NCLEX-PN Test #17

Question 1

The nurse notes a client with heart failure is coughing up pink, frothy sputum. What should the nurse do first?

Accepted Answer

Check the client’s oxygen saturation immediately.

Answer

Encourage the client to drink warm liquids.

Answer

Ask the client to lie flat in bed.

Answer

Ignore the sputum unless it worsens.

Question 2

A client taking a new cholesterol medication reports muscle pain. What should the nurse do first?

Accepted Answer

Report the symptom to the healthcare provider.

Answer

Advise the client to ignore mild pain.

Answer

Encourage the client to increase exercise intensity.

Answer

Recommend doubling the medication dose.

Question 3

The nurse notes that a client with pneumonia has a respiratory rate of 32 breaths per minute. What is the nurse’s priority?

Accepted Answer

Assess lung sounds.

Answer

Have the client lie completely flat.

Answer

Encourage the client to sleep.

Answer

Provide a heavy meal to increase energy.

Question 4

A postoperative client reports severe pain unrelieved by medication. What should the nurse do first?

Accepted Answer

Assess the surgical incision.

Answer

Provide an additional dose of pain medication immediately.

Answer

Apply heat without assessment.

Answer

Encourage the client to walk frequently.

Question 5

The nurse is caring for a client who has not had a bowel movement in four days. What should the nurse do first?

Accepted Answer

Assess bowel sounds in all quadrants.

Answer

Give a strong laxative without assessment.

Answer

Restrict all oral fluids.

Answer

Encourage the client to ignore the symptoms.

Question 6

A client prescribed an antibiotic reports developing itching and a rash. What is the nurse’s first action?

Accepted Answer

Stop the antibiotic infusion immediately.

Answer

Give the next dose early.

Answer

Encourage the client to take deep breaths.

Answer

Ignore the rash unless swelling occurs.

Question 7

A client newly diagnosed with diabetes asks why regular foot checks are necessary. Which response is best?

Accepted Answer

You may not feel foot injuries due to decreased sensation.

Answer

Foot checks are optional unless pain develops.

Answer

Walking barefoot improves circulation.

Answer

Foot checks prevent all diabetic complications.

Question 8

A client with a urinary catheter has cloudy, foul-smelling urine. What should the nurse do first?

Accepted Answer

Notify the healthcare provider.

Answer

Increase the height of the drainage bag.

Answer

Clamp the catheter tubing.

Answer

Ignore the symptom unless fever begins.

Question 9

A diabetic client reports numbness in both feet. What should the nurse do first?

Accepted Answer

Report the symptom to the provider.

Answer

Recommend tight shoes for support.

Answer

Have the client stop diabetes medications.

Answer

Advise massaging feet vigorously.

The nurse notes a client with heart failure is coughing up pink, frothy sputum.What should the nurse do first?