NCLEX RN TEST 1 NGN QUESTIONS AND
ANSWERS COMPLETE SOLUTIONS
◉ A nurse coworker is called into work from home to help care for an
influx of clients being admitted after a bus accident. While assisting
the coworker prepare for incoming clients, the nurse becomes
concerned that the coworker may be under the influence of an
impairing substance. Which action by the nurse is best?
1.
Ask another coworker to observe the individual to confirm the
suspicion
2.
Confront the coworker about the concern and offer emotional support
3.
Speak with the nursing supervisor about the concern
4.
Telephone the appropriate regulatory agency and make a report.
Answer: 3.
◉ A nurse is administering a rituximab infusion to a client with
lymphoma in an oncology clinic. Which client symptom would be a
priority to report to the health care provider?
1.
Dizziness and sudden diarrhea
,2.
Nausea and onset of vomiting
3.
New-onset tachypnea and dyspnea
4.
Temperature of 101 F (38.3 C). Answer: 3.
◉ The student nurse plans postmortem care for an Orthodox Jewish
client hospitalized for the last week with heart failure who did not
sign consents for any postmortem actions. Which statement by the
student would require further education by the supervising nurse?
1.
"I will allow the family to remain with the client at all times."
2.
"I will call the next of kin before providing any postmortem care."
3.
"I will prepare the client for transfer to the morgue for autopsy."
4.
"I will provide a sheet to be placed over the client's face.". Answer: 3.
◉ The nurse is caring for a client with chronic pancreatitis. Which
meal should the nurse recommend when assisting the client in
selecting food items from a menu?
1.
Baked tilapia with lemon wedge, sweet potatoes, and green peas
,2.
Cream of potato soup and roast beef sandwich on a croissant
3.
Sautéed salmon, macaroni and cheese, string beans, and a biscuit
4.
Shrimp enchiladas with tomato salsa, rice, cornbread, and refried
beans. Answer: 1.
◉ The nurse is preparing to change the dressing of a client's
subclavian central venous catheter using a chlorhexidine gluconate
(CHG)-impregnated patch and transparent adhesive dressing. Place
the procedural steps in the correct order. All options must be used.
Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
Cleanse the site with CHG for at least 30 seconds using friction; allow
to air dry completely
Discard the clean gloves, perform hand hygiene, and apply sterile
gloves
Perform hand hygiene, don face mask, place a mask on the client, and
apply clean gloves
, Remove old dressing and CHG-impregnated patch; assess insertion
site. Answer: Perform hand hygiene, don face mask, place a mask on
the client, and apply clean gloves
Remove old dressing and CHG-impregnated patch; assess insertion
site
Discard the clean gloves, perform hand hygiene, and apply sterile
gloves
Cleanse the site with CHG for at least 30 seconds using friction; allow
to air dry completely
Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
◉ Four clients enter the pediatric emergency department at the same
time. Which client should the nurse see first?
1.
2-week-old with tricuspid atresia who has dusky lips and nailbeds
2.
5-week-old with forceful vomiting after every feeding who is crying
3.
12-month-old who was wheezing at home and is now lethargic with
no wheezing
4.
ANSWERS COMPLETE SOLUTIONS
◉ A nurse coworker is called into work from home to help care for an
influx of clients being admitted after a bus accident. While assisting
the coworker prepare for incoming clients, the nurse becomes
concerned that the coworker may be under the influence of an
impairing substance. Which action by the nurse is best?
1.
Ask another coworker to observe the individual to confirm the
suspicion
2.
Confront the coworker about the concern and offer emotional support
3.
Speak with the nursing supervisor about the concern
4.
Telephone the appropriate regulatory agency and make a report.
Answer: 3.
◉ A nurse is administering a rituximab infusion to a client with
lymphoma in an oncology clinic. Which client symptom would be a
priority to report to the health care provider?
1.
Dizziness and sudden diarrhea
,2.
Nausea and onset of vomiting
3.
New-onset tachypnea and dyspnea
4.
Temperature of 101 F (38.3 C). Answer: 3.
◉ The student nurse plans postmortem care for an Orthodox Jewish
client hospitalized for the last week with heart failure who did not
sign consents for any postmortem actions. Which statement by the
student would require further education by the supervising nurse?
1.
"I will allow the family to remain with the client at all times."
2.
"I will call the next of kin before providing any postmortem care."
3.
"I will prepare the client for transfer to the morgue for autopsy."
4.
"I will provide a sheet to be placed over the client's face.". Answer: 3.
◉ The nurse is caring for a client with chronic pancreatitis. Which
meal should the nurse recommend when assisting the client in
selecting food items from a menu?
1.
Baked tilapia with lemon wedge, sweet potatoes, and green peas
,2.
Cream of potato soup and roast beef sandwich on a croissant
3.
Sautéed salmon, macaroni and cheese, string beans, and a biscuit
4.
Shrimp enchiladas with tomato salsa, rice, cornbread, and refried
beans. Answer: 1.
◉ The nurse is preparing to change the dressing of a client's
subclavian central venous catheter using a chlorhexidine gluconate
(CHG)-impregnated patch and transparent adhesive dressing. Place
the procedural steps in the correct order. All options must be used.
Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
Cleanse the site with CHG for at least 30 seconds using friction; allow
to air dry completely
Discard the clean gloves, perform hand hygiene, and apply sterile
gloves
Perform hand hygiene, don face mask, place a mask on the client, and
apply clean gloves
, Remove old dressing and CHG-impregnated patch; assess insertion
site. Answer: Perform hand hygiene, don face mask, place a mask on
the client, and apply clean gloves
Remove old dressing and CHG-impregnated patch; assess insertion
site
Discard the clean gloves, perform hand hygiene, and apply sterile
gloves
Cleanse the site with CHG for at least 30 seconds using friction; allow
to air dry completely
Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
◉ Four clients enter the pediatric emergency department at the same
time. Which client should the nurse see first?
1.
2-week-old with tricuspid atresia who has dusky lips and nailbeds
2.
5-week-old with forceful vomiting after every feeding who is crying
3.
12-month-old who was wheezing at home and is now lethargic with
no wheezing
4.
