NCLEX PN - Predictor Test
A client with autism spectrum disorder aged 10 is admitted to the hospital for diagnostic testing.
Which is the most appropriate nursing action? - ANS-Giving the client a schedule of daily
activities
A 4-year old is diagnosed with Duchenne muscular dystrophy. ANS-Remove throw rugs from
the home. Which nursing lesson is best to reinforce for this child's parents? A client a hx of a
seizure disorder has a seizure while sitting in a chair. Which nursing interventions are
appropriate during the seizure activity? - ANS-- Administer oxygen as needed if client becomes
cyanotic
- Move the client from chair to the floor to prevent a fall.
- Record the duration of seizure activity for documentation.
A client comes to the emergency department after being bitten by a bat. The nurse observes 2
small, nondraining puncture wounds resembling pinpricks on the fingertip. Which action should
the nurse implement first? - ANS-Scrub the wound with povidone-iodine solution or soap and
water
A client has been diagnosed with preeclampsia at 28 weeks of pregnancy. Which are potential
signs/symptoms related to this syndrome? - ANS-- 2+ pitting edema
- 300 mg/24 hr protein urine
- Headache and blurry vision
A client is given the diagnosis of septic knee arthritis. What manifestations does the nurse
expect to find? - ANS-- Fever
- Joint swelling with effusion
- Limited range of motion
- Moderate to severe pain
A client is in cardiac arrest. and resuscitation efforts are in progress when the client's spouse
arrives. The client's spouse insists on coming into the room. How should the nurse respond? -
ANS-Allow the spouse into the room and provide a chair
A female client is visiting the clinic for an annual well-woman examination. The client reports
having had sex with women. Which question will help the nurse determine the client's risk for
sexually transmitted infections? - ANS-What barrier methods do you and your partner use?
A nurse helps a nursing student create a care plan for a hospice client who is nonverbal and
acts restless and grimaces when repositioned. Which statements by the student nurse indicate
a correct understanding of the goals of end-of-life care? - ANS-- I can observe the client's
agitation as an indicator of client's pain level
- I should continue to explain interventions I am performing even though the client is
unresponsive
- I will ask the family if they would like to hold the client's hand while I administer pain
medication
- Managing pain rather than treating disease is the priority goal for this client.
, A nurse in the emergency department is caring for a client should the nurse see first? -
ANS-Client with myasthenia gravis who has a fever and increasing difficulty swallowing.
A nurse is caring for a client 1 day postoperative craniotomy. Which nursing actions are
appropriate to prevent increased intracranial pressure? - ANS-- Administer stool softener
- Dim lights when not providing care
- Maintain body in midline position
At a swimming pool, a nurse is giving an adult cardiopulmonary resuscitation (CPR). A
bystander brings the automated external defibrillator (AED). The victim is wet, lying in a small
pool of water, and wearing a transdermal medication patch on the upper right chest, according
to the nurse. What is the most appropriate action at this time? - ANS-Remove the transdermal
patch and wipe the chest dry before using the AED
A pregnant client in the third trimester completes an intake form for a clinic visit. The nurse
understands that which signs and symptoms warrant further investigation? - ANS-- Copious
amounts of watery, clear vaginal discharge
- Dysuria and right flank pain
- Headache and blurred vision
A student nurse is accompanying the charge nurse when conducting daily rounds. Which
personal protective measure by the charge nurse does the student nurse question? -
ANS-Wears 2 pairs of gloves when emptying the urinary catheter collection bag of a client with
HIV.
After listening to the parents' report and seeing the ff pediatric clients, the nurse knows that
which client demonstrates signs of abuse that may necessitate mandatory reporting? - ANS-5-
year old whose x- ray reveals 1 new and 2 healed humerus fractures after falling from a tree.
An elderly client with diabetes comes to the clinic in winter reporting numbness of the feet.
After removing the client's shoes and socks, the nurse notes that the feet are ice cold to the
touch and appear waxy and pale. What is the appropriate nursing action? - ANS-Soak the
client's lower legs in a warm water bath
An unaccompanied 16 year old girl comes to the emergency department with a severe
abdominal pain and vomiting. The client has a temp of 102.2 F (39 C) and a pulse of 120/min
and is lethargic. The client's parents are out of town, and no guardians can be reached. How
should the client's care be handled? - ANS-Administer care until the parents or guardians can
be reached.
During a follow-up visit to the primary care clinic, the nurse evaluates a client's understanding
about prevention of complications from varicose veins. Which client statements indicate a
correct understanding? - ANS-- I avoid crossing my legs when sitting
- I have started wearing elastic compression hose
- I try to elevate my legs as often as possible
- I try to walk at least a mile every day
For which client is it most important for the nurse to reinforce teaching regarding ways to
prevent the spread of the condition? - ANS-The client with tinea corporis
Four clients enter the emergency department at the same time. Which client should the nurse
alert the health care provider to see first? - ANS-40 year old with a first degree burn and singed
beard from a campfire
A client with autism spectrum disorder aged 10 is admitted to the hospital for diagnostic testing.
