NCLEX-RN Practice Questions with Nurse Brennan

Question 1: A client is being treated for heart failure with digoxin. The nurse should assess which parameter to determine if the medication is effective?

A. Heart rate

B. Platelet count

C. Blood pressure

D. Respiratory rate

Correct Answer: A. Heart rate

Rationale: Digoxin primarily works by slowing and strengthening the heart rate, making it more effective at pumping blood and decreasing symptoms of heart failure. Monitoring heart rate is essential to assess the therapeutic effect and ensure that it remains within a safe range, usually between 60-100 bpm when digoxin is therapeutic. While blood pressure could be indirectly affected, it's not the primary measure of digoxin efficacy.

Question 2: A nurse is preparing discharge instructions for a client who has been prescribed warfarin after a diagnosis of deep vein thrombosis (DVT). What information is crucial to include in the discharge teaching?

A. "Avoid foods high in calcium."

B. "Report any signs of bruising or bleeding immediately."

C. "An increase in physical activity will not affect this medication."

D. "You can stop taking the medication once you feel better."

Correct Answer: B. "Report any signs of bruising or bleeding immediately."

Rationale: Warfarin is an anticoagulant, and clients need to be aware of the signs of bleeding due to the increased risk associated with its use. Bruising easily, unusual bleeding, or prolonged bleeding should be reported immediately to the healthcare provider. Clients should also know that adjustments in physical activity, diet, and even conditions that affect Vitamin K (food consumption) can influence warfarin’s effectiveness, and it should only be stopped if directed by a healthcare provider.

Question 3: A client in the emergency department is experiencing shortness of breath, wheezing, and tachycardia following a peanut allergy exposure. What is the priority action for the nurse to take?

A. Administer oxygen

B. Provide an antihistamine

C. Administer epinephrine

D. Start an IV for fluid administration

Correct Answer: C. Administer epinephrine

Rationale: The priority action in an acute allergic reaction with symptoms indicative of anaphylaxis (such as difficulty breathing and wheezing) is to administer epinephrine. Oxygen can support breathing, and antihistamines may reduce some symptoms, but epinephrine is critical for reversing airway constriction and circulatory collapse inherent in anaphylaxis.

Question 4: A client diagnosed with peptic ulcer disease is prescribed omeprazole. Which important instruction should the nurse provide about this medication?

A. "Take the medication with meals."

B. "You may crush the medication for easier swallowing."

C. "Take the medication before breakfast."

D. "This medication will provide immediate pain relief."

Correct Answer: C. "Take the medication before breakfast."

Rationale: Omeprazole, a proton pump inhibitor, is most effective when taken before meals, particularly breakfast, as it reduces stomach acid production throughout the day. It should not be crushed, and it does not provide immediate pain relief; its effects take time to reduce symptoms of acid-related conditions.

Question 5: A nurse is assessing a client who is receiving lithium for bipolar disorder. Which sign indicates a potential for lithium toxicity?

A. Hypertension

B. Fine hand tremors

C. Increased appetite

D. Blurred vision

Correct Answer: D. Blurred vision

Rationale: Lithium toxicity can present with symptoms such as blurred vision, coarse tremors, confusion, and diarrhea. Fine hand tremors can be a side effect at therapeutic levels, but blurred vision is particularly concerning and should be monitored closely as a sign of potential toxicity.

Question 3: A client is receiving chemotherapy and reports nausea. The nurse should administer which medication to address this symptom?

A. Lorazepam

B. Ondansetron

C. Morphine

D. Acetaminophen

Correct Answer: B. Ondansetron

Rationale: Ondansetron is an antiemetic commonly used to treat nausea and vomiting associated with chemotherapy. While lorazepam may help with anticipatory nausea, ondansetron directly addresses the physiological nausea from chemotherapy. Morphine is for pain, and acetaminophen is for fever/pain relief, not nausea.