NCLEX-RN Practice Questions with Nurse Brennan
Question 1: A client newly diagnosed with hypertension is prescribed lisinopril. Which instruction should the nurse include when teaching the client about this medication?
A. "Increase your intake of potassium-rich foods."
B. "Report any swelling of the lips or tongue immediately."
C. "A persistent, dry cough is common and not concerning."
D. "Take this medication with a high-fat meal to increase absorption."
Correct Answer: B. "Report any swelling of the lips or tongue immediately."
Rationale: Lisinopril, an ACE inhibitor, can cause angioedema, which is characterized by swelling of the lips, face, or tongue. This can be life-threatening and requires immediate medical attention. A dry cough is a common side effect of ACE inhibitors, but can be bothersome to some patients. Increasing potassium intake isn't advised as lisinopril can increase potassium levels. Taking it with a high-fat meal is not necessary and doesn’t affect its absorption significantly.
Question 2: A nurse is administering an IV antibiotic when the client suddenly reports difficulty breathing and a rash develops. What should the nurse do first?
A. Stop the infusion
B. Call the healthcare provider
C. Administer an antihistamine
D. Assess the client's airway
Correct Answer: A. Stop the infusion
Rationale: When a client shows signs of an allergic reaction, such as difficulty breathing and a rash, the nurse should immediately stop the infusion to prevent further administration of the allergen. After stopping the infusion, assess the client’s airway and breathing and prepare to provide intervening actions such as administering emergency medications. Contacting the healthcare provider is important, but only after stopping the infusion and assessing the client's immediate needs.
Question 3: A client is being discharged with a prescription for levothyroxine. What should the nurse emphasize about this medication?
A. "Take the medication with food to avoid an upset stomach."
B. "It is best taken at bedtime for maximum effectiveness."
C. "You will need to have your blood tested regularly."
D. "Expect to feel energetic immediately after starting the medication."
Correct Answer: C. "You will need to have your blood tested regularly."
Rationale: Clients on levothyroxine will need regular blood tests to monitor thyroid hormone levels and ensure the dose is appropriate. Levothyroxine should be taken on an empty stomach, typically in the morning, for optimum absorption, not at bedtime or with food. It may take some time for the client to notice increased energy or effects, rather than immediately.
Question 4: A client with chronic obstructive pulmonary disease (COPD) reports increasing shortness of breath. The nurse notes the client is currently on supplemental oxygen at 4 L/min via nasal cannula. Which action should the nurse consider to address the client’s symptoms effectively?
A. Increase the oxygen delivery to 6 L/min
B. Lower the oxygen delivery to 2 L/min
C. Assess the client's respiratory status and oxygen saturation level
D. Switch the client to an oxygen mask
Correct Answer: C. Assess the client's respiratory status and oxygen saturation level
Rationale: Before making any changes to oxygen delivery, the nurse should assess the client’s respiratory status and perform an oxygen saturation check. COPD clients can be sensitive to too much oxygen, which may depress respiratory drive. Therefore, evaluating the situation with accurate data is crucial before adjustments are made. It is generally inappropriate to increase oxygen flow without understanding the client's status.
Question 5: A nurse is educating a client prescribed nitroglycerin sublingual tablets for angina. Which statement by the client indicates a correct understanding of how to use this medication?
A. "I will take the nitroglycerin with water."
B. "I need to swallow the tablet immediately."
C. "I should lie down after taking the medication."
D. "I should keep the tablets in their original glass bottle."
Correct Answer: D. "I should keep the tablets in their original glass bottle."
Rationale: Nitroglycerin tablets should be kept in their original glass bottle to maintain stability and prevent moisture and air exposure. Clients are advised to lie down when taking nitroglycerin due to possible dizziness from blood pressure changes, but this is secondary to proper storage knowledge. Tablets should not be swallowed or taken with water, as absorption occurs sublingually.
Question 6: A client who is post-operative from hip replacement surgery is receiving enoxaparin (Lovenox). What is essential for the nurse to monitor?
A. Platelet count
B. Blood glucose levels
C. Urine output
D. Serum sodium
Correct Answer: A. Platelet count
Rationale: Monitoring platelet count is important because enoxaparin can cause thrombocytopenia, leading to a risk for bleeding. Although not intrinsic to enoxaparin, monitoring urine output, blood glucose, and serum sodium are good practices for overall health but less relevant specifically for this medication's side effects.
