NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A client who received sedation for a minor surgical procedure is ready for discharge. What is the most crucial instruction the nurse should provide?

A. "You can drive yourself home if you feel alert."

B. "You should refrain from drinking alcohol for the next 8 hours."

C. "Ensure you have a responsible adult to accompany you home."

D. "Resume your normal activities as soon as possible."

Correct Answer: C. "Ensure you have a responsible adult to accompany you home."

Rationale: After receiving sedation, it's essential that clients do not drive or operate machinery, as their judgment and reflexes may still be impaired. Having a responsible adult accompany them home ensures their safety. While avoiding alcohol and resting are also recommended, arranging safe transportation is the priority.

Question 2: A patient with hypertension has been prescribed atenolol. What should the nurse monitor as a potential side effect of this medication?

A. Increased heart rate

B. Low blood pressure

C. Tachycardia

D. Insomnia

Correct Answer: B. Low blood pressure

Rationale: Atenolol, a beta-blocker, is used to manage hypertension and may cause hypotension as a side effect. It's essential to monitor the patient's blood pressure regularly to ensure it does not become too low. Atenolol typically causes bradycardia (slow heart rate) instead of tachycardia and can lead to fatigue rather than insomnia.

Question 3: A client with renal insufficiency is scheduled to receive an intravenous pyelogram (IVP). Which pre-procedure intervention is critical?

A. Increase fluid intake

B. Verify allergy to shellfish or iodine

C. Administer a diuretic

D. Encourage a high-protein snack

Correct Answer: B. Verify allergy to shellfish or iodine

Rationale: Since an intravenous pyelogram (IVP) involves the use of iodine-based contrast dye, verifying the patient’s allergy status to iodine or shellfish—common sources of iodine—is crucial to avoid an allergic reaction. Increasing fluids post-procedure may be necessary to help clear the dye from the kidneys, but pre-procedure allergy verification is the priority.

Question 4: A nurse is caring for a patient experiencing acute chest pain. The physician orders nitroglycerin sublingually. What is the primary action the nurse should take before administering this medication?

A. Assess the patient's respiratory rate

B. Check the patient's heart rate

C. Measure the patient's blood pressure

D. Evaluate the patient's pain level

Correct Answer: C. Measure the patient's blood pressure

Rationale: Before administering nitroglycerin, it's essential to measure the patient's blood pressure because nitroglycerin can cause significant hypotension. Ensuring the blood pressure is stable prevents potential complications like dizziness, fainting, or further cardiac issues. Although assessing pain level is important, blood pressure assessment is critical.

Question 5: A client with type 1 diabetes is interested in starting an exercise program. What advice should the nurse provide regarding exercise and insulin requirements?

A. "Exercise will not affect your insulin drug requirements."

B. "You'll need more insulin when you have a regular exercise routine."

C. "Monitor your blood glucose before, during, and after exercise."

D. "Avoid any changes to your diet or insulin usage."

Correct Answer: C. "Monitor your blood glucose before, during, and after exercise."

Rationale: For clients with type 1 diabetes, exercise can impact blood glucose levels. It is important to monitor blood glucose before, during, and after exercise to adjust insulin as necessary to prevent hypoglycemia. Regular exercise does not automatically increase insulin needs; instead, it may lower them due to increased insulin sensitivity.

Question 6: A patient recovering from a myocardial infarction is prescribed a beta-blocker. Which statement made by the patient indicates an understanding of potential side effects?

A. "This medication might make me feel sleepy and tired."

B. "I need to avoid foods high in vitamin K."

C. "I'll need to increase my salt intake while on this medication."

D. "This medication will make my blood sugar rise."

Correct Answer: A. "This medication might make me feel sleepy and tired."

Rationale: Beta-blockers commonly cause fatigue and tiredness due to their effects on the heart rate and blood pressure. They do not affect vitamin K levels, sodium intake, or inherently raise blood sugar levels, although they can mask hypoglycemia symptoms.