NCLEX NCLEX-PN
Nclex Questions Management of Care
1. What instruction should a client who is about to undergo pelvic ultrasonography be given by a healthcare provider?
- A. “Urinate prior to the test.”
- B. “Have someone drive you home.”
- C. “Do not drink after midnight.”
- D. “Drink plenty of water.”
Correct answer: “Drink plenty of water.”
Rationale: The correct instruction for a client about to undergo pelvic ultrasonography is to 'Drink plenty of water.' A full bladder is required to serve as a landmark to define pelvic organs during the procedure. It is important to ensure the bladder is adequately filled. 'Urinate prior to the test' (Choice A) would not be appropriate as a full bladder is needed for better visualization. 'Have someone drive you home' (Choice B) is unnecessary as no sedation is given during the procedure, so the client can drive home on their own. 'Do not drink after midnight' (Choice C) is unrelated and not necessary for a pelvic ultrasonography examination.
2. Which client should the nurse see first?
- A. Recurring crushing chest pain
- B. Needing an IV for surgery in 5 minutes
- C. Needing PCA morphine for pain control post-hysterectomy
- D. Waiting to get back to bed after sitting in a chair for 30 minutes
Correct answer: Recurring crushing chest pain
Rationale: The client presenting with recurring crushing chest pain should be seen first as this symptom could indicate a myocardial infarction (MI), which is a life-threatening condition requiring immediate attention. Assessing and managing potential cardiac issues take priority over other concerns like needing an IV for surgery, pain control post-hysterectomy, or assistance with mobility. While all clients require care, addressing the chest pain promptly is crucial to ensure the client's safety and well-being.
3. Which of the following can certain foods like broccoli, oranges, dark greens, and dark yellow vegetables help improve?
- A. Vitamin intake
- B. Body functions
- C. Defense mechanisms
- D. Disease cure
Correct answer: Defense mechanisms
Rationale: Certain foods like broccoli, oranges, dark greens, and dark yellow vegetables can help improve defense mechanisms by enhancing the immune system and overall health. While these foods can boost defense mechanisms, they are not a cure for diseases, do not balance body functions, and are not intended to solely supplement vitamin intake, which may be necessary in some cases. Therefore, the correct answer is defense mechanisms as these foods strengthen the body's ability to fight off illnesses and maintain health.
4. The physician has ordered sodium warfarin (Coumadin) for the client with thrombophlebitis. The order should be entered to administer the medication at:
- A. 0900
- B. 1200
- C. 1700
- D. 2100
Correct answer: 1700
Rationale: Sodium warfarin is typically administered in the late afternoon, around 1700 hours. This timing allows for accurate bleeding times to be drawn in the morning. Administering it at 0900 (choice A) would not align with this schedule and may affect the monitoring of bleeding times. Choice B (1200) is midday, which is not the recommended time for sodium warfarin administration. Choice D (2100) is in the evening, which is also not ideal. Therefore, the correct time for administering sodium warfarin is 1700 (choice C).
5. A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Ensure adequate fluid intake 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Administer medication that affects the central nervous system as prescribed
- D. Position the client appropriately for the procedure
Correct answer: B: Ask the client to void immediately before the study
Rationale: The correct answer is to ask the client to void immediately before the study. For an intravenous pyelogram, the client may have orders for laxatives or enemas, so ensuring the client voids before the test is important to prevent obscuring visualization of the kidney, ureters, and bladder. Choice A is incorrect because there is no need to force fluids before the procedure. Choice C is incorrect as medications affecting the central nervous system should not be held unless specified by the healthcare provider. Choice D is incorrect as covering the reproductive organs with an x-ray shield is not necessary for an intravenous pyelogram.
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