Questions 150

NCLEX-RN

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Question 1 of 5

The nurse is caring for a client with a history of gastric bypass surgery. Which of the following vitamins is the client at highest risk for deficiency?

Correct Answer: B

Rationale: Gastric bypass surgery impairs vitamin B12 absorption due to reduced intrinsic factor production, increasing deficiency risk.

Question 2 of 5

A Hispanic client is admitted to the surgical unit from the emergency department for an appendectomy. The nurse conducts the preoperative preparations and determines that the client has difficulty understanding English. The surgeon needs to obtain the client's informed consent. The nurse course for obtaining the client's informed consent is to:

Correct Answer: C

Rationale: The surgeon is required to give the client explanations and have questions answered. The nurse has no way of assessing the client's understanding without the interpreter. The client should sign the Spanish consent form only after receiving an explanation of the procedure, its risks, and alternatives. A family member cannot be relied on to translate the surgeon's instructions accurately.

Question 3 of 5

A client with a history of seizures is prescribed phenytoin (Dilantin). The nurse should instruct the client to report which of the following side effects immediately?

Correct Answer: C

Rationale: A rash may indicate a serious hypersensitivity reaction to phenytoin, such as Stevens-Johnson syndrome, requiring immediate reporting.

Question 4 of 5

A client undergoes cystoscopy with bladder biopsy. After the procedure, which assessment is most appropriate for the nurse to make?

Correct Answer: B

Rationale: Assessing for excessive bleeding post-cystoscopy with biopsy is critical due to the risk of hemorrhage. A Foley catheter may not be present, and culture is less urgent.

Question 5 of 5

The nurse is assessing a client with irreversible shock. The nurse should document which of the following?

Correct Answer: B

Rationale: Irreversible shock is characterized by circulatory collapse, with failure of vital organs due to inadequate perfusion, a critical finding to document.

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