NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
A client with a history of a heart failure is receiving Digoxin (Lanoxin). The nurse should monitor the client for:
Correct Answer: B
Rationale: Digoxin toxicity can cause visual disturbances (e.g., yellow-green halos), requiring monitoring. Tachycardia, hypotension, and weight loss are less specific.
Question 2 of 5
The blood alcohol concentration of a client admitted following a motor vehicle accident is 460 mg/dL. The nurse should give priority to monitoring the client for:
Correct Answer: B
Rationale: A blood alcohol level of 460 mg/dL (0.46%) is life-threatening and can cause respiratory depression, a critical concern requiring close monitoring. Coordination loss and tachycardia are less immediate.
Question 3 of 5
A client with a history of hyperparathyroidism is admitted with complaints of fatigue. The nurse should expect the client to have:
Correct Answer: A
Rationale: Hyperparathyroidism increases parathyroid hormone, leading to hypercalcemia, causing fatigue and other symptoms.
Question 4 of 5
The nurse is caring for a client post-appendectomy. Which finding requires immediate intervention?
Correct Answer: B
Rationale: A temperature of 101.5°F post-appendectomy suggests infection (e.g., abscess), requiring immediate intervention. Pain (
A), serous drainage (
C), and absent bowel sounds (
D) are expected initially.
Question 5 of 5
The nurse is caring for a postoperative client when the client becomes nonresponsive and pale,with a BP of 90/40. The nurse recognizes that the necessary intervention at this time is to:
Correct Answer: B
Rationale: Hypotension (BP 90/40) pallor,and nonresponsiveness suggest hypovolemic shock likely from postoperative bleeding. Increasing the IV infusion rate (e.g. saline) restores volume. Trendelenburg is controversial atropine treats bradycardia,and the emergency cart is secondary to immediate fluid resuscitation.