NCLEX-RN Exam: Practice Questions With Nurse Brennan (Part 5.)

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Below are 10 additional NCLEX practice questions to help supplement your NCLEX review:

NCLEX Practice Questions:

Question #1: A 55-year-old patient is admitted to the ICU with a diagnosis of severe sepsis. The healthcare provider orders the initiation of a norepinephrine infusion. Which assessment finding is most important for the nurse to monitor when administering norepinephrine?

A. Urine output

B. Blood pressure

C. Respiratory rate

D. Oxygen saturation

Question #2: A patient with chronic kidney disease (CKD) is receiving peritoneal dialysis. Which action is essential for the nurse to perform to ensure the safety and effectiveness with every peritoneal dialysis treatment?

A. Administer erythropoietin injections as ordered

B. Monitor the patient's serum potassium levels regularly

C. Encourage the patient to increase fluid intake before dialysis

D. Use strict sterile technique when connecting and disconnecting the dialysis catheter

Question #3: A client is prescribed a diuretic medication, furosemide (Lasix), to manage fluid overload. The nurse should monitor which of the following electrolytes most closely when administering this medication?

A. Sodium

B. Calcium

C. Potassium

D. Magnesium

Question #4: A patient has undergone an appendectomy and is complaining of severe pain on the right side of the abdomen. The nurse assesses the patient's vital signs and finds an elevated temperature and increased heart rate. What action should the nurse take next?

A. Place an ice pack on the surgical site

B. Administer pain medication as ordered

C. Notify the healthcare provider immediately

D. Document the findings and continue to monitor

Question #5: A nurse is preparing to administer immunizations to a 2-month-old infant. The immunization schedule includes DTaP, Hib, Hepatitis B, and IPV. How should the nurse administer these vaccines?

A. All at once in a single injection

B. Over multiple visits, one vaccine per visit

C. In separate injections, using different limbs

D. In a single injection, combining DTaP, Hib, and IPV, and administering Hepatitis B separately

Question #6: A pregnant client at 32 weeks of gestation presents to the labor and delivery unit with complaints of severe abdominal pain, vaginal bleeding, and uterine contractions. What action should the nurse take first?

A. Apply a fetal heart rate monitor

B. Perform a sterile vaginal examination

C. Start an IV line and administer tocolytic medication

D. Prepare the client for an emergency cesarean section

Question #7: A nurse is caring for a postoperative patient who has a nasogastric tube in place for gastric decompression. The nurse notices that there is no drainage in the NG tube. What should the nurse do first?

A. Check for kinks in the NG tube

B. Reposition the patient to the left side

C. Irrigate the NG tube with normal saline

D. Call the healthcare provider immediately

Question #8: A 14-year-old adolescent with type 1 diabetes is brought to the clinic for a follow-up visit. The nurse should assess the adolescent for which of the following potential complications of diabetes?

A. Retinopathy

B. Osteoporosis

C. Hypertension

D. Rheumatic fever

Question #9: A patient is scheduled for elective surgery and asks the nurse why fasting before surgery is necessary. The nurse's response should be based on the understanding that fasting helps prevent:

A. Excessive post-operative thirst

B. Decreased surgical recovery time

C. Gastroesophageal reflux during surgery

D. Aspiration of stomach contents during anesthesia

Question #10: A client is prescribed warfarin (Coumadin) for anticoagulation therapy. The nurse should instruct the client to avoid consuming which of the following foods while taking this medication?

A. Spinach

B. Citrus fruits

C. Lean meats

D. Whole grains

NCLEX Practice Answers and Rationale:

Answer #1: B. Blood pressure

Rationale: Norepinephrine is a vasopressor medication commonly used in the ICU to treat severe hypotension in septic patients. The most critical parameter to monitor when administering norepinephrine is blood pressure. Norepinephrine constricts blood vessels, increasing systemic vascular resistance and, subsequently, blood pressure. It is essential to assess for any signs of hypertension, as well as monitor for any signs of inadequate perfusion or tissue ischemia. Urine output, respiratory rate, and oxygen saturation are important to monitor but are not as directly affected by norepinephrine administration.

Answer #2: D. Use strict sterile technique when connecting and disconnecting the dialysis catheter

Rationale: Peritoneal dialysis involves the introduction of a dialysate solution into the peritoneal cavity through a catheter. It is essential to maintain strict sterile technique when connecting and disconnecting the dialysis catheter to prevent the risk of infection. Infection can lead to peritonitis, which is a serious complication in peritoneal dialysis.

Answer #3: C. Potassium

Rationale: Furosemide is a loop diuretic that can lead to potassium loss through increased urinary excretion. Hypokalemia is a common side effect and can lead to serious complications such as cardiac dysrhythmias. Therefore, potassium levels should be closely monitored when administering furosemide.

Answer #4: C. Notify the healthcare provider immediately

Rationale: The combination of severe pain on the right side of the abdomen, an elevated temperature, and an increased heart rate may indicate postoperative complications such as infection or an abscess. The nurse should promptly notify the healthcare provider to assess and address the situation.

Answer #5: D. In a single injection, combining DTaP, Hib, and IPV, and administering Hepatitis B separately

Rationale: The nurse should administer DTaP, Hib, and IPV in a single combination injection and administer Hepatitis B separately. This is a recommended practice to reduce the number of injections while ensuring appropriate vaccination coverage.

Answer #6: D. Prepare the client for an emergency cesarean section

Rationale: The client's presentation with severe abdominal pain, vaginal bleeding, and uterine contractions at 32 weeks of gestation suggests a potential obstetric emergency, such as placental abruption. The most appropriate initial action is to prepare the client for an emergency cesarean section. The other options may be considered after ensuring the client's safety and addressing the emergent situation.

Answer #7: A. Check for kinks in the NG tube

Rationale: If there is no drainage in the nasogastric (NG) tube, the nurse should first check for kinks or obstructions in the NG tube. Obstructions or kinks in the tube can prevent the proper drainage of gastric contents. Irrigating the tube with normal saline or repositioning the patient may not address the underlying issue, and calling the healthcare provider should be considered only if the problem persists or if there is an emergency, but assessing for tube integrity and patency is the initial step.

Answer #8: A. Retinopathy

Rationale: Adolescents with type 1 diabetes are at risk for developing retinopathy, a complication that affects the eyes and can lead to visual impairment. It is important to monitor for this complication through regular eye examinations. While hypertension can be associated with diabetes, it is not the primary complication seen in adolescents. Osteoporosis and rheumatic fever are not directly related to diabetes.

Answer #9: D. Aspiration of stomach contents during anesthesia

Rationale: Fasting before surgery is essential to prevent the aspiration of stomach contents, which can be a serious complication during anesthesia. This reduces the risk of pulmonary aspiration and related complications.

Answer #10: A. Spinach

Rationale: Warfarin is a vitamin K antagonist, and foods high in vitamin K can interfere with its anticoagulant effects. Spinach is one such food that should not be consumed inconsistently as this can impact the INR (International Normalized Ratio) level. Clients taking warfarin should maintain a consistent intake of vitamin K-containing foods and notify their healthcare provider of any significant dietary changes.