NCLEX-PN
Free NCLEX-PN Practice Questions Questions
Extract:
Question 1 of 5
A client is receiving nitroglycerin ointment (Nitrol) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
Correct Answer: C
Rationale: Hypotension and headache are the most common adverse effects of nitroglycerin.
Therefore, blood pressure is the vital sign most likely to reflect an adverse effect of this drug. The nurse should check the client's blood pressure 1 hour after administering nitroglycerin ointment. A blood pressure decrease of 10 mm Hg is within the therapeutic range. If blood pressure falls more than 20 mm Hg below baseline, the nurse should remove the ointment and report the finding to the physician immediately. An above-normal heart rate (tachycardia) is a less common adverse effect of nitroglycerin. Respiratory rate and temperature don't change significantly after nitroglycerin administration.
Question 2 of 5
A client received six units of regular insulin three hours ago. The nurse would be MOST concerned if which of the following was observed?
Correct Answer: C
Rationale: Regular insulin peaks in 2–4 hours, and the symptoms in choice C (diaphoresis and trembling) are classic signs of hypoglycemia, a potential complication at this time. Hypoglycemia requires immediate intervention, such as administering skim milk or glucose.
Choice A indicates hyperglycemia (Kussmaul respirations), and choices B and D are not specific to hypoglycemia.
Extract:
The nursing intervention that should be instituted immediately to relieve the symptoms associated with the patient's hypoglycemic reaction include:
Question 3 of 5
Giving 8 oz of fruit juice with 2 tablespoon of sugar.
Correct Answer: A
Rationale: Fruit juice with sugar provides rapid glucose to reverse hypoglycemia effectively.
Extract:
The nurse should observe Valerie closely for signs of infectious complications because in Addison's disease there is disturbance in
Question 4 of 5
fluid balance.
Correct Answer: D
Rationale: Because of diminished glucocorticoid production, there is a decreased inflammatory effect, increasing susceptibility to infections.
Extract:
A nurse is going to give health teachings to a group of 11 to 15 years old clients with Diabetes Mellitus.
Question 5 of 5
Considering the group's developmental needs, the type of learning activity planned by the nurse would be:
Correct Answer: D
Rationale: Peer-support activities align with adolescents' developmental need for social connection and shared experiences.