NCSBN TEST BANK FOR THE

NCSBN TEST BANK FOR THE

NCLEX RN (NGN) 2023/2024

VERIFIED 200 QUESTIONS and Answers with Rationale

A nurse is teaching a mother who will breast-feed for the first time.Which of these approaches is a priority?

Give the mother privacy for the initial feeding

Assist the mother to position the newborn at the breast

Give the mother several illustrated pamphlets

Show the mother films on the physiology of lactation - >>ANSWER>>Assist the mother to position the newborn at the breast

All of the approaches should be helpful in teaching. However, the priority is to place the infant to the breast as soon after birth as possible to establish contact and allow the newborn to begin to suck.

• / 4

The nurse in a long-term care facility is evaluating the plan of care for an older adult client with advanced dementia. The client has had several falls out of bed. Which initial intervention should the nurse implement?

Have the client sleep in a recliner at the nurse's station with a tray table across their lap

Put the bed in the lowest position with a thick pad or mat on the floor next to the bed Correct!

Place the client in a bed with an enclosure mesh tent attached to the frame

Position all side rails of the bed up and move the bed close to the door - >>ANSWER>>Falls out of bed are a common occurrence in the long-term care setting. Although it is nearly impossible to eliminate all falls, the nurse can implement interventions to reduce the risk for injury related to a fall. The goal is to start with the least invasive and restrictive intervention to preserve the client's rights, regardless of their level of cognitive function. 'Low' beds and 'landing' mats to soften the fall should the client roll out of bed are commonly used in long-term care settings and represent an appropriate, initial intervention to implement for this client. The other interventions are much more restrictive and should be used only after less restrictive interventions have been attempted.

• / 4

The nurse is developing a plan of care for a client who underwent total hip arthroplasty 24 hours ago. Which interventions should the nurse include? Select all that apply.

• Encourage the client to perform leg exercises while in bed

• Remind the client to not bend the knee of the affected leg while

seated

• Encourage the use of an abduction pillow or splint between the

legs

• Provide a seat riser for the toilet or commode

• Encourage the client to use the incentive spirometer every 2 hours

Assist the client with a clear liquid diet - >>ANSWER>>1,3,4,5

To prevent postoperative complications and complications related to immobility, the client should be up in a chair as soon as possible after surgery. While seated, the client should bend the affected leg at the knee. The nurse should reinforce teaching of simple leg exercises while in bed and the use of an abduction pillow or foam wedge to prevent adduction. To prevent atelectasis and pneumonia the client should be encouraged to use an incentive spirometer every 2 hours.Once the client is alert after surgery and not experiencing nausea or vomiting, they can resume a regular diet. 3 / 4

A nurse is performing physical assessments on adolescents. What finding should the nurse anticipate concerning female growth spurts?

Occur about two years earlier than for males

Begin about the same time for males

Start just prior to the onset of puberty

Characterized by an increase in height of 4 inches each year - >>ANSWER>>Occur about two years earlier than for males

A nurse is caring for a client following a Computed Tomography (CT) scan of the kidneys with contrast. Which of these findings would require prompt intervention by the nurse?

Soreness reported at the IV site

Elevated serum creatinine above baseline

The client states that the urethra feels irritated and sore from the catheter

• / 4