NCLEX-PN Test #5

Question 1

A client with influenza reports increased shortness of breath and chest tightness. Which action should the nurse take first?

Accepted Answer

Assess lung sounds immediately.

Answer

Offer warm fluids for throat comfort.

Answer

Encourage the client to ambulate.

Answer

Lower the room temperature.

Question 2

A client taking a diuretic reports dizziness when standing. What is the nurse’s best initial response?

Accepted Answer

Teach the client to rise slowly from sitting or lying positions.

Answer

Encourage rapid position changes.

Answer

Increase sodium intake significantly.

Answer

Stop the medication without provider approval.

Question 3

A confused client repeatedly tries to pull out their IV line. Which action is most appropriate?

Accepted Answer

Cover the IV site with a protective dressing.

Answer

Apply wrist restraints immediately.

Answer

Discontinue the IV line entirely.

Answer

Ignore the behavior unless the IV is removed.

Question 4

The nurse is reinforcing dietary teaching for a client with high cholesterol. Which statement shows understanding?

Accepted Answer

I will choose baked or grilled foods instead of fried foods.

Answer

I will increase butter intake for extra flavor.

Answer

I will drink whole milk daily.

Answer

I will avoid all fruits because they contain sugar.

Question 5

A client reports burning at the IV site where an antibiotic is infusing. What should the nurse do first?

Accepted Answer

Stop the infusion immediately.

Answer

Increase the infusion rate.

Answer

Apply cold compresses without assessing.

Answer

Ignore it because mild burning is normal.

Question 6

A client with diabetes reports numbness in both feet. What is the nurse’s best action?

Accepted Answer

Report the symptom to the healthcare provider.

Answer

Encourage tight shoes for support.

Answer

Advise stopping all diabetes medications.

Answer

Recommend massaging the feet vigorously.

Question 7

A postoperative client has not voided six hours after surgery. What should the nurse do first?

Accepted Answer

Assess the bladder for distention.

Answer

Provide additional oral fluids immediately.

Answer

Restrict all fluids.

Answer

Instruct the client to ambulate for 30 minutes.

Question 8

A client prescribed a new antihistamine reports drowsiness. What should the nurse tell the client?

Accepted Answer

Avoid driving or operating machinery until you know how it affects you.

Answer

Double the dose if symptoms persist.

Answer

Take it only on an empty stomach at night.

Answer

Ignore drowsinessu2014it will resolve immediately.

Question 9

A client with pneumonia has thick secretions and difficulty coughing. What action should the nurse take first?

Accepted Answer

Encourage increased oral fluid intake.

Answer

Lower the client’s fluid intake.

Answer

Place the client completely flat.

Answer

Ask the client to avoid coughing to rest the lungs.