NCLEX-RN
NCLEX RN SATA Questions Questions
Extract:
Question 1 of 5
A client with a history of deep vein thrombosis is prescribed enoxaparin (Lovenox). Which laboratory value does not require routine monitoring?
Correct Answer: B
Rationale: Enoxaparin, a low-molecular-weight heparin, does not require routine PT monitoring, unlike warfarin, as it primarily affects anti-factor Xa activity.
Question 2 of 5
A nurse is preparing to administer 500 mL of an I.V. solution to a child over 12 hours via tubing that delivers microdrips at 60 gtt/mL. At what rate should the nurse infuse the solution?
Correct Answer: A
Rationale: Calculate: 500 mL over 12 hours = 41.67 mL/hour. For microdrip (60 gtt/mL), 41.67 mL/hour ×60 gtt/mL = 2500 gtt/hour ÷ 60 minutes = 41.67 gtt/minute, rounded to 42 gtt/minute.
Question 3 of 5
The client has sore nares while a nasogastric (NG) tube is in place. Which of the following nursing measures would be most appropriate to help alleviate the client's discomfort?
Correct Answer: C
Rationale: Applying a water-soluble lubricant to the nares reduces irritation and discomfort caused by the NG tube.
Question 4 of 5
A client is receiving total parenteral nutrition (TPN). The nurse notices that the bag of TPN solution has been infusing for 24 hours but has $300 \mathrm{~mL}$ of solution left. The nurse should:
Correct Answer: D
Rationale: TPN solutions should not hang for more than 24 hours due to infection risk. The nurse should discontinue the current bag, change the tubing, and hang a new bag. Continuing or altering the rate is unsafe.
Question 5 of 5
You are precepting a new graduate nurse who will be administering an intramuscular injection to an adult client. The new graduate nurse identifies the gluteus maximus muscle by palpating it. What would you do?
Correct Answer: B
Rationale: The vastus lateralis is preferred over the gluteus maximus for IM injections in adults due to lower risk of sciatic nerve injury.