Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 86
Questions 1. A 52-year-old client who underwent an exploratory laparotomy for a bowel obstruction begins to complain of hunger on the third postoperative day. His nasogastric(NG) tube was removed this morning, and he has an IV of D5W with 0.45% normal saline running at 125 mL/hr. He asks when he can get rid of his IV and start eating. The nurse recognizes that he will be able to begin taking oral fluids and nourishment when:A) It is determined that he has no signs of wound infectionB) He is able to eat a full meal without evidence of nausea or vomitingC) The nurse can detect bowel sounds in all four quadrantsD) His blood pressure returns to its preoperative baseline level or greater2. A 47-year-old client has been admitted to the general surgery unit for bowel obstruction. The doctor has ordered that an NG tube be inserted to aid in bowel de- compression. When preparing to insert a NG tube, the nurse measures from the:A) Lower lip to the shoulder to the upper sternumB) Tip of the nose to the lower lip to the umbilicusC) End of the tube to the first measurement line on the tubeD) Tip of the nose to the ear lobe to the xiphoid process or midepigastric area3. A 65-year-old client who has a new colostomy is preparing for discharge from the hospital. As part of the instructions on colostomy care, the nurse explains to the client that to regulate the bowel, colostomy irrigation should be performed at the same time each day. The best time is:A) After mealsB) Before mealsC) Every 2 hoursD) At bedtime4. A 72-year-old client with a new colostomy is being evaluated at the clinic today for constipation. When discussing diet with the client, the nurse recognizes that which one of the following foods most likely caused this problem?A) Fried chickenB) EggsC) TapiocaD) Cabbage5. When giving discharge instructions to a 24-year-old client who had a short-arm cast applied for a fractured right ulna, the nurse recognizes the importance of telling him that the drying time for a plaster of Paris cast is approximately:A) 30 minutesB) 1 - 4 hoursC) 12 - 24 hoursD) 24 - 72 hours Right Answer and Explanation: 1. Right Answer: CExplanation: (A) The absence of wound infection is related to his surgical wound and not to postoperative GI functioning and return of peristalsis. (B) Routine postoperative protocol involves detection of bowel sounds and return of peristalsis before introduction of clear liquids, followed by progression of full liquids and a regular diet versus a full regular meal first. (C) Routine postoperative protocol for bowel obstruction is to assess for the return of bowel sounds within 72 hours after major surgery, because that is when bowel sounds normally return. If unable to detect bowel sounds, the surgeon should be notified immediately and have the client remain NPO. (D) Routine postoperative protocol for bowel obstruction and other major surgeries involves frequent monitoring of vital signs in the immediate postoperative period (in recovery room) and then every 4 hours, or more frequently if the client is unstable, on the nursing unit. This includes assessing for signs of hypovolemic shock. Vital signs usually stabilize within the first 24 hours postoperatively.2. Right Answer: DExplanation: (A) This measurement is _50 cm (4849 cm). Fifty centimeters is considered the length necessary for the distal end of the tube to be in place in the stomach. This measurement is too short. (B) This measurement is _50 cm (4748 cm). Fifty centimeters is considered the lengthnecessary for the distal end of the tube to be in place in the stomach. This measurement is too short. (C) This measurement gives an approximate indication of the length necessary for the distal end of the tube to be in place in the stomach, but it is not as accurate as actually measuring the client (nose-earxiphoid). (D) This is the correct measurement of 50 cm from the tip of the clients nose to the tip of the earlobe to the xiphoid process (called the NEX [nose-ear-xiphoid] measurement). It is approximately equal to the distance necessary for the distal end of the tube to be located in the correct position in the stomach.3. Right Answer: AExplanation: (A) Bowel movements should be regulated at a specific time each day to prevent 'accidents.' Irrigating after meals takes advantage of the gastrocolic reflex and time of increased peristalsis, so better results may be produced. After meals is the normal time that peristalsis begins in most persons and evacuation of feces occurs. (B) Irrigating before meals may cause poor results because of decreased gastrocolic reflex and decreased peristalsis. (C) Irrigating a colostomy every 2 hours may produce hyperactivity of the bowel, leading to irritation and diarrhea. This would not aid in regulation of the bowel. (D) If irrigation of a colostomy were done at bedtime, there is greater chance of having an 'accident' during sleep. This would not be an advantageous practice of bowel regulation.4. Right Answer: CExplanation: (A) Fried, greasy food, such as fried chicken, will produce diarrhealike stools in individuals with all types of GI ostomies. (B) Eggs will cause odor-producing stools in individuals with all types of GI ostomies. (C) Tapioca and rice products will cause constipation in individuals with all types of GI ostomies. (D) Cabbage will cause odor-producing and flatus-producing stools in individuals with all types of GI ostomies.5. Right Answer: DExplanation: (A) Synthetic cast materials harden in 315 minutes. Weight bearing is permitted in 1530 minutes. Drying time for plaster of Paris is about 2472 hours. (B, C)Plaster of Paris cast materials are heavier than synthetic materials and require a drying time of 2472 hours. Synthetic materials dry within 30 minutes. (D) Plaster of Paris cast materials are heavier thansynthetic materials and require a longer period to set and dry. Even though setting time (hardening) is only 315 minutes, the drying time for plaster of Paris is 2472 hours. This depends on the size and thickness of the cast, exposure to air, and humidity in the air. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 87
