NCLEX-RN
Free NCLEX RN Practice Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client with advanced heart failure and cardiomyopathy. The nurse understands that involving nursing, nutritional services, cardiology, and pharmacy in the client's care team is an example of which approach?
Correct Answer: C
Rationale: A multidisciplinary approach integrates multiple specialties for comprehensive care, as seen with nursing, nutrition, cardiology, and pharmacy.
Question 2 of 5
A client is admitted complaining of chest pain. Which of the following drug orders should the nurse question?
Correct Answer: B
Rationale: Ampicillin, an antibiotic, is not indicated for chest pain, which is typically cardiac-related and treated with nitroglycerin, propranolol, or verapamil.
Question 3 of 5
A client has a chest tube in place with a three-chamber chest drainage system. The nurse notes continuous bubbling in the water seal chamber. This indicates which of the following?
Correct Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates a system air leak (
C), such as a loose connection or hole in the tubing. A pneumothorax (
A) may cause intermittent bubbling, adequate suction (
B) is indicated by bubbling in the suction chamber, and incorrect tube positioning (
D) would not typically cause continuous bubbling.
Question 4 of 5
The client pulls out the chest tube and fails to report the occurrence to the nurse. When the nurse discovers the incidence, he should take which initial action?
Correct Answer: C
Rationale: Covering the insertion site with Vaseline gauze prevents air entry into the pleural space, stabilizing the client until further intervention.
Question 5 of 5
The nurse is assessing elderly clients at a community center. Which of the following findings would be the most cause for concern?
Correct Answer: D
Rationale: Rales bilaterally on chest auscultation suggest fluid in the lungs, which could indicate serious conditions like heart failure or pneumonia, requiring immediate attention. Dry mouth, height loss, and stiffened joints are common in aging but less urgent.