Comprehensive NCLEX-RN| Quiz #1: 75 Questions and Correct Answers/ Rationale (2022 update)

Comprehensive NCLEX-RN| Quiz #1: 75 Questions and Correct Answers/ Rationale (2022 update) Question: A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first? Question: While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child's developmental needs? Question: The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is: Question: The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq potassium chloride in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued? Question: A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body? Question: The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to: Question: During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to: Question: The nurse prepares the client for the insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about: Question: A nurse enters a client's room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is: Question: A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider? Question: The nurse practicing in a maternity setting recognizes that the postmature fetus is at risk due to: Question: The nurse is caring for a client who had a total hip replacement seven (7) days ago. Which statement by the client requires the nurse's immediate attention? Question: While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply. Question: A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications. Question: A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks gestation. How would the nurse accurately document this information? Fill in the blanks. Question: Which individual is at the greatest risk for developing hypertension? Question: A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first? Question: Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure? Question: A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client's temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is: Question: What would the nurse expect to see while assessing the growth of children during their school-age years? Question: At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states "My blood pressure is usually much lower." The nurse should tell the client to: Question: The hospital has sounded the call for a disaster drill on the evening shift. Which of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission? Question: A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication: Question: A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first? Question: In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation? Question: 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? Question: A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN? Question: When teaching a client with coronary artery disease about nutrition, the nurse should emphasize: Question: Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working? Question: The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse's response? Question: The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention? Question: A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time? Question: The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs two (2) hours ago. The nurse should Question: Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test? Question: The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question? Question: A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following assessment cues below may indicate the client is experiencing a negative side effect from the medication? Question: The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing intervention would be most effective in promoting healing? Question: Which of these statements best describes the characteristics of an effective reward-feedback system? Question: The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply. Question: During the evaluation of the quality of home care for a client with Alzheimer's disease, the priority for the nurse is to reinforce which statement by a family member? Question: A nurse is reviewing a patient's medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply. Question: A nurse is reviewing a patient's past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply. Question: A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient's medication does not cause urine discoloration? Question: You are responsible for reviewing the nursing unit's refrigerator. Which of the following drugs, if found inside the fridge, should be removed? Question: A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb? Question: A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take? Question: A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? Question: You are taking the history of a 14-year-old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect? Question: A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect? Question: Rhogam is most often used to treat____ mothers that have a ____ infant. Question: A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU? Question: A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient? Question: A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is? Question: A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient? Question: A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present? Question: A mother has recently been informed that her child has Down's syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down's syndrome? Question: A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following? Question: A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?" Question: A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans? Question: A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long do red blood cells live in my body? The correct response is: Question: A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When should the discharge training and planning begin for this patient? Question: A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson's psychosocial development stages, the child is in which stage? Question: A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in? Question: A young adult is 20 years old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in? Question: A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal? Question: When you are taking a patient's history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking? Question: Which of the following conditions would a nurse not administer erythromycin? Question: A patient's chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute? Question: A patient's chart indicates a history of meningitis. Which of the following would you expect to see with this patient if this condition were acute? Question: A nurse if reviewing a patient's chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition? Question: A nurse is reviewing a patient's chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition? Question: A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two (2) weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed? Question: An 85-year-old male has been losing mobility and gaining weight over the last two (2) months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed? Question: A 20-year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?