NCLEX RN· Full Length · NCLEX RN Exam Practice
Full Question & Rationale Repository
Showing all 10 practice questions with expert explanatory rationales.
A client is being treated with I.V. fluids for hypovolemic shock. Which of the following values is the best indicator that fluid resuscitation has been effective?
Expert Explanatory Rationale
Correct Answer: Urine output of 30 mL/hour.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium (Atrovent). The nurse should instruct the client to:
Expert Explanatory Rationale
Correct Answer: Rinse the mouth after inhalation.
A 6-year-old child is admitted to the hospital for heart surgery to repair tetralogy of Fallot. The child asks the nurse if the cardiac catheterization will hurt. Which of the following statements offers the nurse the best guide for responding to the child's question?
Expert Explanatory Rationale
Correct Answer: The medication used to numb the insertion site will sting
The nurse observes an 18-month-old who has been admitted with a respiratory tract infection (see figure). The nurse should first:
Expert Explanatory Rationale
Correct Answer: Call the rapid response team
The nurse is caring for a client with a history of osteoarthritis. Which of the following interventions should be included in the plan of care?
Expert Explanatory Rationale
Correct Answer: Recommend a high-protein diet.
A client has been receiving radiation therapy for 3 weeks to treat his cancer. He is complaining of fatigue. Which of the following should be considered while the nurse plans interventions to help the client with the fatigue?
Expert Explanatory Rationale
Correct Answer: The client should be closely examined to determine the cause of fatigue
A primary health care provider has written a prescription for a client diagnosed with diabetic gastroparesis to receive metoclopramide four times a day. The nurse schedules this medication to be given at which times?
Expert Explanatory Rationale
Correct Answer: Thirty minutes before meals and at bedtime
A client with a history of systemic lupus erythematosus (SLE) reports joint pain and fatigue. Which intervention should the nurse prioritize?
Expert Explanatory Rationale
Correct Answer: Administer analgesics as ordered
A client diagnosed with chronic obstructive pulmonary disease (COPD) is on home oxygen at 2 L per minute. The nurse assesses the client's respiratory rate at 22 breaths per minute. When the client reports an increase in the dyspnea, what should the nurse do initially?
Expert Explanatory Rationale
Correct Answer: Collect more information about the client's respiratory status.
A client with a history of epilepsy is prescribed carbamazepine (Tegretol). The nurse should monitor the client for which of the following adverse effects?
Expert Explanatory Rationale
Correct Answer: Agranulocytosis.
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