NCLEX-RN
NCLEX RN Test Bank with Rationales Questions
Extract:
Question 1 of 5
A client has had a cardiac catheterization. The left femoral dressing has a moderate amount of bloody drainage, and the client has severe pain in that area. The nurse should first:
Correct Answer: C
Rationale: Applying pressure to the site controls bleeding, which is the priority in this scenario.
Question 2 of 5
The nurse has given client directions for the proper use of aluminum hydroxide tablets. The client indicates an understanding of the medication when which statement is made?
Correct Answer: D
Rationale: Aluminum hydroxide tablets should be chewed thoroughly before swallowing. This prevents them from entering the small intestine undissolved. They should not be swallowed whole. Antacids should be taken at least 2 hours apart from other medications to prevent interactive effects. Constipation is a side effect of aluminum products, but the client should not take a laxative with each dose. This promotes laxative abuse. The client should first try other means to prevent constipation.
Question 3 of 5
The client prescribed phenelzine sulfate suddenly exhibits signs of hypertensive crisis. Which medication should the nurse plan to prepare?
Correct Answer: B
Rationale: The manifestations of hypertensive crisis include hypertension, occipital headache radiating frontally, neck stiffness and soreness, nausea, vomiting, sweating, fever and chills, clammy skin, dilated pupils, and palpitations. Tachycardia, bradycardia, and constricting chest pain may also be present. The antidote for hypertensive crisis is phentolamine and a dosage by intravenous injection is administered. Protamine sulfate is the antidote for heparin. Calcium gluconate is used for magnesium overdose. Phytonadione is the antidote for warfarin overdose.
Question 4 of 5
The nurse is teaching a client with a new diagnosis of epilepsy about safety precautions. Which of the following instructions should be included?
Correct Answer: A, D
Rationale: Avoiding driving and using a low bed with rails prevent injury during seizures.
Question 5 of 5
The nurse is teaching a client with diabetes mellitus about foot care. Which of the following instructions is most important?
Correct Answer: B
Rationale: Inspecting feet daily for cuts or sores is critical to prevent infections, a common complication in diabetes.