NCLEX-RN
NCLEX RN Practice Questions Exam Cram
1. A patient is on bedrest 24 hours after a hip fracture. Which regular assessment or intervention is essential for detecting or preventing the complication of Fat Embolism Syndrome?
- A. Performing passive, light range-of-motion exercises on the hip as tolerated.
- B. Assess the patient's mental status for drowsiness or sleepiness.
- C. Assess the pedal pulse and capillary refill in the toes.
- D. Administer a stool softener as ordered.
Correct answer: B
Rationale: In detecting or preventing Fat Embolism Syndrome (FES), assessing the patient's mental status for drowsiness or sleepiness is crucial. Decreased level of consciousness is an early sign of FES due to decreased oxygen levels. Performing passive, light range-of-motion exercises on the hip may not directly relate to FES. Assessing pedal pulse and capillary refill in the toes is essential for assessing circulation but not specific to detecting FES. Administering a stool softener, while important for preventing constipation in immobilized patients, is not directly related to detecting or preventing FES.
2. Which of the following techniques can help to prevent skin irritation or breakdown around a tracheostomy site?
- A. Manage secretions by providing suction on a regular basis
- B. Cleanse the site daily with a mixture of povidone-iodine and water
- C. Avoid using tube ties to secure the tube
- D. None of the above
Correct answer: A
Rationale: Excess secretions from the tracheostomy tube can collect near the stomal opening and cause skin breakdown. Management of secretions through regular suctioning will keep the area clean and dry, minimizing skin irritation. Choice B, cleansing the site daily with povidone-iodine and water, is incorrect as it may lead to skin irritation due to the harshness of povidone-iodine. Choice C, avoiding tube ties to secure the tube, is also incorrect as securing the tube is essential for stability. Choice D, 'None of the above,' is incorrect as managing secretions through suctioning is crucial in preventing skin irritation.
3. The nurse provides discharge instructions to a patient who was hospitalized for pneumonia. Which statement, if made by the patient, indicates a good understanding of the instructions?
- A. I will call the doctor if I still feel tired after a week.
- B. I will continue to do the deep breathing and coughing exercises at home.
- C. I will continue to do the deep breathing and coughing exercises at home.
- D. I'll cancel my chest x-ray appointment if Im feeling better in a couple weeks
Correct answer: C
Rationale: Patients should continue to cough and deep breathe after discharge. Fatigue is expected for several weeks. The Pneumovax and influenza vaccines can be given at the same time in different arms. Explain that a follow-up chest x-ray needs to be done in 6 to 8 weeks to evaluate resolution of pneumonia.
4. A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection?
- A. Trichomoniasis
- B. Chlamydia
- C. Staphylococcus
- D. Streptococcus
Correct answer: B
Rationale: Chlamydial infections are one of the most common causes of salpingitis or pelvic inflammatory disease. Chlamydia can ascend from the vagina or cervix to the reproductive organs, leading to inflammation and infection. Trichomoniasis, caused by a parasite, typically presents with different symptoms than pelvic inflammatory disease and is not the primary cause. Staphylococcus and Streptococcus are bacteria that can cause other types of infections but are not the primary culprits in most cases of pelvic inflammatory disease.
5. A client has developed a vitamin C deficiency. Which of the following symptoms might the nurse most likely see with this condition?
- A. Cracks at the corners of the mouth
- B. Altered mental status
- C. Bleeding gums and loose teeth
- D. Anorexia and diarrhea
Correct answer: C
Rationale: A client with a severe vitamin C deficiency has a condition called scurvy. Scurvy is characterized by symptoms such as bleeding gums, loose teeth, poor wound healing, and easy bruising. The correct answer is 'Bleeding gums and loose teeth' because these are classic signs of scurvy due to vitamin C deficiency. Choice A ('Cracks at the corners of the mouth') is more indicative of a deficiency in B vitamins, specifically riboflavin. Choice B ('Altered mental status') is not typically associated with vitamin C deficiency but can occur with other conditions like vitamin B12 deficiency. Choice D ('Anorexia and diarrhea') are not common symptoms of vitamin C deficiency, as they are more commonly associated with other gastrointestinal issues or deficiencies in different nutrients.
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