NCLEX-PN Test #22 2

Question 1

A nurse is caring for a client with cirrhosis who is experiencing ascites. Which dietary modification should the nurse anticipate?

Accepted Answer

Sodium-restricted diet

Answer

Sodium restriction is the primary dietary modification for ascites because sodium retention contributes to fluid accumulation in the peritoneal cavity.

Question 2

A client is prescribed lithium carbonate for bipolar disorder. Which laboratory value requires the nurse to hold the medication and notify the provider?

Accepted Answer

Serum lithium level of 2.1 mEq/L

Answer

A serum lithium level of 2.1 mEq/L exceeds the therapeutic range (0.6-1.2 mEq/L) and indicates lithium toxicity.

Question 3

A nurse is reinforcing teaching with a client newly diagnosed with glaucoma. Which statement by the client indicates effective teaching?

Accepted Answer

I need to use my prescribed eye drops consistently to control eye pressure

Answer

Glaucoma requires lifelong medication compliance to maintain controlled intraocular pressure and prevent optic nerve damage.

Question 4

A client with an indwelling urinary catheter develops a temperature of 101.8°F (38.8°C) and cloudy, foul-smelling urine. Which action should the nurse take first?

Accepted Answer

Encourage increased fluid intake and notify the provider

Answer

Cloudy, foul-smelling urine with fever suggests a catheter-associated urinary tract infection (CAUTI). The nurse should encourage fluids and notify the provider for further orders.

Question 5

A practical nurse is assisting with the care of a neonate born at 34 weeks gestation. Which assessment finding warrants immediate intervention?

Accepted Answer

Nasal flaring and grunting with respirations

Answer

Nasal flaring and grunting are signs of respiratory distress in a neonate and require immediate intervention to prevent deterioration.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #22 2