NCLEX-RN
NCLEX RN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client taking vancomycin. The nurse anticipates drawing a peak and trough on this client. Which statement regarding peak and trough levels is correct?
Correct Answer: A
Rationale: The peak is drawn 1 hour after infusion to measure maximum concentration, and the trough is drawn just before the next dose to measure minimum concentration.
Question 2 of 5
The nurse should be particularly alert for which one of the following problems in a client with barbiturate overdose?
Correct Answer: C
Rationale: Barbiturate overdose primarily causes respiratory depression, leading to apnea, which is life-threatening and requires immediate intervention.
Question 3 of 5
A nulliparous client has been admitted after 12 hours of mild contractions at home. On examination, the client is found to be fully effaced and dilated to 3 cm. Contractions are every 5 minutes and last approximately 60 seconds. The client asks the nurse approximately how long it should take to get to 10 cm dilation. Which of the following is the most appropriate response?
Correct Answer: D
Rationale: Nulliparous women progress at ~1 cm/hour in active labor. From 3 cm to 10 cm is 7 cm, so ~7 hours (
D) is expected.
Question 4 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.
Question 5 of 5
A client with a T6 injury 6 months ago develops facial flushing and a BP of 210/106. After elevating the head of the bed, which is the most appropriate nursing action?
Correct Answer: B
Rationale: The symptoms suggest autonomic dysreflexia, often triggered by a distended bladder in spinal cord injury patients. Assessing and relieving the bladder is the priority after elevating the bed.