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Practice Test 10 - NCLEX Rn

20 questions. Answer them in any order, then submit to see your score and every explanation.

  1. A 67-year-old client with chronic kidney disease is hospitalized for sepsis and has both an NG tube for gastric decompression and a Foley catheter for strict intake and output. The client becomes restless and attempts to pull at the NG tube; the nurse notes the NG tube is secured but the Foley drainage bag contains 30 mL of urine in the last 4 hours, the tubing is patent, and the client has new crackles in both lung bases with SpO2 90% on 2 L/min nasal cannula. The nurse should IMPLEMENT which intervention FIRST?
  2. An 80-year-old client from a long-term care facility is brought to the emergency department for decreased oral intake and new confusion. Findings: temperature 37.9°C, heart rate 116/min, blood pressure 90/48 mm Hg, respiratory rate 24/min, oxygen saturation 96% on room air; skin is cool and mottled; lactate 3.9 mmol/L (0.5–2.0). Which assessment finding should the nurse address FIRST?
  3. A 41-year-old client is receiving a blood transfusion for symptomatic anemia. Ten minutes after initiation, the infusion pump displays an error and stops; the client reports chills and back discomfort. Which action should the nurse take FIRST?
  4. A bus accident has resulted in numerous injuries at a rural clinic, and the nurse is using START triage. Which victim should the nurse attend to FIRST? Victims include: (1) a 26-year-old ambulatory with a painful wrist deformity, respirations 18/min, radial pulse present; (2) a 40-year-old with respirations 10/min, shallow, responds to verbal stimuli, radial pulse weak; (3) a 58-year-old with a large scalp laceration, bleeding controlled, respirations 20/min, oriented; (4) a 33-year-old who is crying and hyperventilating at 30/min after minor abrasions, follows commands and has a strong radial pulse.
  5. During a telehealth visit for hypertension, a 50-year-old client asks the nurse to switch from the secure video platform to a public video app because "it works better." Which action should the nurse take FIRST to ensure client privacy during the telehealth session?
  6. A 26-year-old client sprained the wrist 1 hour ago and reports pain 5/10 that is throbbing with mild swelling; the client asks, "Should I use ice or heat?" Skin is intact and sensation is normal. Which intervention is MOST appropriate given the client's pain type?
  7. A 24-year-old man presents to a community clinic. He reports multiple partners and inconsistent condom use; he has no symptoms. He is concerned about cost and asks which STI screening is most important to do routinely. Which screening should be prioritized for this client?
  8. A 49-year-old client with ovarian cancer is in an outpatient infusion clinic. Labs today: ANC 460/mm³. The client reports a new cough and feels "warm," with an oral temperature of 38.1°C (100.6°F). What is the PRIORITY nursing action?
  9. A 24-year-old client with asthma comes to the clinic with worsening shortness of breath and wheezing despite using a rescue inhaler at home. Respiratory rate is 30/min, heart rate is 120/min, blood pressure is 136/84 mm Hg, oxygen saturation is 90% on room air, and the client is speaking in short phrases. What is the PRIORITY nursing intervention?
  10. A 28-year-old client with no chronic illnesses is 8 hours postoperative from exploratory laparotomy and is using an intravenous opioid PCA. Current assessment: pain 1/10, blood pressure 112/66 mm Hg, heart rate 60/min, respiratory rate 9/min, oxygen saturation 91% on room air; pupils are pinpoint and the client is difficult to keep awake. Which finding indicates a complication of PCA therapy?
  11. In a community health home-visit program, an RN is working with an LPN and a UAP. A 68-year-old client with osteoarthritis is stable and needs a home safety check to reduce fall risk (lighting, loose rugs, and clear pathways). Which task can the RN delegate to the UAP?
  12. A 90-year-old nursing home resident with severe arthritis reports that a staff member frequently withholds pain medication "to keep you from getting addicted." The medication administration record shows missed doses without explanation. The resident appears grimacing and rates pain 8/10. Which intervention best supports client rights in this scenario?
  13. A 27-year-old client in an outpatient clinic discloses suicidal ideation after losing housing and separating from a partner. History includes major depressive disorder and one prior suicide attempt 3 years ago; the client is anxious, tearful, and reports access to a friend's handgun. The nurse and client begin developing a safety plan. The nurse should QUESTION which part of the client's safety plan?
  14. A 38-year-old client with a chest tube for pneumothorax is ambulating when the drainage system tips over and the water-seal chamber empties. VS: HR 102, RR 22, BP 130/80, SpO2 93% on room air; drainage is minimal serosanguineous. What is the nurse's PRIORITY action?
  15. A 66-year-old client is 2 days postoperative from a colectomy with a Jackson-Pratt (JP) drain in place on a surgical unit. The client reports increasing pain at the drain site; assessment shows erythema extending 2 cm around the insertion site, warmth, purulent drainage at the skin, and temperature 38.6°C (101.5°F). The nurse should IMPLEMENT which intervention FIRST?
  16. A 33-year-old client presents after being trapped briefly in a burning apartment with approximately 20% total body surface area partial-thickness burns to the face and neck. History includes no chronic illness; assessment shows carbonaceous sputum and mild confusion. Vital signs: T 37.0°C (98.6°F), HR 110/min, RR 24/min, BP 118/74 mm Hg, SpO2 100% on room air. Which intervention should the nurse prioritize for this burn client?
  17. On an acute care postoperative unit, the RN is working with an LPN and a UAP. Which client care task requires RN intervention for a 54-year-old client who is 6 hours postoperative after abdominal surgery and has a new heart rate of 128/min with cool, clammy skin?
  18. In a community health clinic, an RN is coordinating care for a family and working with a UAP and an LPN. A 6-year-old child is scheduled for a well-child visit and needs height, weight, and vital signs obtained before the RN assessment. Which task can the RN delegate to the UAP?
  19. A 61-year-old client with newly diagnosed heart failure is being discharged from the hospital and asks, "What is an advance directive?" The client is alert, has a supportive partner, and has no document on file. Current assessment: blood pressure 128/76 mm Hg, heart rate 84/min, mild ankle edema, denies chest pain. Which action is MOST appropriate for the nurse when discussing advance directives with the client?
  20. A 45-year-old Hispanic client is 6 hours postoperative after a laparoscopic cholecystectomy and reports incisional pain rated 6/10 that is aching and worse with deep breathing; the client has used slow breathing in the past and prefers to try nonmedication options first. Vital signs are stable and the incision dressing is clean and dry. Which nonpharmacologic technique should the nurse implement FIRST?

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