Questions 1. A 58-year-old client on a general surgery unit is scheduled for transurethral resection of the prostate (TURP) in 2 hours. The nurse explains to the client that this procedure means:A) Removal of the prostate tissue by way of a lower abdominal midline incision through the bladder and into the prostate glandB) Removal of prostate tissue by a resectoscope that is inserted through the penile urethraC) Removal of the prostate tissue by an open surgical approach through an incision between the ischial tuberosities, the scrotum, and the rectumD) Removal of prostate tissue by an open surgical approach through a low horizontal incision, bypassing the bladder, to the prostate gland2. A postoperative TURP client returns from the recovery room to the general surgery unit and is in stable condition. One hour later the nurse assesses him and finds him to be confused and disoriented. She recognizes that this is most likely caused by:A) Hypovolemic shockB) HypokalemiaC) HypernatremiaD) Hyponatremia3. A postoperative TURP client is ordered continuous bladder irrigations. Later in the evening on the first postoperative day, he complains of increasing suprapubic pain. When assessing the client, the nurse notes diminished flow of bloody urine and several large blood clots in the drainage tubing. Which one of the following should be the initial nursing intervention?A) Call the physician about the problem.B) Irrigate the Foley catheter.C) Change the Foley catheter.D) Administer a prescribed narcotic analgesic.4. A postoperative prostatectomy client is preparing for discharge from the hospital the next morning. The nurse realizes that additional instructions are necessary when he states:A) 'If I drink 10 to 12 glasses of fluids each day, that will help to prevent any clot formation in my urine.'B) 'The isometric exercises will help to strengthen my perineal muscles and help me control my urine.'C) 'If I feel as though I have developed a fever, I will take a rectal temperature, which is the most accurate.'D) 'I do not plan to do any heavy lifting until I visit my doctor again.'5. A 67-year-old postoperative TURP client has hematuria. The nurse caring for him reviews his postoperative orders and recognizes that which one of the following prescribed medications would best relieve this problem?A) Acetaminophen suppository 650 mgB) Meperidine 50 mg IMC) Promethazine 25 mg IMD) Aminocaproic acid (Amicar) 6 g/24 hr Right Answer and Explanation: 1. Right Answer: BExplanation: (A) This describes a suprapubic (transvesical) prostatectomy procedure. (B) This is the correct description of a TURP procedure. (C) This describes a perineal prostatectomy procedure. (D) This describes a retropubic (extravesical) prostatectomy procedure.2. Right Answer: DExplanation: (A) Early signs of hypovolemic shock include hypotension, tachycardia, tachypnea, pallor, and diaphoresis. (B) Early signs of potassium depletion include muscular weakness or paralysis, tetany, postural hypotension, weak pulse, shallow respirations, apathy, weak voice, and electrocardiographic changes. (C) Early signs of an elevated sodium level include dry oral mucous membranes, marked thirst, hypertension, tachycardia, oliguria or anuria, anxiety, and agitation. (D) This answer is correct. Important early clinical findings of a decreased sodium concentration include confusion and disorientation. Hyponatremia can occur after aTURP because absorption during surgery through the prostate veins can increase circulating blood volume and decrease sodium concentration.3. Right Answer: BExplanation: (A) The physician should be notified as problems arise, but in this case, the nurse can attempt to irrigate the Foley catheter first and call the physician if irrigation is unsuccessful. Notifying the physician of problems is a subsequent nursing intervention. (B) This answer is correct. Assessing catheter patency and irrigating as prescribed are the initial priorities to maintain continuous bladder irrigation. Manual irrigation will dislodge blood clots that have blocked the catheter and prevent problems of bladder distention, pain, and possibly fresh bleeding. (C) The Foley catheter would not be changed as an initial nursing intervention, but irrigation of the catheter should be done as ordered to dislodge clots that interfere with patency. (D) Even though the client complains of increasing suprapubic pain, administration of a prescribed narcotic analgesic is not the initial priority. The effect of the medication may mask the symptoms of a distended bladder and lead to more serious complications.4. Right Answer: CExplanation: (A) This is correct health teaching. Drinking 1012 glasses of clear liquid will help increase urine volumes and prevent clot formation. (B) This is correct health teaching. These types of exercises are prescribed by physicians to assist postprostatectomy clients to strengthen their perineal muscles. (C) This action is not recommended post-TURP because of the close proximity of the prostate and rectum. (D) This is correct healthcare teaching. The client should limit walking long distances, lifting heavy objects, or driving a car until these activities are cleared by the physician at the first office visit.5. Right Answer: DExplanation: (A) Acetaminophen (Tylenol) has analgesic and antipyretic actions approximately equivalent to those of aspirin. It produces analgesia possibly by action on the peripheral nervous system. It reduces fever by direct action on the hypothalamus heat-regulating center with consequent peripheral vasodilation. It is generally used for temporary relief of mild to moderate pain, such as a simple headache, minor joint and muscle pains, and control of fever. (B) Meperidine is a narcotic agonist analgesic with properties similar to morphine except that it has a shorter duration of action and produces less depression of urinary retention and smooth muscle spasm. It is used for moderate to severe pain, for a preoperative medication, for support of anesthesia, and for obstetrical analgesia. In a postoperativeTURP client, it would be used in conjunction with other medications for relief of moderate to severe pain, but not specifically for bladder spasms associated withTURP surgery. (C) Promethazine hydrochloride is an antihistamine, antiemetic preparation. It exerts antiserotonin, anticholinergic, and local anesthetic actions. It is used for symptomatic relief of various allergic conditions, motion sickness, nausea, and vomiting. It is used for preoperative, postoperative, and obstetrical sedation and as an adjunct to analgesics for control of pain. (D) This answer is correct because aminocaproic acid is prescribed specifically for hematuria.Aminocaproic acid is excreted in the urine. The nurse should be alert for possible signs of thrombosis, particularly in the extremities. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 88
