NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
The client is prescribed ciprofloxacin (Cipro) for a urinary tract infection. Which instruction should the nurse include?
Correct Answer: B
Rationale: Ciprofloxacin can cause photosensitivity, so avoiding sun exposure prevents skin reactions. Dairy products reduce absorption, and the full course must be completed, regardless of symptoms.
Question 2 of 5
The nurse has just received the change of shift report. Which client should the nurse assess first?
Correct Answer: A
Rationale: The client two hours post-lobectomy with 150mL of chest drainage is at risk for complications such as hemorrhage or tension pneumothorax, requiring immediate assessment. The other clients are stable: scant drainage is expected post-gastrectomy, a fever in pneumonia is concerning but less urgent, and a fractured hip in traction is typically stable.
Question 3 of 5
The nurse is preparing to administer a dose of gentamicin (Garamycin) IV. Which laboratory value should the nurse check before administration?
Correct Answer: A
Rationale: Gentamicin is nephrotoxic, so serum creatinine is checked to assess kidney function before administration to prevent toxicity. Other labs are less directly related to gentamicin risks.
Question 4 of 5
A 40-year-old client has been admitted to the hospital with severe substernal chest pain radiating down his left arm. The nurse caring for the client establishes the following priority nursing diagnosis--Alteration in comfort, pain related to:
Correct Answer: A
Rationale: Anaerobic metabolism results because the decreased blood supply to the myocardium causes a release of lactic acid. Lactic acid is an irritant to the myocardial neural receptors, producing chest pain. Chest pain is caused by a decrease in the O2 supply to the myocardial cells. Treatment modalities for chest pain are aimed toward increasing the blood flow through coronary arteries. Chest pain causes an increase in the stimulation of the sympathetic nervous system. This stimulation increases the heart rate and blood pressure, causing an increase in myocardial workload aggravating the chest pain. Chest pain and anxiety cause increased secretion of catecholamines by stimulating the sympathetic nervous system. This stimulation increases chest pain by increasing the workload of the heart.
Question 5 of 5
A female client has a chest tube placed. It is accidentally pulled out of the intrapleural space when she is ambulating. The first action the nurse should take is to:
Correct Answer: C
Rationale: This action is inappropriate. Coughing will not re-expand the lung and could result in further harm. This action is a medical procedure, not a nursing procedure. An occlusive dressing will prevent further air leak until the physician institutes further treatment. The decision to reinsert the tube is a medical decision, not a nursing one.