NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A client with type 1 diabetes is found unconscious in the emergency department. The nurse suspects hypoglycemia. What is the first action the nurse should take?

A. Administer an oral glucose gel

B. Start an IV line and give IV glucose

C. Call for the doctor immediately

D. Place the client in a supine position

Correct Answer: B. Start an IV line and give IV glucose

Rationale: For a client who is unconscious and suspected of hypoglycemia, the priority is to quickly administer glucose intravenously to restore normal blood sugar levels. Oral glucose gels are not appropriate for unconscious patients due to aspiration risk. Calling for the doctor and positioning the patient are important, but treating the hypoglycemia takes precedence.

Question 2: A nurse is preparing to administer a medication to a client when the client states they have never taken the medication before. What should the nurse do next?

A. Administer the medication as prescribed

B. Explain the purpose and effects of the medication to the client

C. Hold the medication and verify the order with the provider

D. Ask the client if they are allergic to any medications

Correct Answer: B. Explain the purpose and effects of the medication to the client

Rationale: Before administering a new medication, the nurse should explain its purpose, effects, and any potential side effects to ensure informed consent. Verifying allergies is part of routine checks, but clear communication about the medication itself is crucial for client understanding and safety.

Question 3: A client is admitted with pneumonia and is on several medications. Which medication should the nurse question if the client is diagnosed with a penicillin allergy?

A. Ciprofloxacin

B. Acetaminophen

C. Amoxicillin

D. Metoprolol

Correct Answer: C. Amoxicillin

Rationale: Amoxicillin is a type of penicillin. In a client with a known penicillin allergy, this medication could cause an allergic reaction and should be verified with the healthcare provider. Ciprofloxacin, acetaminophen, and metoprolol do not belong to the penicillin class and may generally be considered safe alternatives, though all patient allergies should still be verified.

Question 4: A client with a history of hypertension is prescribed hydrochlorothiazide. What should the nurse include in the teaching plan about this medication?

A. "This medication may cause your blood sugar to decrease."

B. "You might experience increased urination."

C. "Avoid foods high in potassium."

D. "This medication will not affect your weight."

Correct Answer: B. "You might experience increased urination."

Rationale: Hydrochlorothiazide is a thiazide diuretic that helps reduce blood pressure by eliminating excess fluid from the body, which will increase urination. Clients should be advised about this effect to prevent dehydration. Thiazide diuretics can increase blood sugar levels, and patients should be monitored, especially if they have diabetes. Unlike loop diuretics, thiazides can lower potassium levels, so patients may need to monitor their potassium intake, not avoid it entirely.

Question 5: A client who is postoperative following an appendectomy reports pain at a level of 8 on a 0-10 scale. The nurse has an order to administer morphine 4 mg IV every 4 hours as needed for pain. What should the nurse do first?

A. Administer the morphine as ordered

B. Contact the healthcare provider

C. Reassess the client’s pain level in 30 minutes

D. Check the client’s blood pressure and respiratory rate

Correct Answer: D. Check the client’s blood pressure and respiratory rate

Rationale: Before administering morphine, it is important to assess the client's vital signs, particularly respiratory rate and blood pressure, as opioid medications can cause respiratory depression and hypotension. This ensures safe administration of the medication. If vital signs are within safe limits, the nurse can then proceed with administering the medication to manage the client’s pain.

Question 6: A nurse is teaching a client with newly diagnosed gastroesophageal reflux disease (GERD) about dietary modifications. Which statement by the client indicates a need for further teaching?

A. "I will avoid caffeine and chocolate in my diet."

B. "I can have a glass of wine with dinner."

C. "I should eat smaller, more frequent meals."

D. "I will try not to eat within two hours of bedtime."

Correct Answer: B. "I can have a glass of wine with dinner."

Rationale: Clients with GERD should avoid alcohol as it can exacerbate symptoms by relaxing the esophageal sphincter, increasing gastric acid production, or both. This statement indicates a need for further teaching about alcohol avoidance. Avoiding caffeine and chocolate, having smaller meals, and not eating before bedtime are correct dietary strategies for managing GERD symptoms.