Questions 1. A 52-year-old client is scheduled for a small-bowel resection in the morning. In conjunction with other preoperative preparation, the nurse is teaching her diaphragmatic breathing exercises. She will teach the client to:A) Inhale slowly and deeply through the nose until the lungs are fully expanded, hold the breath a couple of seconds, and then exhale slowly through the mouth. Repeat 23 more times to complete the series every 12 hours while awakeB) Purse the lips and take quick, short breaths approximately 18 - 20 times/minC) Take a large gulp of air into the mouth, hold it for 10 - 15 seconds, and then expel it through the nose. Repeat 4 - 5 times to complete the seriesD) Inhale as deeply as possible and then immediately exhale as deeply as possible at a rate of approximately 20 - 24 times/min2. A 27-year-old healthy primigravida is brought to the labor and birthing room by her husband at 32 weeks gestation. She experienced a sudden onset of painless vaginal bleeding. Following an ultrasound examination, the diagnosis of bleeding secondary to complete placenta previa is made. Expected assessment findings concerning the abdomen would include:A) A rigid, boardlike abdomenB) Uterine atonyC) A soft relaxed abdomenD) Hypertonicity of the uterus3. A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP 104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:A) Decreased cardiac output related to excessive bleedingB) Potential for fluid volume excess related to fluid resuscitationC) Anxiety related to threat to selfD) Alteration in parenting related to potential fetal injury4. A 27-year-old primigravida at 32 weeks gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:A) DinitrophenylhydrazineB) Metachromatic stainC) Blood serum phenylalanine testD) Lecithin-sphingomyelin ratio5. The nurse is notified that a 27-year-old primigravida diagnosed with complete placenta previa is to be admitted to the hospital for a cesarean section. The client is now at 36 weeks gestation and is presently having bright red bleeding of moderate amount. On admission, the nursing intervention that the nurse should give the highest priority to is:A) Shave the client - s abdomen and arrange her lab workB) Determine the status of the fetus by fetal heart tonesC) Start an IV infusion in the client - s armD) Insert an indwelling catheter into her bladder Right Answer and Explanation: 1. Right Answer: AExplanation: (A) This is the correct method of teaching diaphragmatic breathing, which allows full lung expansion to increase oxygenation, prevent atelectasis, and move secretions up and out of the lungs to decrease risk of pneumonia. (B) Quick, short breaths do not allow for full lung expansion and movement of secretions up and out of the lungs. Quick, short breaths may lead to O2 depletion, hyperventilation, and hypoxia. (C) Expelling breaths through the nose does not allow for full lung expansion and the use of diaphragmatic muscles to assist in moving secretions up and out of the lungs. (D) Inhaling and exhaling at a rate of 2024 times/min does not allow time for full lung expansion to increase oxygenation. This would most likely lead to O2 depletion and hypoxia.2. Right Answer: CExplanation: (A) A rigid, boardlike abdomen is an assessment finding indicative of placenta abruptio. (B) A cause of postbirth hemorrhage is uterine atony. With placenta previa, uterine tone is within normal range. (C) The placenta is located directly over the cervical os in complete previa. Blood will escape through the os, resulting in the uterus and abdomen remaining soft and relaxed. (D) In placenta abruptio, hypertonicity of the uterus is caused by the entrapment of blood between the placenta and uterine wall, a retroplacental bleed. This does not exist in placenta previa.3. Right Answer: AExplanation: (A) Based on the clients history, presence of bright red vaginal bleeding, and hemoglobin value on admission, the priority nursing diagnosis would be decreased cardiac output related to excessive bleeding. (B) This nursing diagnosis is a potential problem that does not exist at the present time, and therefore is not the priority problem. (C) The clients expressed anxiety is for her child. The fetus will remain physiologically safe if the decreased cardiac output is resolved. (D) Initial spontaneous bleeding with placenta previa is rarely life threatening to the mother or the fetus. Delivery of the fetus will be postponed until fetal maturity is achieved and survival is likely.4. Right Answer: DExplanation: (A) Dinitrophenylhydrazine is a laboratory test used to detect phenylketonuria, maple syrup urine disease, and Lowes syndrome. (B) Metachromatic stain is a laboratory test that may be used to diagnose Tay-Sachs and other lipid diseases of the central nervous system. (C) The blood serum phenylalanine test is diagnostic of phenylketonuria and can be used for wide-scale screening. (D) A lecithin-sphingomyelin ratio of at least 2:1 is indicative of fetal lung maturity, and survival of the fetus is likely.5. Right Answer: BExplanation: (A) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium. (B) Determining the physiological status of the fetus would constitute the highest priority in evaluating and maintaining fetal life. (C) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium. (D) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 89
