NCLEX-RN Practice Questions with Nurse Brennan
Question 1: A client with diabetes mellitus is prescribed insulin glargine. What is important for the nurse to emphasize in education regarding this medication?
A. "This insulin should be taken immediately after meals."
B. "Do not mix this insulin with any other insulins in the same syringe."
C. "You should expect episodes of hypoglycemia shortly after taking it."
D. "Insulin glargine should be used only at mealtimes."
Correct Answer: B. "Do not mix this insulin with any other insulins in the same syringe."
Rationale: Insulin glargine is a long-acting insulin and should not be mixed with any other insulins. Mixing can affect the action of insulin glargine, making blood sugar management unpredictable. It's typically administered once daily and is not designed for meal-time glucose control. Hypoglycemia can occur but is less common due to the continuous, stable release.
Question 2: A nurse is reviewing the medication list of a client newly diagnosed with hypertension. Which class of medication should the nurse anticipate discussing with the client?
A. Beta-blockers
B. Corticosteroids
C. Antifungals
D. Antivirals
Correct Answer: A. Beta-blockers
Rationale: Beta-blockers are commonly used to manage hypertension as they help to lower heart rate and blood pressure. They are often discussed early in the treatment of hypertension. Corticosteroids, antifungals, and antivirals are not typically used for this condition.
Question 3: A client is being treated with heparin for a deep vein thrombosis (DVT). While reviewing lab results, which value would indicate the need for a dose adjustment?
A. Hemoglobin level
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count
Correct Answer: C. Activated Partial Thromboplastin Time (aPTT)
Rationale: The aPTT is used to monitor how well and safely heparin is working, with adjustments made to maintain it within a therapeutic range. The INR is monitored for clients on warfarin therapy. Hemoglobin and platelet count provide important information but do not determine heparin dosing.
Question 4: A nurse is providing education to a client who has been prescribed spironolactone. Which dietary instruction is important for the nurse to include?
A. "Increase your intake of potassium-rich foods."
B. "Avoid salt substitutes that contain potassium."
C. "Consume more calcium-rich foods."
D. "Limit your fluid intake to 1000 mL per day."
Correct Answer: B. "Avoid salt substitutes that contain potassium."
Rationale: Spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia (elevated potassium levels). It is important to avoid salt substitutes containing potassium to prevent potentially dangerous levels. Increasing intake of potassium-rich foods can be harmful, while fluid and calcium directives are less relevant to spironolactone use.
Question 5: A client is receiving morphine for severe pain. Which side effect should the nurse anticipate and monitor for?
A. Diarrhea
B. Insomnia
C. Respiratory depression
D. Hypertension
Correct Answer: C. Respiratory depression
Rationale: Respiratory depression is a potentially serious side effect of morphine, an opioid analgesic, and requires careful monitoring. Constipation, not diarrhea, is a more common gastrointestinal side effect. Morphine often causes drowsiness rather than insomnia, and hypotension, not hypertension, can occur.
Question 6: A nurse is administering lispro insulin to a client with type 1 diabetes. When should the client be advised to eat following the injection?
A. 30 minutes after injection
B. Immediately after injection
C. 2 hours after injection
D. Only when feeling hungry
Correct Answer: B. Immediately after injection
Rationale: Lispro is a rapid-acting insulin, and to prevent hypoglycemia, clients should eat immediately after administration, as lispro begins to lower glucose soon after injection. Waiting can result in a rapid drop in blood sugar levels.
