NClex Readiness Part 1

NClex Readiness Part 1 3.0 (2 reviews) Students also studied Terms in this set (200) Science MedicineNursing Save VATI Comprehensive Predictor NCL...175 terms robncashPreview NCLEX Bootcamp 2025 Practice Qu...67 terms sammiebooth719 Preview Nclex readiness 234 terms joseph_RoodPreview ATI com 198 term h_tr What intervention is essential prior to starting a client on atorvastatin therapy?

• Assessing for muscle strength
• Assessing the client's dietary intake
• Determining if the client is on digoxin therapy
• Monitoring liver function tests
• Assessing the client's dietary intake

The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage. Which client statement indicates an understanding of teaching?

• "I need to be on bed rest for the duration of my

pregnancy."

• "I will notify my health care provider if I start having

low back aches."

• "Pelvic pressure is to be expected after cerclage

placement."

• "The cerclage will be removed once my baby is at 28

weeks."

• "I will notify my health care provider if I start having low back aches."

During the first prenatal assessment, the client reports the last normal menstrual period starting on March 1 and ending on March 5, but also slight spotting on March 23.The client had unprotected intercourse on March 15.Using Naegele's rule, what is the estimated date of birth?

• December 8
• December 12
• December 22
• December 30
• December 8

A client is prescribed long-term pharmacologic therapy with hydroxychloroquine to treat systemic lupus erythematosus. Which intervention related to the drug's adverse effects should the nurse include in the teaching plan?

• Have an ophthalmologic examination every 6 months
• Take the medication on an empty stomach
• Take vitamin D and calcium supplements
• Wear a Medic Alert bracelet
• Have an ophthalmologic examination every 6 months

The nurse is caring for a client diagnosed with Guillain- Barré syndrome (GBS) after a recent gastrointestinal (GI) illness. Monitoring for which of the following is a nursing care priority for this client?

• Diaphoresis with facial flushing
• Hypoactive or absent bowel sounds
• Inability to cough or lift the head
• Warm, tender, and swollen leg
• Inability to cough or lift the head

The nurse notes muffled heart tones in a client with a pericardial effusion. How would the nurse assess for a pulsus paradoxus?

• Check for variation in amplitude of QRS complexes on

the electrocardiogram strip

• Compare apical and radial pulses for any deficit
• Measure the difference between Korotkoff sounds

auscultated during expiration and throughout the respiratory cycle

• Multiply diastolic blood pressure (DBP) by 2, add

systolic blood pressure (SBP), and divide the result by 3; [(DBP x 2) + (SBP)]/3

• Measure the difference between Korotkoff sounds auscultated during

expiration and throughout the respiratory cycle The nurse is developing a nutritional plan for a 6-month- old who has recently been started on solid foods. Which of the following recommendations has the highest priority in the plan?

• Canned baby food is more expensive than food

prepared at home

• Finger foods can be introduced before the child has

teeth

• New foods should be introduced at least 5-7 days

apart

• Rice cereal can be mixed with cow's milk to increase

nutritional intake

• New foods should be introduced at least 5-7 days apart

A female client with liver cirrhosis and chronic anemia is hospitalized for a deep venous thrombosis. The client is receiving a heparin infusion and suddenly develops epistaxis. Which laboratory value would indicate that the heparin infusion needs to be turned off?

• Hematocrit of 30% (0.30)
• Partial thromboplastin time of 110 seconds
• Platelet count of 80,000/mm3 (80 x 109/L)
• Prothrombin time of 11 seconds
• Partial thromboplastin time of 110 seconds

An 84-year-old client with oxygen-dependent chronic obstructive pulmonary disease is admitted with an exacerbation and steady weight loss. The client has been in the hospital 4 times over the last several months and is "tired of being poked and prodded." Which topic would be most important for the nurse to discuss with this client's health care team?

• Need for discharge to a skilled nursing facility
• Nutritional consult with instructions on a high-calorie

diet

• Option of palliative care
• Physical therapy prescription to promote activity
• Option of palliative care

The nurse working on the inpatient psychiatric unit is

preparing to administer 9:00 AM medications to a client.

The medication administration record is shown in the exhibit. On assessment, the client is tremulous, exhibits muscle rigidity, and has a temperature of 101.1 F (38.4 C).Which action should the nurse take?

• Give all medications, including acetaminophen, and

reassess in 30 minutes

• Hold the haloperidol, give acetaminophen, and

reassess in 30 minutes

• Hold the haloperidol and notify the health care

provider (HCP) immediately

• Hold the hydrochlorothiazide and notify the HCP

immediately

• Hold the haloperidol and notify the health care provider (HCP) immediately

A client, who has been hospitalized for 3 days with major depressive disorder, has stayed in the room and not gotten out of bed except for toileting. The nurse enters the room to remind the client that breakfast will be served in the dining room in 20 minutes. The client says, "I'm not hungry and I don't feel like doing anything." What is the best response by the nurse?

• "I will help you get ready; then we can walk to the

dining room together."

• "I'll have breakfast brought to your room."
• "It's okay. You can join us when you are ready."
• "You'll feel better when you get up."
• "I will help you get ready; then we can walk to the dining room together."

The public health nurse conducts a program at the community senior citizen center about preventing falls at home. Which statement made by a participant indicates that further education is needed?

• "I bought a new nightlight for the hallway to the

bathroom."

• "I feel so much more secure wearing my electronic fall

alert device."

• "I walk in my stockings at home because it helps to

relieve my bunion pain."

• "My daughter helped me secure the small, thin rug in

my kitchen with strong tape."

• "I walk in my stockings at home because it helps to relieve my bunion pain."

A 15-year-old parent brings a 4-month-old infant for a well-baby checkup. The parent tells the nurse that the baby cries all the time; the parent has tried everything to keep the infant quiet but nothing works. What is the priority nursing action?

• Advise the parent to give a pacifier whenever the infant

cries

• Ask the parent to describe what is done to "keep the

baby quiet"

• Assess the infant's pattern and frequency of crying
• Explore the parent's support system
• Assess the infant's pattern and frequency of crying

A major earthquake has occurred. Local gas lines and water pipes are breaking with resulting fires and flooding in collapsed buildings. Multiple victims arrive at the triage area. Which client should the nurse care for first?

• Client with charred, leathery skin over entire back,

chest, and legs

• Client with cool skin, shivering from sitting in water until

rescued

• Client with diabetes who was unable to take

prescribed insulin today

• Client with high-pitched, crowing inspiratory

respirations

• Client with high-pitched, crowing inspiratory respirations

The charge nurse in the cardiac intensive care unit responds to a client room where a resuscitation effort is in progress. The client's immediate family member refuses to leave the room. How should the charge nurse handle this situation?

• Call security to escort the family member to the waiting

room

• Have the family member stand or sit in an area that is

not in the staff's way

• Inform the family member that relatives are not allowed

in rooms during emergency situations

• Let the family member stay and assign a staff person to

explain what is happening

• Let the family member stay and assign a staff person to explain what is

happening The nurse prepares to administer clozapine to a client with schizophrenia. Which client statement would require priority investigation before administering the medication?

• "I have gained a few pounds since I started this

medication."

• "I have had a sore throat for 3 days and feel feverish

today."

• "I have noticed increased salivation and drooling."
• "I often feel sleepy when I take this medication."
• "I have had a sore throat for 3 days and feel feverish today."