Questions 1. A 29-year-old client delivered her fifth child by the Lamaze method and developed a postpartal hemorrhage in the recovery room. What are the initial symptoms of shock that she may experience?A) Marked elevation in blood pressure, respirations, and pulseB) Decreased systolic pressure, cold skin, and anuriaC) Rapid pulse; narrowed pulse pressure; cool, moist skinD) No urinary output, tachycardia, and restlessness2. The nurse has been assigned a client who delivered a 6- lb, 12-oz baby boy vaginally 40 minutes ago. The initial assessment of greatest importance for this client would be:A) Length of her laborB) Type of episiotomyC) Amount of IV fluid to be infusedD) Character of the fundus3. On the first postpartal day, a client tells the nurse that she has been changing her perineal pads every 1/2 hour because they are saturated with bright red vaginal drainage. When palpating the uterus, the nurse assesses that it is somewhat soft, 1 fingerbreadth above the umbilicus, and midline. The nursing action to be taken is to:A) Gently massage the uterus until firm, express any clots, and note the amount and character of lochiaB) Catheterize the client and reassess the uterusC) Begin IV fluids and administer oxytocic medicationD) Administer analgesics as ordered to relieve discomfort4. The nurse assesses a client on the second postpartum day and finds a dark red discharge on the peripad. The stain appears to be about 5 inches long. Which of the following correctly describes the character and amount of lochia?A) Lochia alba, lightB) Lochia serosa, heavyC) Lochia granulosa, heavyD) Lochia rubra, moderate5. A 2-day-old infant boy has been diagnosed with an atrial septal defect due to a persistent patent foramen ovale.When explaining the diagnosis to the mother, the nurse includes in the discussion the function of the foramen ovale. In fetal circulation, the foramen ovale allows a portion of the blood to bypass the:A) Left ventricleB) Pulmonary systemC) LiverD) Superior vena cava Right Answer and Explanation: 1. Right Answer: CExplanation: (A) Early shock does not exhibit the symptom of marked elevation in blood pressure. A narrowing of the pulse pressure is indicative of early shock. (B) Anuria is a clinical finding in late shock. (C) All of these clinical findings are congruent with early shock. (D) Absence of urinary output is a clinical finding in the late phase of shock.2. Right Answer: DExplanation: The length of labor has little bearing on the fourth stage of labor. The type of labor and delivery is significant. (B) The type of episiotomy will affect the clients comfort level. However, the nurses assessment and implementations center on prevention of hemorrhage during the fourthstage of labor. The amount of bleeding from the episiotomy or hematoma formation is of higher priority than the type of episiotomy. (C) The amount of IV fluid to be infused is a nursing function to be attended to; however, it is lower in priority than determining if hemorrhaging is occurring. (D) Character of the fundus would be the priority nursing assessment because changes in uterine tone may identify possible postpartum hemorrhage.3. Right Answer: AExplanation: (A) Gentle massage and expression of clots will let the fundus return to a state of firmness, allowing the uterus to function as the 'living ligature.' (B) A distended bladder may promote uterine atony; however, after determining the bladder is distended, the nurse would have the client void. Catheterization is only done if normal bladder function has not returned. (C) Oxytocic medications are ordered and administered if the uterus does not remain contracted after gentle massage and determining if the bladder is empty. (D) The client is not complaining of discomfort or pain; therefore, analgesics are not necessary.4. Right Answer: DExplanation: (A) Lochia alba occurs approximately 10 days after birth and is yellow to white. A discharge is classified as light when less than a 4-inch stain exists. (B) Lochia serosa is pink to brown and occurs 34 days after delivery. A stain is classified as heavy when a peripad is saturated in 1 hour. (C) Lochia granulosa is not a proper classification. (D) Lochia rubra is red, consisting mainly of blood, debris, and bacteria, and lasts from the time of delivery to 34 days afterward. A stain is classified as moderate when less than a 6-inch stain exists.5. Right Answer: BExplanation: (A) The foramen ovale permits a percentage of the blood to shunt from the right atrium to the left atrium. The blood then goes to the left ventricle, permitting systemic fetal circulation with blood containing a higher O2 saturation. (B) As the blood shunts from the right atrium to the left atrium, the pulmonary system is bypassed. The fetus receives O2 from the maternal circulation, thereby permitting the partial bypass of the pulmonary system. (C) The foramen ovale is locatedin the atrial septum of the heart and does not affect the liver. (D) The superior vena cava returns blood to the heart, bringing blood to the location of the foramen ovale. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 90
Questions 1. A client has been admitted to the nursing unit with the diagnosis of severe anemia. She is slightly short of breath, has episodes of dizziness, and complains her heart sometimes feels like it will 'beat out of her chest.' The physician has ordered her to receive 2 U of packed red blood cells. The most important nursing action to be taken is:A) Starting an 18-gauge IV infusionB) Having the consent form on the chartC) Administering the correct blood product to the correctclientD) Transfusing the blood in a 2-hour time frame2. A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:A) Take a baseline set of vital signsB) Hang Ringer - s lactate as the companion fluidC) Use microdrip tubing for the blood administrationD) Have the registered nurse in charge assume responsibility for verifying the client and blood product information3. A clients transfusion of packed red blood cells has been infusing for 2 hours. She is complaining of a raised, itchy rash and shortness of breath. She is wheezing, anxious, and very restless. The nurse knows these assessment findings are congruent with:A) Hemolytic transfusion reactionB) Febrile transfusion reactionC) Circulatory overloadD) Allergic transfusion reaction4. Diagnostic assessment findings for an infant with possible coarctation of the aorta would include:A) A third heart soundB) A diastolic murmurC) Pulse pressure difference between the upper extremitiesD) Diminished