NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
The nurse is preparing to administer a dose of nitroglycerin sublingual to a client with chest pain. Which instruction should be given to the client?
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets are placed under the tongue to dissolve, allowing rapid absorption to relieve angina. Swallowing, chewing, or taking with milk reduces effectiveness or delays onset.
Question 2 of 5
A client has an order to administer cisplatin (Platinol). Which drug would the nurse expect to be ordered to reduce renal toxicity from the cisplatin infusion?
Correct Answer: A
Rationale: Amifostine protects kidneys from cisplatin’s nephrotoxicity by neutralizing free radicals. Dexrazoxane (
B) protects the heart, Mesna (
C) prevents bladder toxicity, and Pamidronate (
D) treats hypercalcemia.
Question 3 of 5
The client is admitted with a diagnosis of gestational trophoblastic disease. Which diagnostic test is most likely to be ordered?
Correct Answer: C
Rationale: Serum hCG levels are markedly elevated in gestational trophoblastic disease and ultrasound reveals a characteristic “snowstorm” pattern or grape-like vesicles. Both tests are essential for diagnosis.
Question 4 of 5
A 70-year-old female client is admitted to the medical intensive care unit with a diagnosis of cerebrovascular accident (CVA). She is semicomatose, responding to pain and change in position. She is unable to speak or cough. In planning her nursing care for the first 24 hours following a CVA, which nursing diagnosis should receive the highest priority?
Correct Answer: A
Rationale: An effective airway is necessary to prevent hypoxia and subsequent cardiac arrest. Cerebral tissue perfusion is necessary to preserve remaining cerebral tissue, but this goal is secondary to maintenance of an effective airway. While prevention of injury is important, it is secondary to maintaining an effective airway and cerebral tissue perfusion. Impaired verbal communication is not life threatening in the acute phase of recovery. It is the lowest priority of the nursing diagnoses listed.
Question 5 of 5
The primary reason that an increase in heart rate (100 bpm) detrimental to the client with a myocardial infarction (MI) is that:
Correct Answer: D
Rationale: Decreased stroke volume and blood pressure will occur secondary to decreased diastolic filling. Tachycardia primarily decreases diastole; systolic time changes very little. Contractility decreases owing to the decreased filling time and decreased time for fiber lengthening. Decreased O2 supply due to decreased time for filling of the coronary arteries increases ischemia and infarct size. Tachycardia primarily robs the heart of diastolic time, which is the primary time for coronary artery filling.