NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The patient with migraine headaches has a seizure. After the seizure, which action can you delegate to the nursing assistant?
- A. Document the seizure
- B. Perform neurologic checks
- C. Take the patient's vital signs
- D. Restrain the patient for protection
Correct answer: C
Rationale: After a patient with migraine headaches has a seizure, it is important to assess their vital signs to monitor their condition. This task can be safely delegated to a nursing assistant as it falls within their scope of practice. Documenting the seizure and performing neurologic checks require a higher level of training and should be done by a nurse or healthcare provider. Restraint should never be used as a first-line intervention after a seizure unless there is an immediate threat to the patient's safety, and it should be done following proper protocols and with appropriate training.
2. Which term best describes changes such as retirement, grandparenting, and increased dependence on others?
- A. Moral
- B. Psychosocial
- C. Self-esteem
- D. Psychomotor
Correct answer: B
Rationale: The correct answer is 'Psychosocial.' Retirement, grandparenting, and increased dependence on others are examples of psychosocial changes because they involve social interactions, relationships, and psychological aspects. 'Moral' (Choice A) does not directly relate to the changes mentioned. 'Self-esteem' (Choice C) is more about self-perception and confidence, not the social changes mentioned. 'Psychomotor' (Choice D) refers to physical movements and skills, which are not the focus of the changes described in the question.
3. The nurse is preparing to examine a 4-year-old child. Which action by the nurse is appropriate for this age group?
- A. Explain the procedures briefly to alleviate the child's anxiety.
- B. Give the child feedback and reassurance during the examination.
- C. Ask the child to undress as needed for the examination.
- D. Perform an examination of the head last.
Correct answer: B
Rationale: For a 4-year-old child, short and simple explanations should be provided to avoid overwhelming the child. It is important to give feedback and reassurance during the examination to create a comforting environment for the child. Asking the child to undress as needed is appropriate for a thorough examination, as children at this age are usually willing to do so. Performing an examination of the head last allows the child to become more comfortable during the assessment. Therefore, the most appropriate action for a 4-year-old child is to provide feedback and reassurance during the examination, ensuring a positive experience for the child.
4. Which of these actions illustrates the correct technique for a nurse when assessing oral temperature with a glass thermometer?
- A. Wait 30 minutes if the patient has ingested hot or iced liquids.
- B. Leave the thermometer in place for 3 to 4 minutes if the patient is afebrile.
- C. Shake the glass thermometer down to 35.5�C before taking the patient's temperature.
- D. Place the thermometer at the base of the tongue and ask the patient to close his or her lips.
Correct answer: B
Rationale: The correct technique for assessing oral temperature with a glass thermometer involves leaving the thermometer in place for 3 to 4 minutes if the patient is afebrile and up to 8 minutes if the patient is febrile. Waiting 30 minutes if the patient has ingested hot or iced liquids is incorrect; instead, the nurse should wait 15 minutes in such cases. Shaking the glass thermometer down to 35.5�C, not 37.5�C, is the correct procedure before taking the patient's temperature. Placing the thermometer at the base of the tongue, not the front, and asking the patient to close their lips is the proper way to position the thermometer. Therefore, the correct answer is to leave the thermometer in place for 3 to 4 minutes if the patient is afebrile and up to 8 minutes if the patient is febrile.
5. In the term 'Hemoglobin,' the suffix '-globin' means:
- A. Protein
- B. Iron
- C. Metal
- D. Blood
Correct answer: A
Rationale: The suffix '-globin' in the term 'Hemoglobin' specifically refers to a protein. Hemoglobin is a protein found in red blood cells that carries oxygen. Choice B, 'Iron,' is incorrect as iron is a mineral component of hemoglobin but not the meaning of the suffix. Choice C, 'Metal,' is too broad and not specific to the meaning of the suffix in this context. Choice D, 'Blood,' is incorrect as it refers to the overall term 'Hemoglobin' rather than the specific meaning of the suffix '-globin.' Therefore, the correct answer is A: 'Protein.'
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