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Free NCLEX PN Questions
The nurse is assisting with procedural moderate sedation (conscious sedation) at a client's bedside. The unlicensed assistive personnel (UAP) comes to the door and indicates that the client in the next room needs the nurse right now. How should the nurse respond
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Ask the UAP to go back and ask the client what the current needs are
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Ask the UAP to stay and take over while the nurse goes to check on the client in the next room
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Tell the UAP to inform the client in the next room that the nurse will be there shortly
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Tell the UAP to tell the charge nurse about the needs of the client in the next room
Explanation
Correct answer D. Tell the UAP to tell the charge nurse about the needs of the client in the next room
Explanation:
When assisting with moderate (conscious) sedation, the nurse must stay at the client’s bedside to monitor airway, breathing, vital signs, and level of sedation closely. This task is nondelegable due to the potential for rapid clinical changes and the need for immediate intervention. The nurse cannot safely leave the sedated client, nor can a UAP take over this responsibility. The most appropriate action is to direct the UAP to inform the charge nurse, who can assess and respond to the other client’s needs. This maintains client safety for both individuals.
The nurse is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube and a gastric residual volume of 75 mL. Which of the following actions should the nurse take
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Administer the scheduled feeding as prescribed.
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Discard the aspirated residual in a biohazard container.
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Place the client in the high-Fowler position during the feeding.
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Flush the nasogastric tube before and after administering the feeding.
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Check the pH of the residual and notify the health care provider if the pH is > 5.
Explanation
Correct Answers:
A. Administer the scheduled feeding as prescribed.
C. Place the client in the high-Fowler position during the feeding.
D. Flush the nasogastric tube before and after administering the feeding.
Explanation of Each Correct Answer:
A. Administer the scheduled feeding as prescribed
A residual volume of 75 mL is considered acceptable, especially if under institutional policy limits (often <200 mL). It is safe to proceed with the feeding.
C. Place the client in the high-Fowler position during the feeding
Elevating the head of the bed to at least 30–45 degrees helps prevent aspiration and promotes proper digestion.
D. Flush the nasogastric tube before and after administering the feeding
Flushing the tube helps ensure patency and clears formula to reduce the risk of tube blockage.
You are reinforcing counseling for two parents that are preparing for the birth of their first child. They decided to undergo genetic testing and find out that they are both carriers of sickle cell anemia. What is the chance of their baby having sickle cell anemia
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25%
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50%
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75%
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100%
Explanation
Correct Answer : 25%
Explanation:
Sickle cell anemia is an autosomal recessive genetic disorder, which means that a child must inherit two copies of the mutated gene (one from each parent) to have the disease. When both parents are carriers (heterozygous), each pregnancy has the following probabilities:
25% chance the child will inherit two abnormal genes (one from each parent) and have sickle cell disease.
50% chance the child will inherit one abnormal gene and be a carrier like the parents.
25% chance the child will inherit two normal genes and be unaffected.
These probabilities apply independently to each pregnancy, and are based on Mendelian inheritance patterns.Why Other Options Are Wrong:
50% represents the chance of the child being a carrier, not having the disease.
75% would be the combined chance of the child being a carrier or having the disease, but this is not what the question is asking.
100% would only occur if both parents had sickle cell disease, not if they are merely carriers.
The nurse is caring for a client with partial hearing loss. Which of the following actions will promote effective communication
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Dim lights to prevent overstimulation
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Provide written information to supplement conversation
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Raise voice to speak loudly to the client
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Directly face the client when speaking
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Ensure hearing aids are properly applied
Explanation
Correct Answers:
B. Provide written information to supplement conversation
D. Directly face the client when speaking
E. Ensure hearing aids are properly applied
Explanation of the Correct Answers:
B. Provide written information to supplement conversation:
Written materials help reinforce spoken communication and ensure the client receives accurate information. This is especially helpful if the client misses part of the verbal exchange due to hearing limitations.
D. Directly face the client when speaking:
Facing the client allows them to see your lips and facial expressions, aiding lip-reading and comprehension. Clear visibility of the speaker enhances understanding and reduces the chance of miscommunication.
E. Ensure hearing aids are properly applied:
Hearing aids must be correctly positioned and functional to improve the client’s ability to hear. Checking that they are working properly is a fundamental step in facilitating communication.
A nursing diagnosis of "ineffective airway clearance related to pain" is identified for a client who had open abdominal surgery 2 days ago. Which intervention should the nurse implement first
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Administer prescribed analgesic medication for incisional pain
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Encourage use of incentive spirometer every 2 hours while awake
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Offer an additional pillow to splint the incision while coughing
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Promote increased oral fluid intake
Explanation
Correct Answer A. Administer prescribed analgesic medication for incisional pain
Explanation:
Pain can significantly inhibit a postoperative client’s ability to cough, deep breathe, or use an incentive spirometer—key actions needed to maintain airway clearance and prevent complications like atelectasis or pneumonia. Administering analgesic medication first ensures that the client is comfortable enough to fully participate in other respiratory interventions. This addresses the root cause (pain) contributing to ineffective airway clearance, making it the priority action before encouraging physical efforts like coughing or using the spirometer. Once pain is controlled, other supportive interventions can be more effectively implemented.