Which is the most appropriate nursing action? - ANS-Giving the client a schedule of daily
activities
A 4-year old is diagnosed with Duchenne muscular dystrophy. ANS-Remove throw rugs from
the home. Which nursing lesson is best to reinforce for this child's parents? A client a hx of a
seizure disorder has a seizure while sitting in a chair. Which nursing interventions are
appropriate during the seizure activity? - ANS-- Administer oxygen as needed if client becomes
cyanotic
- Move the client from chair to the floor to prevent a fall.
- Record the duration of seizure activity for documentation.
A client comes to the emergency department after being bitten by a bat. The nurse observes 2
small, nondraining puncture wounds resembling pinpricks on the fingertip. Which action should
the nurse implement first? - ANS-Scrub the wound with povidone-iodine solution or soap and
water
A client has been diagnosed with preeclampsia at 28 weeks of pregnancy. Which are potential
signs/symptoms related to this syndrome? - ANS-- 2+ pitting edema
- 300 mg/24 hr protein urine
- Headache and blurry vision
A client is given the diagnosis of septic knee arthritis. What manifestations does the nurse
expect to find? - ANS-- Fever
- Joint swelling with effusion
- Limited range of motion
- Moderate to severe pain
A client is in cardiac arrest. and resuscitation efforts are in progress when the client's spouse
arrives. The client's spouse insists on coming into the room. How should the nurse respond? -
ANS-Allow the spouse into the room and provide a chair
A female client is visiting the clinic for an annual well-woman examination. The client reports
having had sex with women. Which question will help the nurse determine the client's risk for
sexually transmitted infections? - ANS-What barrier methods do you and your partner use?
A nurse helps a nursing student create a care plan for a hospice client who is nonverbal and
acts restless and grimaces when repositioned. Which statements by the student nurse indicate
a correct understanding of the goals of end-of-life care? - ANS-- I can observe the client's
agitation as an indicator of client's pain level
- I should continue to explain interventions I am performing even though the client is
unresponsive
- I will ask the family if they would like to hold the client's hand while I administer pain
medication
- Managing pain rather than treating disease is the priority goal for this client.
, A nurse in the emergency department is caring for a client should the nurse see first? -
ANS-Client with myasthenia gravis who has a fever and increasing difficulty swallowing.
A nurse is caring for a client 1 day postoperative craniotomy. Which nursing actions are
appropriate to prevent increased intracranial pressure? - ANS-- Administer stool softener
- Dim lights when not providing care
- Maintain body in midline position
At a swimming pool, a nurse is giving an adult cardiopulmonary resuscitation (CPR). A
bystander brings the automated external defibrillator (AED). The victim is wet, lying in a small
pool of water, and wearing a transdermal medication patch on the upper right chest, according
to the nurse. What is the most appropriate action at this time? - ANS-Remove the transdermal
patch and wipe the chest dry before using the AED
A pregnant client in the third trimester completes an intake form for a clinic visit. The nurse
understands that which signs and symptoms warrant further investigation? - ANS-- Copious
amounts of watery, clear vaginal discharge
- Dysuria and right flank pain
- Headache and blurred vision
A student nurse is accompanying the charge nurse when conducting daily rounds. Which
personal protective measure by the charge nurse does the student nurse question? -
ANS-Wears 2 pairs of gloves when emptying the urinary catheter collection bag of a client with
HIV.
After listening to the parents' report and seeing the ff pediatric clients, the nurse knows that
which client demonstrates signs of abuse that may necessitate mandatory reporting? - ANS-5-
year old whose x- ray reveals 1 new and 2 healed humerus fractures after falling from a tree.
An elderly client with diabetes comes to the clinic in winter reporting numbness of the feet.
After removing the client's shoes and socks, the nurse notes that the feet are ice cold to the
touch and appear waxy and pale. What is the appropriate nursing action? - ANS-Soak the
client's lower legs in a warm water bath
An unaccompanied 16 year old girl comes to the emergency department with a severe
abdominal pain and vomiting. The client has a temp of 102.2 F (39 C) and a pulse of 120/min
and is lethargic. The client's parents are out of town, and no guardians can be reached. How
should the client's care be handled? - ANS-Administer care until the parents or guardians can
be reached.
During a follow-up visit to the primary care clinic, the nurse evaluates a client's understanding
about prevention of complications from varicose veins. Which client statements indicate a
correct understanding? - ANS-- I avoid crossing my legs when sitting
- I have started wearing elastic compression hose
- I try to elevate my legs as often as possible
- I try to walk at least a mile every day
For which client is it most important for the nurse to reinforce teaching regarding ways to
prevent the spread of the condition? - ANS-The client with tinea corporis
Four clients enter the emergency department at the same time. Which client should the nurse
alert the health care provider to see first? - ANS-40 year old with a first degree burn and singed
beard from a campfire
