NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A client with a history of epilepsy is prescribed phenytoin. Which instruction should the nurse include in the client’s education about this medication?

A. "Take the medication on an empty stomach."

B. "Report any unusual bleeding or gum swelling."

C. "You may stop taking the medication once symptoms subside."

D. "Limit fluid intake while on this medication."

Correct Answer: B. "Report any unusual bleeding or gum swelling."

Rationale: Phenytoin can cause side effects such as gingival hyperplasia (gum enlargement) and bleeding tendencies. Clients should report these symptoms immediately. The medication should be taken consistently around the same time each day, with or without food, and should not be stopped abruptly, as this could trigger seizures. Fluid intake should not be limited.

Question 2: A nurse is providing care for a client who has been prescribed prednisone for an acute exacerbation of asthma. What is an important side effect to monitor in this client?

A. Hyperglycemia

B. Hypotension

C. Weight loss

D. Hyperkalemia

Correct Answer: A. Hyperglycemia

Rationale: Glucocorticoids like prednisone can raise blood sugar levels, so monitoring for hyperglycemia is important, especially in clients with diabetes. Prednisone can also cause fluid retention and weight gain, not loss. It generally causes hypokalemia (low potassium) rather than hyperkalemia.

Question 3: A client who is undergoing treatment for tuberculosis asks why they have to take multiple medications. What is the best response by the nurse?

A. "Multiple medications are needed to prevent the disease from becoming contagious."

B. "This approach reduces the duration of treatment to a few weeks."

C. "Using several medications decreases the chance of resistance development."

D. "It prevents any possibility of experiencing side effects."

Correct Answer: C. "Using several medications decreases the chance of resistance development."

Rationale: The use of multiple medications in tuberculosis treatment is to prevent Mycobacterium tuberculosis from developing resistance to any single drug. This approach ensures that the treatment is more effective. Tuberculosis treatment typically lasts several months and might still have side effects.

Question 4: A client with hypothyroidism has been prescribed levothyroxine. Which statement by the client indicates a need for further teaching?

A. "I will take this medication every morning before breakfast."

B. "If I miss a dose, I can double up the next day."

C. "I should inform my doctor if I experience chest pain or palpitations."

D. "It's important to have my thyroid levels checked regularly."

Correct Answer: B. "If I miss a dose, I can double up the next day."

Rationale: Clients should not double up on doses of levothyroxine if a dose is missed, as this can lead to symptoms of hyperthyroidism. It's best taken on an empty stomach for consistent absorption, and regular monitoring of thyroid levels ensures the dosage remains appropriate. Chest pain and palpitations should be reported, as they can indicate too high a dose.

Question 5: A client presenting with acute shortness of breath and wheezing is diagnosed with an asthma attack. What medication does the nurse anticipate administering for immediate relief?

A. Montelukast

B. Albuterol

C. Fluticasone

D. Salmeterol

Correct Answer: B. Albuterol

Rationale: Albuterol is a fast-acting bronchodilator used for quick relief during an acute asthma attack. Montelukast is a daily medication for long-term control, fluticasone is a corticosteroid for reducing inflammation, and salmeterol is a long-acting bronchodilator, neither providing immediate relief.

Question 6: A nurse is teaching a client about the signs of hypoglycemia. Which symptoms should the client report if experienced?

A. Increased thirst and urination

B. Weight gain and fatigue

C. Sweating, shakiness, and confusion

D. Abdominal pain and nausea

Correct Answer: C. Sweating, shakiness, and confusion

Rationale: Hypoglycemia (low blood sugar) can cause symptoms such as sweating, shakiness, confusion, dizziness, and irritability as the body's response to insufficient glucose levels. Increased thirst and urination are typically associated with hyperglycemia (high blood sugar).