NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A nurse is educating a diabetic patient on the importance of foot care. Which statement by the patient indicates a correct understanding of the teaching?

A. "I will soak my feet daily to prevent dryness."

B. "I will walk barefoot in my house to strengthen my feet."

C. "I will inspect my feet daily for any cuts or sores."

D. "I will cut my toenails straight across, then curve the edges."

Correct Answer: C. "I will inspect my feet daily for any cuts or sores."

Rationale: Daily inspection of the feet is crucial for diabetic patients as they are at increased risk of foot injuries and infections due to possible neuropathy and decreased circulation. Soaking the feet can cause skin breakdown, and walking barefoot increases the risk of injury. Toenails should be cut straight across to avoid ingrown nails.

Question 2: A patient with newly diagnosed hypertension is prescribed lisinopril. Which side effect should the nurse instruct the patient to report immediately?

A. Persistent dry cough

B. Dizziness upon standing

C. Swelling of the face or lips

D. Increased urination

Correct Answer: C. Swelling of the face or lips

Rationale: Swelling of the face or lips may indicate angioedema, a serious side effect of ACE inhibitors like lisinopril, and requires immediate medical attention. A persistent dry cough and dizziness upon standing are common side effects and should be reported, but they are not emergencies. Increased urination is not typically associated with lisinopril.

Question 3: For a client receiving chemotherapy, which white blood cell count result would necessitate the nurse to implement neutropenic precautions?

A. 5,000 cells/mm³

B. 4,000 cells/mm³

C. 2,000 cells/mm³

D. 1,000 cells/mm³

Correct Answer: D. 1,000 cells/mm³

Rationale: Neutropenic precautions are implemented when a patient has a significantly reduced white blood cell count, typically below 1,000 cells/mm³, placing them at increased risk of infection. This situation demands protective isolation to prevent exposure to infections.

Certainly! Let's work through more NCLEX questions with rationales:

Question 4: A patient with hypothyroidism is prescribed levothyroxine. Which instruction should the nurse include in the patient's teaching plan?

A. Take the medication with food to enhance absorption.

B. Expect to see improvement in symptoms within 2 days.

C. Report any symptoms of chest pain or palpitations immediately.

D. Discontinue the medication once symptoms improve.

Correct Answer: C. Report any symptoms of chest pain or palpitations immediately.

Rationale: Palpitations and chest pain can indicate overtreatment with levothyroxine, leading to hyperthyroid symptoms. Patients should be instructed to report these symptoms immediately. Levothyroxine should be taken on an empty stomach for better absorption, usually in the morning. Improvement in symptoms may take a few weeks, not just 2 days. It's important to continue taking the medication even after symptoms improve, as it’s a lifelong therapy for hypothyroidism.

Question 5: The nurse is preparing to administer a transfusion of packed red blood cells (PRBCs) to a client. What is the most important action to prevent a transfusion reaction?

A. Administering the transfusion with normal saline

B. Ensuring the blood type and Rh factor match between the patient and the blood

C. Monitoring vital signs before and during the transfusion

D. Infusing the transfusion slowly for the first 15 minutes

Correct Answer: B. Ensuring the blood type and Rh factor match between the patient and the blood

Rationale: The most critical step in preventing a transfusion reaction is verifying that the patient's blood type and Rh factor match with the donor blood. Although all actions listed are essential to safe transfusion practice, matching the blood is the key to avoiding serious hemolytic reactions.

Question 6: A client with bipolar disorder is prescribed lithium carbonate. Which patient statement indicates an understanding of the medication's side effects?

A. "I can continue my low-sodium diet while on this medication."

B. "If I experience diarrhea or vomiting, I will continue to take the medication as usual."

C. "I should drink 2-3 liters of fluid each day while taking lithium."

D. "I will reduce my caffeine consumption to avoid lithium toxicity."

Correct Answer: C. "I should drink 2-3 liters of fluid each day while taking lithium."

Rationale: Adequate fluid intake is essential when taking lithium to maintain therapeutic levels and prevent toxicity. Maintaining sodium intake is important, and a low-sodium diet can increase lithium levels. Diarrhea or vomiting can increase the risk of toxicity, so the healthcare provider should be notified. Caffeine can impact fluid balance but is less directly related to lithium toxicity than sodium and fluid intake.