NCLEX-RN
RN NCLEX Practice Questions Questions
Extract:
Question 1 of 5
A client with a tracheostomy is exhibiting difficulty breathing, and respirations are increasingly noisy. Secretions are very thick. Which of the following initial interventions is most indicated?
Correct Answer: A
Rationale: Thick secretions causing noisy respirations and breathing difficulty indicate the need for increased humidification to thin secretions and suctioning to clear the tracheostomy tube (
A). Notifying the physician (
B) or encouraging coughing (
C) is secondary, and irrigation (
D) is not typically the initial step.
Question 2 of 5
A student nurse is precepting on the unit and caring for a client with a Dobbhoff nasoenteric tube. Which statement by the student nurse indicates the need for further teaching on caring for a client with this tube? Select all that apply.
Correct Answer: B, C
Rationale: Auscultation is not a reliable method for confirming tube placement; X-ray is required. Mixing medications with feedings can cause clogs or interactions. The other statements are correct.
Question 3 of 5
The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?
Correct Answer: A
Rationale: Prothrombin time (PT/INR) measures the therapeutic level of warfarin, ensuring effective anticoagulation.
Question 4 of 5
Which of the following would be considered a sensible type of fluid loss?
Correct Answer: A
Rationale: Sensible fluid loss is measurable, such as sweat or urine. Respiratory excretions, vomit, and fecal water loss are insensible (not easily measured).
Question 5 of 5
A client in cardiac arrest is given 40 units of vasopressin (Pitressin) IV push. The nurse knows the desired action of this medication in a cardiac arrest is to
Correct Answer: A
Rationale: Vasopressin, used in cardiac arrest, is a vasopressor that raises blood pressure by vasoconstriction, improving perfusion during CPR.