation. Immediate attention is required to prevent complications. Capillary refill of 3 seconds, warm and normally colored skin, and slight swelling of fingers are expected findings after a closed reduction and casting. These findings do not typically indicate a critical issue and can be managed with routine monitoring.
2. What preparation should be made for a client undergoing a KUB (Kidney, Ureter, Bladder) radiography test?
- A. Client must be NPO before the examination
- B. Enema should be administered before the examination
- C. Medicate the client with furosemide 20 mg IV 30 minutes before the examination
- D. No special orders are necessary for this examination
Correct answer: No special orders are necessary for this examination
Rationale: The correct answer is that no special orders are necessary for a KUB radiography test. It is important to inform the client to remove any clothing, jewelry, or objects that may interfere with the test. Option A is incorrect because there is no need for the client to be NPO before this examination. Option B is incorrect as enemas are not routinely administered prior to a KUB radiography test. Option C is incorrect as there is no need to medicate the client with furosemide before this examination.
3. What action would be most appropriate for the nurse to minimize agitation in a disturbed client?
- A. Ensure minimal staff contact.
- B. Increase environmental sensory stimulation.
- C. Limit unnecessary interactions with the client.
- D. Discuss reasons for the client’s suspicions.
Correct answer: Limit unnecessary interactions with the client.
Rationale: The most appropriate action to minimize agitation in a disturbed client is to limit unnecessary interactions. This approach helps reduce stimulation, thus decreasing agitation. Constant staff contact can lead to increased stimulation and agitation. Increasing environmental sensory stimulation can overwhelm the client's senses and escalate agitation. Discussing suspicions may not be beneficial as not all disturbed clients are suspicious and the client may not be in a state to engage in such discussions effectively.
4. Which statement by an 8-year-old girl, who was just admitted to the hospital, needs to be explored?
- A. ''Wow! This hospital has bright colors.''
- B. ''Is my mother allowed to visit me tonight?'
- C. ''Those boys are so cute. I hope their room is next to mine!'
- D. ''I'm scared about being here. Can you stay with me awhile?'
Correct answer: ''Those boys are so cute. I hope their room is next to mine!'
Rationale: The correct answer is C. An 8-year-old child showing a strong attraction to boys at this age may raise concerns about precocious sexual behavior or exposure to inappropriate sexual content, potentially signaling the need to investigate for possible sexual abuse. It is important to explore this statement further. Choice A, expressing admiration for bright colors, is a common behavior for children of this age and does not raise immediate concerns. Choice B, inquiring about the mother's visit, is a typical concern for a hospitalized child seeking comfort and support. Choice D, expressing fear and seeking reassurance from the nurse, is also a normal reaction for an 8-year-old in a new and possibly intimidating environment. However, the statement in Choice C stands out as it deviates from age-appropriate behavior and warrants further exploration to ensure the child's safety and well-being.
5. A child is admitted to the hospital with a diagnosis of Wilms tumor, stage II. Which of the following statements most accurately describes this stage?
- A. The tumor is less than 3 cm in size and requires no chemotherapy.
- B. The tumor did not extend beyond the kidney and was completely resected.
- C. The tumor extended beyond the kidney but was completely resected.
- D. The tumor has spread into the abdominal cavity and cannot be resected.
Correct answer: The tumor extended beyond the kidney but was completely resected.
Rationale: In Wilms tumor staging, stage II indicates that the tumor extends beyond the kidney but is completely resected. This means that the tumor has spread beyond the kidney but has been successfully removed. Choices A and B are incorrect because a tumor less than 3 cm in size and a tumor that did not extend beyond the kidney do not align with the characteristics of stage II Wilms tumor. Choice D is also incorrect as it describes a more advanced stage where the tumor has spread into the abdominal cavity and cannot be completely resected. Therefore, the correct answer is C, as it accurately reflects the characteristics of a stage II Wilms tumor.
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