or absent femoral pulses5. Decreased pulmonary blood flow, right-to-left shunting, and deoxygenated blood reaching the systemic circulation are characteristic of:A) Tetralogy of FallotB) Ventricular septal defectC) Patent ductus arteriosusD) Transposition of the great arteries Right Answer and Explanation: 1. Right Answer: CExplanation: (A) An 18-gauge IV is an appropriate size for administering blood; however, client safety demands that the right blood product must be administered. (B) The consent form is legally necessary to be on the chart, but client safety is maintained by giving the correct blood component to the correct client. (C) Administering the correct blood product to the correct client will maintain physiological safety and minimize transfusion reactions. (D) The blood administration should take place over the ordered time frame designated by the physician.2. Right Answer: AExplanation: (A) A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. (B) The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringers lactate can cause clotting. (C) Only a blood administration set should be used.A microdrip tube would cause lysis of the red blood cells. (D) Proper identification of the recipient and the blood product must be validated by at least two people.3. Right Answer: DExplanation: (A) A hemolytic transfusion reaction would be characterized by fever, chills, chest pain, hypotension, and tachypnea. (B) Fever, chills, and headaches are indicative of a febrile transfusion reaction. (C) Circulatory overload is manifest by dyspnea, cough, and pulmonary crackles. (D) Urticaria, pruritus, wheezing, and anxiety are indicative of an allergic transfusion reaction.4. Right Answer: DExplanation: (A) S1 and S2 in an infant with coarctation of the aorta are usually normal. S3 and S4 do not exist with this diagnosis. (B) Either no murmur will be heard or a systolic murmur from an associated cardiac defect will be heard along the left upper sternal border. A diastolic murmur is not associated with coarctation of the aorta. (C) Pulse pressure differences of>20 mm Hg exist between the upper extremities and the lower extremities. It is important to evaluate the upper and lower extremities with the appropriate- sized cuffs. (D) Femoral and pedal pulses will be diminished or absent in infants with coarctation of the aorta.5. Right Answer: AExplanation: (A) Tetralogy of Fallot is the most common cyanotic heart defect, which includes a VSD, pulmonary stenosis, an overriding aorta, and ventricular hypertrophy. The blood flow is obstructed because the pulmonary stenosis decreases the pulmonary blood flow and shunts blood through the VSD, creating a right-to-left shunt that allows deoxygenated blood the reach the systemic circulation. (B) A VSD alone creates a left-to-right shunt. The pressure in the left ventricle is greater than that of the right; therefore, the blood will shunt from the left ventricle to the right ventricle, increasing the blood flow to the lungs. No deoxygenated blood will reach the systemic circulation. (C) In patent ductus arteriosus, the pressure in the aorta is greater than in the pulmonary artery, creating a left-to-right shunt. Oxygenated blood from the aorta flows into the unoxygenated blood of the pulmonary artery. (D) Transposition of the great arteries results in two separate and parallel circulatory systems. The only mixing or shunting of blood is based on the presence of associated lesions. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 91
Questions 1. A 2-year-old child will undergo a cardiac catheterization tomorrow to evaluate his ventricular septal defect. Based on his developmental stage, the nurse:A) Uses pictures to explain the procedure to the child and his parents that eveningB) Explains the procedure using simple words and sentences just before the preoperative sedationC) Asks the parents to explain the procedure to the child after she explains it to themD) Asks the parents to leave the room while the preoperative medication and instructions are given2. Home-care instructions for the child following a cardiac catheterization should include:A) Notify the physician if a slight bruise develops around the insertion site.B) Use sponge bathing until stitches are removed.C) Give aspirin if the child complains of pain at the insertion site.D) Keep a clean, dry dressing on the insertion site for 2 days.3. Nursing care for the parents of a child with a congenital heart defect would include:A) Encouraging the parents not to tell the child about the seriousness of the congenital heart defect, so the child will function as normally as possibleB) Acknowledging the fear and concern surrounding their childs health and assisting the parents through the grieving process as they mourn the loss of their fantasized healthy childC) Identifying anger and resentment as destructive emotions that serve no purposeD) Expressing to the parents after the corrective surgery has been completed successfully that all their grief feelings will resolve4. An infant with a congenital heart defect is being discharged with an order for the administration of digoxin elixir every 12 hours. The parents need to be taught when administering digoxin to the infant that:A) If the infant vomits within 30 minutes of the digoxin administration, repeat the doseB) They need to mix it with formula so the infant swallows it easilyC) If the infant vomits two or more consecutive doses or becomes listless or anorexic, notify thephysicianD) If a dose of digoxin is skipped for more than 6 hours, a new timetable for administration must be developed5. A 4-year-old child with a history of sickle cell anemia is admitted to the nursing unit with dizziness, shortness of breath, and pallor. Nursing assessment findings reveal tenderness in the abdomen. The child is most likely experiencing a/an:A) Aplastic crisisB) Vaso-occlusive crisisC) Dactylitis crisisD) Sequestration crisis Right Answer and Explanation: 1. Right Answer: BExplanation: (A) A toddler is not capable of conceptualizing about the inside of his body and is concerned about body intactness; therefore, diagrams would not be useful. Also, the previous evening is too far from the procedure for the toddler to remember the