NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A client with a diagnosis of chronic kidney disease is on a low-protein diet. The nurse understands that the purpose of this dietary restriction is to:

A. Promote weight loss

B. Prevent uremia

C. Increase protein levels in the blood

D. Improve wound healing

Correct Answer: B. Prevent uremia

Rationale: A low-protein diet is often prescribed to patients with chronic kidney disease (CKD) to limit the buildup of nitrogenous wastes in the blood, thus preventing or delaying the progression to uremia. It is not intended for weight loss, although it might provide that effect as a secondary benefit. The primary goal is to reduce the workload on the kidneys and prevent the accumulation of urea and other nitrogenous waste.

Question 2: A nurse is providing discharge instructions to a patient diagnosed with chronic heart failure. Which statement indicates that the patient understands the management of their condition?

A. "I can use table salt as long as I don't exceed two tablespoons per meal."

B. "It's important to weigh myself daily and report weight gain of more than 2 pounds in one day."

C. "I don't need to worry about my weight once I feel better."

D. "I can stop taking my medications once I feel better."

Correct Answer: C. "I will check my blood sugar before administering insulin."

Rationale: Daily monitoring of blood glucose levels before insulin administration is a crucial practice for individuals with diabetes taking insulin. It allows for proper dosing and helps prevent complications such as hyperglycemia or hypoglycemia. The other statements either do not relate to this specific scenario or are incorrect: a low-protein diet for a patient with impaired kidney function aims to reduce the kidney's workload, promoting better health rather than weight loss, and the photograph on Friday is less immediately critical than managing current blood glucose levels in a diabetes patient.

Question 3: A nurse is monitoring a patient who has just begun infusion therapy with a heparin drip. Which laboratory value should the nurse monitor closely?

A. Hematocrit

B. Platelet count

C. Prothrombin time (PT)

D. Activated partial thromboplastin time (aPTT)

Correct Answer: D. Activated partial thromboplastin time (aPTT)

Rationale: The aPTT is the lab value used to monitor the efficacy of heparin therapy. It measures the time it takes for blood to clot and helps ensure that the patient is receiving the appropriate dose of heparin to prevent blood clots. Hematocrit and platelet counts are important too, but they are not used specifically for monitoring heparin therapy. PT is used for monitoring the effects of warfarin, not heparin.

Question 4: A client who is prescribed digoxin for heart failure presents with nausea, vomiting, and visual disturbances. What is the most appropriate action by the nurse?

A. Administer the next dose as scheduled

B. Withhold the medication and notify the healthcare provider

C. Give an antiemetic to control nausea

D. Check the patient's blood pressure immediately

Correct Answer: B. Withhold the medication and notify the healthcare provider

Rationale: Nausea, vomiting, and visual disturbances are classic signs of digoxin toxicity. The nurse should withhold the next dose and immediately notify the healthcare provider for further assessment and potential adjustment of the medication. Continuing the medication could exacerbate the toxicity, and while assessing the patient further is important, contacting the healthcare provider is a priority in this potential emergency situation.

Question 5: A client with asthma has been prescribed albuterol. Which of the following should the nurse include in the teaching plan about the common side effects of this medication?

A. Weight gain

B. Increased heart rate

C. Constipation

D. Decreased appetite

Correct Answer: B. Increased heart rate

Rationale: Albuterol is a bronchodilator and can cause side effects such as an increased heart rate (tachycardia), nervousness, and jitteriness. It does not typically cause weight gain, constipation, or decreased appetite.