NCLEX-RN Practice Questions with Nurse Brennan
Question 1: A nurse is reviewing the laboratory results of a patient receiving chemotherapy. Which result requires immediate intervention?
A. Hemoglobin level of 12 g/dL
B. White blood cell count of 2,000 cells/mm³
C. Platelet count of 150,000 cells/mm³
D. Serum creatinine level of 1.0 mg/dL
Correct Answer: B. White blood cell count of 2,000 cells/mm³
Rationale: A white blood cell (WBC) count of 2,000 cells/mm³ indicates leukopenia, which places the patient at high risk for infection. This requires immediate intervention, including protective isolation measures and possibly administering colony-stimulating factors to boost white blood cell production. The other values are within or near normal ranges and less immediately concerning.
Question 2: A patient with a history of heart failure is experiencing shortness of breath and has gained 5 pounds in the last three days. What is the nurse's priority intervention?
A. Encourage increased oral fluid intake
B. Assess the patient's vital signs
C. Administer prescribed diuretics
D. Raise the head of the bed
Correct Answer: D. Raise the head of the bed
Rationale: The first action should be to ease the patient's breathing by raising the head of the bed, which can help alleviate shortness of breath by promoting lung expansion. After the immediate need is addressed, assessing vital signs and administering diuretics to manage fluid overload can follow.
Question 3: A nurse is teaching a client about using a metered-dose inhaler (MDI) for asthma. Which action indicates that the client needs further instruction?
A. Shaking the inhaler before use
B. Inhaling rapidly while pressing the inhaler
C. Holding breath for 10 seconds after inhaling the medication
D. Waiting one minute between puffs
Correct Answer: B. Inhaling rapidly while pressing the inhaler
Rationale: The correct technique involves inhaling slowly and deeply while activating the inhaler. Rapid inhalation does not allow the medication to be properly distributed within the lungs. The other actions are correct and demonstrate proper use of an MDI.
Question 4: A client with a history of peptic ulcer disease is being discharged with a prescription for omeprazole. Which statement by the client indicates effective teaching?
A. "I need to take this medication right before bed."
B. "I should take this medication before meals on an empty stomach."
C. "I will chew the tablet to help with absorption."
D. "I can stop taking the medication once my symptoms improve."
Correct Answer: B. "I should take this medication before meals on an empty stomach."
Rationale: Omeprazole is a proton pump inhibitor (PPI) that should be taken before meals, typically in the morning, to effectively reduce stomach acid production and allow the medication to work optimally. It should not be chewed or stopped abruptly without consulting a healthcare provider.
Question 5: During the assessment of a client in active labor, the nurse notes variable decelerations in the fetal heart rate. What is the nurse's priority action?
A. Administer oxygen at 2 liters per minute via nasal cannula
B. Turn the patient onto her left side
C. Increase the intravenous fluid rate
D. Prepare for immediate delivery
Correct Answer: B. Turn the patient onto her left side
Rationale: Variable decelerations are often caused by umbilical cord compression. Repositioning the mother, such as turning onto her left side, can relieve pressure on the cord and improve blood flow to the fetus. Other interventions may follow, but repositioning is typically the immediate action.
Question 6: A nurse is administering furosemide to a client with heart failure. Which lab value should be monitored to prevent complications?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial as imbalances can result in cardiac disturbances. While other electrolytes may also be affected, potassium monitoring is prioritized due to its critical role in cardiac function.