instructions. (B) A simple explanation the morning of the procedure is the best developmental strategy to use, because it focuses on the toddlers need for parental support, body intactness, and short attention span. (C) A relationship between the nurse and the child needs to develop. Also, misinformation may be given to the child if the parents explain the procedure to the child. (D) The parents are the childs support system and need to be there to strengthen the child.2. Right Answer: BExplanation: (A) A small bruise may develop around the insertion site and is not a reason for alarm. (B) It is best to keep the child out of the bathtub until the sutures are removed. (C) Acetaminophen, not aspirin, is the drug of choice if there is pain at the insertion site. (D) The insertion site should be kept clean and dry and open to air.3. Right Answer: BExplanation: (A) It is important to discuss with parents the need to treat the child as they would any other children, but they must be truthful and honest with the child about the heart defect. As the child grows older, explanations can go into greater depth. (B) Parents of children with congenital heart defects go through a grieving process over the loss of their 'healthy' child. The nurse needs to recognize these feelings and give the parents a role in the child s care when they are ready. (C) Anger and resentment are normal feelings that must be dealt with appropriately. (D) Parents may go through a second grieving process after the repair of the cardiac defect. During this grieving period, they mourn the loss of the 'defective' child who now may be essentially 'normal.'4. Right Answer: CExplanation: (A) Occasionally the child may vomit. They should not repeat the dose because the amount of digoxin that was absorbed is un-known, and serum levels of digoxin that are too high are more dangerous than those that are temporarily too low. (B) To ensure that the entire dose of digoxin is received, never mix it with food or formula. (C) Vomiting, anorexia, and listlessness are all signs of digoxin toxicity and should be reported to the physician immediately. (D) If a dose is forgotten for more than 6 hours, the nurse should advise the parents to skip that dose and to continue the next dose as scheduled.5. Right Answer: DExplanation: (A) Aplastic anemia is characterized by a lack of reticulocytes in the blood. Platelet and white blood cell counts are usually not depressed. It is usually self-limiting, lasting 510 days. (B) Vaso-occlusive crisis is the most common type of crisis in sickle cell anemia. Sickled cells become clogged, leading to distal tissue hypoxia and infarction. Joints and extremities are the most commonly affected areas. (C) Dactylitis crisis, or 'hand-foot syndrome,' causes symmetrical infarction of the bones in the hands and feet, resulting in painful swelling in the soft tissues of the hands and feet. (D) Sequestration crisis occurs as enormous volumes of blood pool within the spleen. The spleen enlarges, causing tenderness. Signs of shock including pallor, tachypnea, and faintness result, related to the deficient intravascular volume. This type of crisis is potentially fatal. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 92
Questions 1. The primary focus of nursing interventions for the child experiencing sickle cell crisis is aimed toward:A) Maintaining an adequate level of hydrationB) Providing pain reliefC) Preventing infectionD) O2 therapy2. A 30-year-old client is exhibiting auditory hallucinations. In working with this client, the nurse would be most effective if the nurse:A) Encourages the client to discuss the voicesB) Attempts to direct the client - s attention to the here and nowC) Exhibits sincere interest in the delusional voicesD) Gives the medication as necessary for the acting-out behavior3. One week ago, a 21-year-old client with a diagnosis of bipolar disorder was started on lithium 300 mg po qid. A lithium level is ordered. The clients level is 1.3 mEq/L. The nurse recognizes that this level is considered to be:A) Within therapeutic rangeB) Below therapeutic rangeC) Above therapeutic rangeD) At a level of toxic poisoning4. A client was exhibiting signs of mania and was recently started on lithium carbonate. She has no known physical problems. A teaching plan for this client would include which of the following?A) Regular foods should be eaten, including those that contain salt, such as bacon, ham, V-8 juice, and tomato juice.B) Restrict fluids to 1000 mL/day.C) Restrict foods that contain salt or sodium.D) Discontinue the medication if nausea occurs.5. A behavioral modification program is recommended by the multidisciplinary team working with a 15-year-old client with anorexia nervosa. A nursing plan of care based on this modality would include:A) Role playing the client - s eating behaviorsB) Restriction to the unit until she has gained 2 lbC) Encouraging her to verbalize her feelings concerning food and food intakeD) Provision for a high-calorie, high-protein snack between meals Right Answer and Explanation: 1. Right Answer: AExplanation: (A) Maintaining the hydration level is the focus for nursing intervention because dehydration enhances the sickling process. Both oral and parenteral fluids are used. (B) The pain is a result of the sickling process. Analgesics or narcotics will be used for symptom relief, but the underlying cause of the pain will be resolved with hydration. (C) Serious bacterial infections may result owing to splenic dysfunction. This is true at all times, not just during the acute period of a crisis. (D) O2 therapy is used for symptomatic relief of the hypoxia resulting from the sickling process. Hydration is the primary intervention to alleviate the dehydration that enhances the sickling process.2. Right Answer: BExplanation: (A) This answer is incorrect. Encouraging discussion of the voices will reinforce the delusion. (B) This answer is correct. The nurse should appropriately present reality. (C) This answer is incorrect. Showing interest would reinforce the delusional system. (D) This answer is incorrect. The statement only indicates that the client is hearing voices. It does not state that the client is acting out.3. Right Answer: AExplanation: (A) This answer