NCLEX-RN Practice Questions with Nurse Brennan
Question 1: A client with a suspected diagnosis of meningitis is admitted to the hospital. Which of the following actions should the nurse perform first?
A. Administer prescribed antibiotics
B. Obtain blood cultures
C. Prepare the client for a CT scan
D. Initiate droplet precautions
Correct Answer: D. Initiate droplet precautions
Rationale: Initiating droplet precautions is the priority action to prevent the spread of infection to others. Bacterial meningitis can be highly contagious, and safety for healthcare workers and other patients is paramount. While the other actions are also important in the management and diagnosis of meningitis, establishing appropriate isolation must come first.
Question 2: A patient with type 2 diabetes mellitus is taking metformin. Which laboratory test should the nurse monitor to assess the medication's side effect?
A. Liver function tests
B. Blood urea nitrogen (BUN)
C. Creatinine
D. Electrolytes
Correct Answer: C. Creatinine
Rationale: Metformin is contraindicated in patients with renal impairment because it is excreted by the kidneys, and accumulation can lead to lactic acidosis. Therefore, monitoring renal function, particularly serum creatinine, is crucial to ensuring safe use and avoiding potential toxicity.
Question 3: A client with deep vein thrombosis (DVT) is receiving warfarin therapy. Which dietary instruction should the nurse include?
A. Increase the intake of green leafy vegetables to boost vitamin K
B. Avoid foods high in vitamin K, like spinach and broccoli
C. Double the dose of warfarin if you eat foods rich in vitamin K
D. Completely abstain from foods containing vitamin K
Correct Answer: B. Avoid foods high in vitamin K, like spinach and broccoli
Rationale: Warfarin works by inhibiting vitamin K–dependent clotting factors. Consistent intake of vitamin K is important for maintaining therapeutic levels of anticoagulation; however, sudden increases in vitamin K intake can counteract the effects of warfarin. It's essential for patients to maintain a consistent diet and avoid sudden increases in vitamin K-rich foods.
Question 4: A client newly prescribed prednisone for arthritis asks the nurse about potential side effects. Which information should the nurse include?
A. "You may experience high blood pressure while taking this medication."
B. "Prednisone will cause an immediate increase in energy levels."
C. "You should increase your calcium intake as this medication may weaken bones."
D. "Expect your symptoms of arthritis to worsen initially."
Correct Answer: C. "You should increase your calcium intake as this medication may weaken bones."
Rationale: Long-term use of corticosteroids like prednisone can lead to osteoporosis due to decreased bone density. Clients are advised to ensure adequate calcium and vitamin D intake to mitigate this risk. While increased blood pressure can occur, it is not as directly associated with prednisone as bone density issues. The other options (immediate energy increase and worsening symptoms) are not typical effects of prednisone.
Question 5: A client in the emergency department is showing signs of an allergic reaction after eating shellfish. Which medication should the nurse anticipate administering first?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Prednisone
Correct Answer: C. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis, a severe allergic reaction. It acts quickly to reduce airway swelling, improve breathing, and support blood pressure. Diphenhydramine and prednisone might also be administered but are not as fast-acting as epinephrine and are not first-line in anaphylaxis cases. Albuterol might be used if bronchospasm is present but is adjunctive to epinephrine.
Question 6: A nurse is caring for a client with hyperthyroidism who is receiving methimazole. Which side effect should the nurse primarily monitor?
A. Dehydration
B. Hypoglycemia
C. Agranulocytosis
D. Weight gain
Correct Answer: C. Agranulocytosis
Rationale: Methimazole can cause agranulocytosis, a dangerous reduction in white blood cells, leading to increased infection risk. The nurse should monitor for signs of infection and check white blood cell counts routinely. Dehydration and hypoglycemia are not commonly associated with methimazole. Weight gain might occur as thyroid levels are brought under control, but isn’t an immediate concern compared to agranulocytosis.
