Free NCLEX-PN Practice Questions
Question 1 of 5.
Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding signals a significant problem during this procedure?
A. Blood glucose level of 200 mg/dl
B. White blood cell (WBC) count of 20,000/mm3
C. Potassium level of 3.8 mEq/L
D. Hematocrit (HCT) of 35%
Explanation: An increased WBC count indicates infection, probably resulting from peritonitis, which may have been caused by insertion of the peritoneal catheter into the peritoneal cavity. Peritonitis can cause the peritoneal membrane to lose its ability to filter solutes; therefore, peritoneal dialysis would no longer be a treatment option for this client. Hyperglycemia occurs during peritoneal dialysis because of the high glucose content of the dialysate; it's readily treatable with sliding-scale insulin. A potassium level of 3.8 mEq/L is an acceptable value. An HCT of 35% is lower than normal. However, in this client, the value isn't abnormally low because of the daily blood samplings. A lower HCT is common in clients with chronic renal failure because of the lack of erythropoietin.
Question 2 of 5.
The nurse on the psychiatric unit is caring for several clients. Which client needs the most immediate attention?
A. A man is pacing the floor in circles.
B. A man is rocking back and forth and crying.
C. A man is screaming and running around.
D. A man is sitting in the corner and not moving or speaking.
Explanation: Screaming and running indicate potential danger to self or others, requiring immediate intervention to ensure safety.
Question 3 of 5.
An adult has injured her ankle and asks her neighbor, a nurse, for assistance. The ankle appears swollen, and the client cannot move it without severe pain. Before arranging transport to the emergency room, which action by the nurse would be most appropriate?
A. Applying a warm compress to the ankle
B. Keeping the ankle elevated
C. Performing range-of-motion exercises on the ankle
D. Seeing if the client can ambulate safely
Explanation: Elevation reduces swelling and pain in an acute ankle injury, preparing for safe transport to the ER.
Question 4 of 5.
A woman had a hysterectomy this morning. She asks the nurse why she has to wear 'these uncomfortable stockings on my legs.' How should the nurse reply?
A. They are to keep your legs warm after the surgery in the cool operating room.
B. They help to prevent varicose veins, which are common after your type of surgery.
C. If they are uncomfortable, I can remove them now.
D. They help to prevent blood clots in your legs, which can be dangerous.
Explanation: Compression stockings prevent deep vein thrombosis by promoting venous return, critical post-surgery.
Question 5 of 5.
The nurse is talking with a client who has just had an ECG. The client says to the nurse, 'The doctor said I had a sinus rhythm. What does that mean?' Which response to the client is best?
A. I wouldn't worry about that. It's pretty normal.'
B. Sinus rhythm means that the heartbeat starts where it should. That is a place called the sinoatrial node. Sinus rhythm is good.'
C. Many people have a sinus rhythm and do very well. It is not a bad rhythm.'
D. Sinus rhythm means that the heartbeat is starting in the sinus of the heart. The physician will monitor your rhythm frequently to make sure it does not get worse.'
Explanation: Sinus rhythm originates from the sinoatrial node, the heart's normal pacemaker, indicating a healthy rhythm. This explanation is accurate and educational without causing alarm or implying unnecessary monitoring.