is correct. The therapeutic range is 1.01.5 mEq/L in the acute phase. Maintenance control levels are 0.61.2 mEq/L. (B, C) This answer is incorrect. A level of 1.3 mEq/L is within therapeutic range. (D) This answer is incorrect. Toxic poisoning is usually at the 2.0 level or higher.4. Right Answer: AExplanation: (A) This answer is correct. A balanced diet with adequate salt intake is necessary. (B) This answer is incorrect. The client must drink six to eight full glasses of fluid per day (20003000 mL/day). (C) This answer is incorrect. The client should be instructed to avoid fluctuations of sodium intake. Diet should be balanced, with an adequate salt intake. (D) This answer is incorrect. Nausea is a frequent side effect that can be minimized with administration of drug with meals or after eating food.5. Right Answer: BExplanation: (A) This answer is incorrect. Role playing is based on learning but is not based on the behavioral modification model. (B) This answer is correct. The behavioral modification model is based on negative and positive reinforcers to change behavior. (C) This answer is incorrect. Verbal catharsis is not an intervention based on behavioral modification. (D) This answer is incorrect. Although an acceptable nursing intervention, it is not based on behavioral modification. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 93
Questions 1. A 22-year-old client presents with a diagnosis of antisocial personality disorder and a history of using drugs, writing numerous checks with insufficient funds, and stealing. He appears charming and intelligent, and the other clients are impressed and want to be liked by him. The greatest problem that may arise from this situation is that:A) He will manipulate the other clients for his own benefitB) He will cause the other clients to become psychoticC) He will become delusional and hallucinate as a result of the excess attention given to him by peersD) He may exhibit self-mutilative behavior2. In admitting a client to the psychiatric unit, the nurse must explain the rules and regulations of the unit. A client with antisocial personality disorder makes the following remark, 'Forget all those rules. I always get along well with the nurses.' Which nursing response to him would be most effective?A) 'OK, don - t listen to the rules. See where you end up.'B) 'I - m pleased that you get along so well with the staff.You must still know and abide by the rules.'C) 'It is irrelevant whether you get along with the nurses.'D) 'I - m not the other nurses. You better read the rules yourself.'3. A client was admitted to the hospital after falling in her home. At the time of admission, her blood alcohol level was 0.27 mg%. Her family indicates that she has been drinking a fifth of vodka a day for the past 9 months. She had her last drink 30 minutes prior to admission. Alcohol withdrawal symptoms would most likely be exhibited by her:A) Two to 4 hours after the last drinkB) Six to 8 hours after the last drinkC) Immediately on admissionD) Twenty-four hours after the last drink4. A client has begun to exhibit signs of alcohol withdrawal. Her blood pressure has risen from 120/60 to 190/100, pulse is increased from 88 to 110 bpm, and she is irritable and agitated and has gross motor tremors of the hands. The nurse notifies the doctor. The nurse can anticipate that the doctor will order which of the following?A) An opiate such as propoxyphene napsylate (Darvocet)B) A benzodiazepine such as chlordiazepoxide (Librium)C) A tricyclic antidepressant such as amitriptyline (Elavil)D) A phenothiazine such as chlorpromazine (Thorazine)5. A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimers disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:A) Allowing the client to perform activities of daily living as much as possible unassistedB) Confronting confabulationsC) Reality testingD) Providing a highly stimulating environment Right Answer and Explanation: 1. Right Answer: AExplanation: (A) This answer is correct. Persons with antisocial personality disorder typically are very manipulative. (B) This answer is incorrect. The clients behavior cannot cause another person to become psychotic. (C) This answer is incorrect. Psychosis is not a symptom of antisocial personality. One of the criteria for diagnosis of this disorder is that no psychosis be present. In addition, the client would love the attention. (D) This answer is incorrect. Self-mutilative behavior is characteristic of the borderline personality disorder.2. Right Answer: BExplanation: (A) This answer is incorrect. A nurse should be an appropriate role model. Threats are not appropriate. No limit setting was stated. (B) This answer is correct. The nurse made a positive statement followed by a simple, clear, concise setting of limits. (C) This answer is incorrect. It appears to have a negative connotation.There was no limit setting. (D) This answer is incorrect. The nurse obviously responded in a negative manner. Learning takes place more readily when one is accepted, not rejected. No limits were set.3. Right Answer: BExplanation: (A) This answer is incorrect. Alcohol withdrawal usually begins approximately 68 hours after the last drink. (B) This answer is correct. It takes approximately 68 hours for metabolism of alcohol. (C) This answer is incorrect. The alcohol is still in the system, as indicated by the high blood alcohol level. (D) This answer is incorrect. Symptoms of alcohol withdrawal usually begin within 68 hours of the last drink.4. Right Answer: BExplanation: (A) This answer is incorrect. Benzodiazepines are drugs of choice for alcohol withdrawal. (B) This answer is correct. The drug has a sedative effect, is safe, and has an anticonvulsant effect.(C) This answer is incorrect. Amitriptyline is an antidepressant. (D) This answer is incorrect. Chlorpromazine is most effective in psychotic disorders.5. Right Answer: AExplanation: (A) This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. (B) This answer is incorrect. Confrontation tends to increase anxiety. (C) This answer is incorrect. Reality testing is an assessment tool. It does not decrease anxiety. (D) This answer is incorrect. A highly stimulating environment increases distractibility and anxiety. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
