NCLEX-PN 400 practice questions

NCLEX-PN 400 practice questions
1. A client in the prenatal clinic presents with a blood pressure reading of 140/90 mm Hg, which is an
elevation from last month's reading of 114/66 mm Hg. Which additional sign or symptom suggests
to the nurse that the client has
mild preeclampsia?
1.Headaches
2.Generalized edema
3.Weight gain of 10 pounds
4.Trace amount of protein
4.Trace amount of protein
Rationale: Preeclampsia is considered
mild when the diastolic blood pressure does not exceed 100 mm Hg
and proteinuria is no more than 500
mg/day (trace to 1+). Symptoms such as
headache, visual disturbances, or abdominal pain are typically absent with
mild preeclampsia. Therefore, the only
sign of mild preeclampsia from the options given is a trace amount of protein. A rapid weight gain and generalized edema may occur. Headaches are
present in severe preeclampsia.
2. A 4-year-old child is hospitalized
with a suspected diagnosis of
Wilms' tumor. The nurse reviews
the plan of care and would question which intervention that is
written in the plan?
1.Palpate the abdomen for a mass.
2.Check the urine for the presence
of hematuria.
3.Monitor the blood pressure for
the presence of hypertension.
4.Monitor the temperature for the
presence of a kidney infection.
1.Palpate the abdomen for a mass.
Rationale: Wilms' tumor is an intraabdominal and kidney tumor. If Wilms'
tumor is suspected, the mass should
not be palpated. Excessive manipulation can cause seeding of the tumor and
thus cause the spread of the cancerous cells. Hematuria, hypertension, and
fever are signs and symptoms that are
associated with Wilms' tumor.
3. The nurse is caring for a
58-year-old client with chronic kidney disease who is receiving peritoneal dialysis. Which finding is
considered most important by the
nurse, requiring primary health
care provider notification? Refer
to chart.
2. WBC 15,000 mm3
Rationale: Peritonitis is the most common complication of peritoneal dialysis
and is often caused by a contamination in the system. This infection can
initially be determined by an increased
WBC count. It can also include abdom