The practical nurse is collaborating with the registered nurse to develop a care plan for a homeless client just brought into the emergency department with frostbite to the fingers and toes. The client is experiencing numbness, and assessment shows mottled skin. Which interventions should be included in the client's plan of care
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Apply occlusive dressings after rewarming
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Elevate affected extremities after rewarming
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Massage the areas to increase circulation
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Provide adequate analgesia
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Provide continuous warm water soaks
Explanation
Correct Answers:
A. Apply occlusive dressings after rewarming
B. Elevate affected extremities after rewarming
D. Provide adequate analgesia
Explanation of the Correct Answers:
A. Apply occlusive dressings after rewarming:
Once the affected areas have been rewarmed, occlusive dressings can be applied to the frostbitten areas to help prevent further injury and protect the tissues. These dressings can also help maintain warmth in the affected areas. Sterile dressing may be used to prevent infection and prevent further damage.
B. Elevate affected extremities after rewarming:
After rewarming, it is important to elevate the affected extremities to reduce swelling and promote venous return. This helps prevent further damage to the tissues by reducing edema and allows for better circulation as the tissues heal.
D. Provide adequate analgesia:
Frostbite is painful, and the client may experience significant pain once the rewarming process begins. Providing adequate analgesia (such as opioids or NSAIDs) is essential to manage pain and discomfort. Pain management will also help the client tolerate the rewarming process, which can be intense.
The nurse is reinforcing discharge instructions for a client with degenerative joint disease and a new prescription for naproxen. What instructions regarding this drug does the nurse include
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Avoid driving while taking this medicine
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Change positions slowly
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Discontinue immediately if suicidal thoughts occur
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Notify the health care provider of tarry stools
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Take the medicine with food
Explanation
Correct Answers:
D. Notify the health care provider of tarry stools
E. Take the medicine with food
Explanation of Each Correct Answer:
D. Notify the health care provider of tarry stools
Naproxen can cause gastrointestinal bleeding. Tarry (black) stools may indicate upper GI bleeding, which is a serious adverse effect that must be reported immediately.
E. Take the medicine with food
NSAIDs like naproxen can irritate the stomach lining, so taking it with food or milk helps reduce the risk of gastritis or ulcers.
A client with active herpes lesions has new prescriptions for oral acyclovir and topical lidocaine. What discharge teaching will the nurse reinforce to the client
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Adhesive bandaging should remain on the lesions to prevent virus shedding
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Blood tests will be drawn to ensure that the virus is eradicated
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Condoms should be used during intercourse until the lesions are healed
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Gloves should be used to apply the medication to the lesions
Explanation
Correct Answer D. Gloves should be used to apply the medication to the lesions
Explanation of the Correct Answer:
Clients with active herpes lesions should be taught to wear gloves or use an applicator when applying topical medications to prevent autoinoculation (spreading the virus to other areas of the body, such as the eyes) and to reduce transmission to others. Proper hand hygiene before and after application is also essential.
Which measures will help prevent falls in the elderly clients of a long-term care facility
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Exercise programs
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Good room lighting
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Handrails in stairwell
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Smooth-soled shoes
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Staff hourly rounds
Explanation
Correct Answers:
A. Exercise programs
B. Good room lighting
C. Handrails in stairwell
E. Staff hourly rounds
Explanation of Each Correct Answer:
A. Exercise programs
Regular exercise improves muscle strength, balance, and coordination, which are essential in reducing fall risk in older adults.
B. Good room lighting
Proper lighting reduces the chance of tripping over unseen objects or misjudging surfaces. Poor lighting is a well-known environmental fall hazard.
C. Handrails in stairwell
Handrails provide support and stability for clients navigating stairs or hallways, helping to prevent falls during movement.
E. Staff hourly rounds
Routine rounding allows staff to assist with toileting, repositioning, and mobility needs, reducing the chance of clients trying to move independently and risking a fall.
The nurse is triaging phone calls in the prenatal clinic. The nurse should initially follow up on the client who is
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16 weeks of gestation and reports a fluttering sensation
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30 weeks of gestation and reports perianal itching and bright red blood in the stool
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28 weeks of gestation and reports intermittent leg cramping with swelling in her feet
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38 weeks of gestation and reports lower back pain that increases with walking
Explanation
Correct Answer C. 28 weeks of gestation and reports intermittent leg cramping with swelling in her feet
Explanation:
This client may be exhibiting signs of deep vein thrombosis (DVT), which can be a serious and potentially life-threatening condition during pregnancy. Swelling in one or both legs, especially if accompanied by cramping or pain, can indicate a thrombotic event and requires immediate medical attention. Pregnancy increases the risk of clot formation due to hormonal changes and decreased venous return from the lower extremities.
Why Other Options Are Wrong:
A. 16 weeks of gestation and reports a fluttering sensation
This is incorrect. A fluttering sensation, known as quickening, is typically felt between 16–20 weeks of pregnancy and is a normal developmental milestone, not a concern.
B. 30 weeks of gestation and reports perianal itching and bright red blood in the stool
This is incorrect. These symptoms suggest hemorrhoids, which are common and generally not urgent during pregnancy. Though uncomfortable, they are not dangerous.
D. 38 weeks of gestation and reports lower back pain that increases with walking
This is incorrect. Lower back pain in late pregnancy is typically associated with early labor or musculoskeletal strain, both of which are expected findings at 38 weeks unless there are other alarming symptoms.
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