Created by - Jenny Clarke
NCLEX-RN Exam Questions - Part 94
Questions 1. A 74-year-old client seen in the emergency room is exhibiting signs of delirium. His family states that he has not slept, eaten, or taken fluids for the past 24 hours.The planning of nursing care for a delirious client is based on which of the following premises?A) The delirious client is capable of returning to his previous level of functioning.B) The delirious client is incapable of returning to his previous level of functioning.C) Delirium entails progressive intellectual and behavioral deterioration.D) Delirium is an insidious process.2. A 48-year-old client presents with a long history of severedepression unrelieved by medication. He is admitted to the hospital for electroconvulsive therapy.Familymembers are very concerned about this therapy and are requesting information about aftereffects of the treatment. The nurse informs the family that he will:A) Have transient memory loss, confusion, andheadacheB) Be alert and oriented immediately after the treatmentC) Have insomnia for the first few daysD) Require no special care after the procedure3. An 80-year-old widow is living with her son and daughter- in-law. The home health nurse has been making weekly visits to draw blood for a prothrombin time test.The client is taking 5 mg of coumadin per day. She appears more debilitated, and bruises are noted on her face. Elder abuse is suspected. Which of the following are signs of persons who are at risk for abusing an elderly person?A) A family member who is having marital problems and is regularly abusing alcoholB) A person with adequate communication and coping skills who is employed by the familyC) A friend of the family who wants to help but is minimally competentD) A lifelong friend of the client who is often confused4. A 16-year-old client with a diagnosis of oppositional defiant disorder is threatening violence toward another child. In managing a potentially violent client, the nurse:A) Must use the least restrictive measure possible to control the behaviorB) Should put the client in seclusion until he promises to behave appropriatelyC) Should apply full restraints until the behavior is under controlD) Should allow other clients to observe the acting out so that they can learn from the experience5. The nurse is planning a reality orientation program for a group of clients with organic brain syndrome at the mental health center. Props that could be used for this program are:A) Month-old magazines that are provided by volunteersB) Large maps and posters depicting area of current residenceC) A litter of kittens for the clients to petD) A library of biographical books Right Answer and Explanation: 1. Right Answer: AExplanation: (A) This answer is correct. If the cause is removed, the delirious client will recover completely. (B) This answer is incorrect. The demented client is incapable of returning to previous level of functioning. The delirious client is capable of returning to previous functioning. (C) This answer is incorrect. The demented client, not the delirious client, has progressive intellectual and behavioral deterioration. (D) This answer is incorrect. Delirium develops rapidly, whereas dementia is insidious.2. Right Answer: AExplanation: (A) This answer is correct. The client will be confused and have a memory loss, which is usually temporary, after electroconvulsive shock therapy. (B) This answer is incorrect. The client will experience transient memory loss, look bewildered, and be confused initially. (C) This answer is incorrect. The client will sleep immediately following the treatment. (D) This answer is incorrect. Vital signs are taken at least hourly after treatment. The client is monitored for hypotension, tachycardia, respiratory problems, and possible seizure activity.3. Right Answer: AExplanation: (A) This answer is correct. Two risk factors are identified in this answer. (B) This answer is incorrect. Persons at risk tend to lack communication skills and effective coping patterns. (C) This answer is incorrect. Persons at risk are usually family members or those reluctant to provide care. (D) This answer is incorrect.This individual has a vested interest in providing care.4. Right Answer: AExplanation: (A) This answer is correct. Least restrictive measures should always be attempted before a client is placed in seclusion or restraints. The nurse should first try a calm verbal approach, suggest a quiet room, or request that the client take 'time-out' before placing the client in seclusion, givingmedication as necessary, or restraining. (B) This answer is incorrect. A calm verbal approach or requesting that a client go to his room should be attempted before restraining. (C) This answer is incorrect. Restraints should be applied only after all other measures fail to control the behavior. (D) This answer is incorrect. Other clients should be removed from the area. It is often very anxiety producing for other clients to see a peer out of control. It could also lead to mass acting- out behaviors.5. Right Answer: BExplanation: (A) This answer is incorrect. Current magazines would be appropriate. (B) This answer is correct. Maps of the state and town and posters that depict current events in the area are appropriate props. (C) This answer is incorrect. Kittens would be appropriate for pet therapy, not reality therapy. (D) This answer is incorrect. Biographies depict a past, not a present, orientation. .col-md-12 { -webkit-user-select: none; -ms-user-select: none; user-select: none; } .flash-sale-container{background:#134981;text-align:center;padding:2%;} p.flash-sale-text{ font-size:24px;font-family:"Poppins";letter-spacing:2px;line-height:1.4em; } span.flash-break{ display:block; } .flash-sale-text { -webkit-animation-name:flash; animation: blink 1.5s infinite; } @keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } @-webkit-keyframes blink{ 0% { color: #D3585F; } 20% { color: #D3585F; } 40% { color: #FFF; } 60% { color: #FFF; } 80% { color: #D3585F; } 100% { color: #D3585F; } } 80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
More detailsPublished - Thu, 23 Feb 2023
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