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Questions 149

NCLEX-RN

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Extract:


Question 1 of 5

A post-operative client has an order for Demerol (meperidine) 75 mg and Phenergan (promethazine) 25 mg IM every 3-4 hours as needed for pain. The combination of the two medications produces a/an:

Correct Answer: B

Rationale: Demerol (opioid) and Phenergan (antihistamine) together produce a synergistic effect, enhancing pain relief and sedation beyond the sum of their individual effects.

Question 2 of 5

A client was transferred to the hospital unit as a direct admit from a small community hospital. While the nurse is obtaining part of the admission history information, the client suddenly becomes semiconscious. Assessment reveals a systolic BP of 70, heart rate of 130, and respiratory rate of 24. What is the nurse's initial action?

Correct Answer: B

Rationale: The client's symptoms suggest shock (low BP, high HR, elevated RR). Initiating an IV with a large bore needle allows for rapid fluid resuscitation, which is critical. Lowering the bed may worsen perfusion, notifying the physician delays action, and CPR is premature without pulselessness.

Question 3 of 5

The nurse is caring for a client with staphylococcus epidermidis. The client is on a vancomycin IV. What nursing consideration should the nurse be aware of regarding this medication?

Correct Answer: C

Rationale: Vancomycin requires monitoring trough levels (drawn before a dose) to ensure therapeutic efficacy and prevent toxicity.

Question 4 of 5

The nurse is caring for a 12-year-old client with appendicitis. The client's mother is a Jehovah's Witness and refuses to sign the blood permit. What nursing action is most appropriate?

Correct Answer: D

Rationale: Notifying the physician respects the mother's beliefs while ensuring the medical team addresses the refusal appropriately.

Question 5 of 5

The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?

Correct Answer: B

Rationale: Coolness and discoloration of reimplanted digits indicate compromised blood flow, requiring immediate reporting to prevent tissue loss.

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