NCLEX-PN
Nclex PN Questions and Answers
1. While preparing a client for a bronchoscopy, a nurse notes that the client is wearing a gold necklace. What should the nurse do to safeguard the client's necklace?
- A. Ask the client for permission to lock the necklace in the hospital safe
- B. Ask the client to remove the necklace and place it in the top drawer of the bedside table
- C. Ask the client whether the necklace is gold
- D. Ask the client to sign a release to free the hospital of responsibility if the necklace is damaged or lost during the procedure
Correct answer: A
Rationale: When a client has valuables such as jewelry, the nurse should ensure their safekeeping. It is appropriate for the nurse to ask the client for permission to lock the necklace in the hospital safe to prevent loss or damage. This option prioritizes the security of the necklace while allowing the client to make an informed decision. Asking the client to sign a release form does not guarantee the necklace's safety; it only releases the hospital from liability. Placing the necklace in a bedside table drawer does not provide adequate security as it is not as secure as a hospital safe. Inquiring whether the necklace is gold is irrelevant to safeguarding the jewelry during the procedure, as the primary concern is its safekeeping.
2. To remove hard contact lenses from an unresponsive client, what should the nurse do?
- A. Gently irrigate the eye with an irrigating solution from the inner canthus outward
- B. Grasp the lens with a gentle pinching motion
- C. Don sterile gloves before attempting the procedure
- D. Ensure that the lens is centered on the cornea before gently manipulating the lids to release the lens
Correct answer: D
Rationale: When removing hard contact lenses from an unresponsive client, the nurse should ensure that the lens is centered on the cornea before gently manipulating the lids to release the lens. This approach helps prevent scratching the cornea. Gently maneuvering the upper and lower eyelids assists in loosening the lens for easy removal. Options A, B, and C are incorrect because irrigating the eye, grasping the lens, or wearing sterile gloves are not recommended methods for removing hard contact lenses. It is crucial to handle the situation delicately to avoid causing harm or discomfort to the client.
3. The LPN is checking for residual before administering enteral feeding through a PEG tube. Which of these steps is incorrect?
- A. The LPN elevates the head of the bed by at least 30 degrees.
- B. If the residual is greater than 200mL, the LPN should not administer the enteral feeding.
- C. The LPN should discard the residual before administering the tube feeding.
- D. The residual pH level is tested to ensure appropriate placement.
Correct answer: C
Rationale: The incorrect step is choice C. The residual should be discarded before administering the tube feeding. Discarding the residual is essential to prevent contamination and ensure accurate measurement of the enteral feeding. Elevating the head of the bed by at least 30 degrees (choice A) is correct as it helps prevent aspiration during feeding. Testing the pH level of the residual (choice D) ensures proper placement of the tube. Withholding feeding if the residual is greater than 200mL (choice B) is crucial to prevent overfeeding, making this statement correct.
4. Which of the following is an indication for electroencephalography?
- A. paralysis
- B. neuropathy
- C. seizure disorder
- D. myocardial infarction
Correct answer: C
Rationale: The correct answer is C: 'seizure disorder.' Electroencephalography is used to assess clients with seizure disorders by recording the brain's electrical activity. Seizure disorder is a primary indication for an EEG as it helps in diagnosing and managing seizure activity. Paralysis (choice A) is not typically an indication for an EEG as it relates to loss of muscle function rather than brain activity. Neuropathy (choice B) involves nerve damage and is not directly assessed by an EEG. Myocardial infarction (choice D) is related to heart issues and is not a condition that an EEG is used to diagnose.
5. A syringe pump is a type of electronic infusion pump used to infuse fluids or medications directly from a syringe. This device is commonly used for:
- A. solutions administered in obstetrics.
- B. dilute antibiotics.
- C. large volumes of IV solutions.
- D. the neonatal and pediatric populations.
Correct answer: D
Rationale: The correct answer is 'the neonatal and pediatric populations.' Syringe pumps are commonly used in neonatal and pediatric populations because they allow for precise infusion of small volumes of medications or fluids at controlled rates. This is crucial for ensuring safety and accuracy in these delicate populations. Choice A is incorrect because syringe pumps are not limited to obstetrics; they are used in various healthcare settings. Choices B and C are incorrect because syringe pumps are not typically used for dilute antibiotics or large volumes of IV solutions. Instead, they are preferred for delivering small volumes accurately, making them ideal for neonatal and pediatric care.
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