NCLEX-RN
RN NCLEX Next Gen Questions Questions
Extract:
Question 1 of 5
A client is at risk for development of metabolic alkalosis because of persistent vomiting. The nurse should assess the client specifically for:
Correct Answer: B
Rationale: Persistent vomiting causes loss of hydrochloric acid, leading to metabolic alkalosis, which can manifest as hyperventilation as the body compensates for elevated pH.
Question 2 of 5
How many drops per minute would you administer when the doctor's order states that the client should receive 1 liter of fluid over 8 hours and the intravenous set delivers 20 gtts per cc?
Correct Answer: A
Rationale:
To calculate: 1,000 mL ÷ 8 hours = 125 mL/hr.
Then, 125 mL × 20 gtts/mL ÷ 60 min = 41.67 gtts/min, rounded to 31 gtts/min based on closest option.
Question 3 of 5
A client with a history of chronic kidney disease is admitted with edema. The nurse should monitor the client for which of the following electrolyte imbalances? Select all that apply.
Correct Answer: A, B, C, D
Rationale: Chronic kidney disease can cause hyperkalemia, hyponatremia, hypocalcemia, and hypermagnesemia due to impaired excretion and filtration.
Question 4 of 5
A client has a prescription to have a set of arterial blood gases (ABGs) drawn, and the intended site is the radial artery. The nurse ensures that which is positive before the ABGs are drawn?
Correct Answer: A
Rationale: The Allen test is performed before drawing ABGs. Both the radial and ulnar arteries are occluded and then pressure on the ulnar artery is released. Observation is made in the distal circulation. If the results are positive, then the client has adequate circulation and the radial artery may be used. Turner's sign is the bluish discoloration of the flanks and is indicative of pancreatitis. The Babinski reflex is checked by stroking upward on the sole of the foot. Brudzinski's sign tests for nuchal rigidity by bending the head down toward the chest.
Question 5 of 5
Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 45 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do?
Correct Answer: B
Rationale: The client's advance directive clearly states a desire for all life-saving measures, including CPR and advanced cardiac life support. Despite the nurse's professional judgment about futility, the nurse is legally and ethically obligated to follow the advance directive and initiate CPR immediately in the event of a cardiac and respiratory arrest. Notifying the doctor or family or ensuring comfort are secondary actions after initiating life-saving measures as per the client's documented wishes.