Questions 150

NCLEX-RN

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Question 1 of 5

Before the nurse administers I.V. replacement of 5% dextrose in water with potassium chloride, what nursing intervention must be completed first?

Correct Answer: B

Rationale: Evaluating electrolyte levels, especially potassium, is critical before administering potassium chloride to prevent hyperkalemia. Adding potassium at the bedside is unsafe, and priming or checking rates follows.

Question 2 of 5

A client with a history of type 2 diabetes is prescribed sitagliptin (Januvia). The nurse should instruct the client to:

Correct Answer: B

Rationale: Sitagliptin can cause pancreatitis, requiring monitoring for abdominal pain.

Question 3 of 5

The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration?

Correct Answer: C

Rationale: NPH is an intermediate-acting insulin with a peak time in 4 to 12 hours. The remaining options describe periods of time that are either too short or too long.

Question 4 of 5

A client who had transurethral resection of the prostate complains of dribbling urine after his Foley catheter is removed on the second postoperative day. The nurse notes that the client had $200 \mathrm{~mL}$ of urine output in the last 8 hours with a $1,000 \mathrm{~mL}$ intake. Which of the following interventions is a priority for the nurse at this time?

Correct Answer: B

Rationale: Low urine output and dribbling post-TURP suggest possible bladder distention, which requires immediate assessment to prevent complications. Other interventions may follow based on findings.

Question 5 of 5

Which of the following nursing interventions would best accomplish the goal of preventing atelectasis and pneumonia in a postoperative client?

Correct Answer: B

Rationale: Pain control is essential to enable effective deep breathing and incentive spirometry, which prevent atelectasis and pneumonia by promoting lung expansion. Oxygen and fluid intake are supportive but secondary.

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