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NCLEX RN High-Yield Questions Questions

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Question 1 of 5

A nurse is caring for a client who is having an allergic reaction to a blood transfusion. In what order should the nurse provide care for this client?

Correct Answer: A,C,D

Rationale: The correct order is: 1) Stop the transfusion to halt the reaction, 2) Keep the vein open with saline to maintain access, 3) Administer antihistamine to manage symptoms, and 4) Send the blood bag to the blood bank for analysis.

Question 2 of 5

A 75-year-old man is receiving meperidine (Demerol) after surgery. For which of the following side effects of meperidine should the nurse carefully evaluate the client?

Correct Answer: A

Rationale: Meperidine can cause respiratory depression, especially in the elderly, requiring careful monitoring. Seizures are a concern with high doses, but respiratory depression is more immediate.

Question 3 of 5

A client is to receive 2 g of metronidazole (Flagyl) orally in a single dose. The medication is available in 500-mg tablets. How many tablets should the nurse administer?

Correct Answer: 4 tablets.

Rationale: 2 g equals 2000 mg. Dividing 2000 mg by 500 mg per tablet results in 4 tablets.

Question 4 of 5

The nurse is making rounds and observes a client who is unconscious (see fi gure). The nursing assistant has just turned the client from lying on her back. Before raising the side rail, the nurse should:

Question Image

Correct Answer: C

Rationale: The client is positioned correctly in the side-lying position. The pillows support the client’s joints and do not cause unnecessary pressure on the joints or skin. It is not necessary to add another pillow under the arm or to elevate the head of the bed. The nurse should assess the client’s skin for signs of breakdown, particularly at the elbows, back, hips, and heels where there were pressure points from the position in which the client was previously lying.

Question 5 of 5

A 16-year-old primiparous client has decided to place her baby for adoption. The adoptive parents are on their way to the hospital when the mother says, 'I want to see the baby one last time.' Which of the following should the nurse do?

Correct Answer: D

Rationale: Allowing the client to see and hold the baby supports emotional closure and respects her autonomy in this significant decision.

Similar Questions

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The nurse observes that a client who has received midazolam (Versed) for local anesthesia is having shallow respirations. The nurse should:
The mother of an infant with iron deficiency anemia asks the nurse what she could have done to prevent the anemia. The nurse should teach the mother that it is helpful to introduce solid foods into the infant's diet at age:
Which of these stress management techniques employs deep focused breathing, movement and meditation?
A client has been prescribed lansoprazole for 4 weeks. The nurse should monitor the client for relief from which problem?

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