NCLEX-RN
NCLEX RN Question Bank Free Questions
Extract:
Question 1 of 5
A client has received an overdose of sympathomimetic agents. The nurse should assess the client for which of the following late signs of an overdose? Select all that apply.
Correct Answer: C, D, E
Rationale: Sympathomimetic overdose can cause seizures, profound pyrexia (fever), and hypertension due to excessive stimulation of the sympathetic nervous system.
Question 2 of 5
A 1-year-old is brought to the clinic with failure to thrive. Which assessment should the nurse prioritize?
Correct Answer: A
Rationale: Dietary intake history is critical in failure to thrive to identify inadequate caloric intake or feeding issues, guiding intervention.
Question 3 of 5
The nurse has administered a dose of diazepam to the client. Which most important action should the nurse take before leaving the client's room?
Correct Answer: D
Rationale: Diazepam is a benzodiazepine and has sedative/hypnotic effects with anticonvulsant and skeletal muscle relaxant properties. The nurse should institute safety measures before leaving the client's room to ensure that the client does not injure self. The most frequent side effects of this medication are dizziness, drowsiness, and lethargy. For this reason, the nurse raises a side rail on the bed and instructs the client not to get out of bed without assistance. Note that agency policy regarding the use of side rails is always followed. Although the remaining options may be helpful measures that provide a comfortable, restful environment, instructing the client to ask for assistance when getting out of bed provides for the client's safety needs.
Question 4 of 5
The nurse is teaching a client with a new diagnosis of asthma about the use of a spacer with a metered-dose inhaler. Which of the following instructions is most important?
Correct Answer: C
Rationale: Cleaning the spacer weekly prevents bacterial buildup, ensuring safe and effective medication delivery.
Question 5 of 5
The nurse has finished suctioning the tracheostomy of a client. Which parameter should the nurse monitor to determine the effectiveness of the procedure?
Correct Answer: A
Rationale: After suctioning a client either with or without an artificial airway, the breath sounds are auscultated to determine the extent to which the airways have been cleared of respiratory secretions. The other assessment items are not as precise as breath sounds for this purpose.