NCLEX-RN Exam: Practice Questions With Nurse Brennan (Part 6.)

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

NCLEX Practice Questions:

Question #1: A patient in the ICU is receiving mechanical ventilation due to acute respiratory distress syndrome (ARDS). The respiratory therapist suggests changing the ventilator settings to increase positive end-expiratory pressure (PEEP). What is the rationale for increasing PEEP in ARDS?

A. To reduce barotrauma

B. To decrease oxygenation

C. To improve lung compliance

D. To minimize the risk of pneumonia

Question #2: A 4-year-old child with a history of asthma is admitted to the pediatric unit with an acute asthma exacerbation. The nurse assesses the child and finds increased respiratory rate, audible wheezing, and use of accessory muscles. Which intervention should the nurse prioritize?

A. Administer a corticosteroid medication

B. Administer oxygen via a non-rebreather mask

C. Administer a prescribed bronchodilator medication

D. Administer intravenous (IV) fluids to maintain hydration

Question #3: A 58-year-old patient with end-stage renal disease (ESRD) is receiving hemodialysis. During the procedure, the nurse notices that the patient's blood pressure has dropped significantly, and the patient complains of dizziness. What is the nurse's initial priority action?

A. Notify the healthcare provider

B. Administer an intravenous bolus of normal saline

C. Slow down the dialysis machine's blood pump rate

D. Check the patient's access site for signs of bleeding

Question #4: A nurse is assessing a client with schizophrenia who is experiencing auditory hallucinations. The client is agitated and reports hearing voices commanding self-harm. What is the nurse's priority intervention?

A. Place the client in seclusion for safety

B. Administer a PRN antipsychotic medication

C. Conduct a group therapy session for the client

D. Encourage the client to share their hallucination experiences

Question #5: A nurse is caring for a client with heart failure. Which assessment finding is most indicative of worsening heart failure?

A. Decreased edema

B. Increased urine output

C. Decreased blood pressure

D. Decreased respiratory rate

Question #6: A postoperative client who had abdominal surgery is at risk for postoperative complications. What action should the nurse prioritize to prevent atelectasis and pneumonia in this client?

A. Provide a clear liquid diet

B. Monitor vital signs every 4 hours

C. Administer pain medication as needed

D. Encourage deep breathing and coughing exercises

Question #7: A nurse is caring for a client with diabetes who is prescribed Humulin-R (regular insulin). The nurse should instruct the client to administer insulin at which time?

A. Just before eating a meal

B. 30 minutes after eating a meal

C. In the morning upon waking up

D. When the blood sugar is above 200 mg/dL

Question #8: A client with a history of peptic ulcer disease is prescribed misoprostol. What is the primary purpose of misoprostol in this client's treatment plan?

A. Pain relief

B. Promoting appetite

C. Preventing ulcer recurrence

D. Reducing gastric acid production

Question #9: A 6-month-old infant is brought to the emergency department with a fever of 102.5°F (39.2°C). The nurse assesses the infant's fontanelle, which appears to be bulging. Which action should the nurse take first?

A. Initiate a sepsis workup

B. Offer the infant a pacifier

C. Administer acetaminophen

D. Encourage the parents to provide more fluids

Question #10: A patient is scheduled for surgery and has been receiving warfarin (Coumadin) for the management of atrial fibrillation. The surgeon has requested that the patient's anticoagulation therapy be managed before surgery. What should the nurse expect to do?

A. Continue administering warfarin

B. Switch to aspirin therapy until surgery

C. Administer heparin as a bridging therapy

D. Hold warfarin for 7 days before the surgery

NCLEX Practice Answers and Rationale:

Answer #1: A. To reduce barotrauma

Rationale: Increasing PEEP in ARDS helps recruit collapsed alveoli, improve oxygenation, and reduce the risk of ventilator-associated lung injury (barotrauma). PEEP is used to maintain functional residual capacity and prevent alveolar collapse.

Answer #2: C. Administer a prescribed bronchodilator medication

Rationale: In an acute asthma exacerbation, the priority is to provide a bronchodilator, such as albuterol, to relieve bronchoconstriction and improve airway function. Bronchodilators help dilate the airways and relieve wheezing. IV fluids and corticosteroids are important interventions, but bronchodilator administration comes first in the treatment of an acute asthma attack.

Answer #3: D. Check the patient's access site for signs of bleeding

Rationale: A sudden drop in blood pressure during hemodialysis may be indicative of a hemorrhage, particularly if the patient complains of dizziness. The nurse's initial priority should be to assess the patient's access site for any signs of bleeding, such as blood oozing from the site or hematoma formation. Prompt assessment of the access site can help identify and address any access-related issues.

Answer #4: B. Administer a PRN antipsychotic medication

Rationale: When a client with schizophrenia is experiencing auditory hallucinations with commands for self-harm, the priority is to ensure the client's safety. Administering a PRN (as-needed) antipsychotic medication can help reduce the intensity of the hallucinations and alleviate agitation. It is essential to address the safety concern first.

Answer #5: C. Decreased blood pressure

Rationale: Worsening heart failure can lead to decreased cardiac output, which may result in decreased blood pressure.

Answer #6: D. Encourage deep breathing and coughing exercises

Rationale: Promoting deep breathing and coughing exercises is essential to prevent atelectasis and pneumonia in postoperative clients. It helps clear secretions and maintain lung function. While managing pain is important, it is not the priority in this case. Monitoring vital signs and providing a clear liquid diet are also essential but do not directly address the prevention of atelectasis and pneumonia.

Answer #7: B. 30 minutes after eating a meal

Rationale: Regular insulin should be administered 30 minutes before eating a meal. This timing allows the insulin to be available in the bloodstream to manage the rise in blood glucose that occurs after eating. It helps prevent postprandial hyperglycemia.

Answer #8: C. Preventing ulcer recurrence

Rationale: Misoprostol is a medication that is often prescribed to prevent ulcer recurrence in clients with a history of peptic ulcer disease. It does this by promoting mucosal protection and reducing the risk of ulcers associated with nonsteroidal anti-inflammatory drug (NSAID) use.

Answer #9: A. Initiate a sepsis workup

Rationale: The bulging fontanelle in an infant with a fever is concerning for increased intracranial pressure, which may be a sign of meningitis. Therefore, the priority is to initiate a sepsis workup, including obtaining blood and cerebrospinal fluid cultures, and starting antibiotics if indicated.

Answer #10: C. Administer heparin as a bridging therapy

Rationale: Warfarin is an anticoagulant that can lead to an increased risk of bleeding during surgery. To minimize this risk while ensuring the patient's underlying condition is managed, heparin can be used as a bridging therapy. Heparin has a shorter half-life and can be easily reversed if necessary, making it a safer choice for the perioperative period.