NCLEX-RN
NCLEX RN SATA Questions Questions
Extract:
Question 1 of 5
The nurse is teaching a client with a new diagnosis of osteoporosis about dietary management. Which of the following foods should the nurse recommend?
Correct Answer: A
Rationale: Yogurt is high in calcium, essential for bone health in osteoporosis.
Question 2 of 5
A client has massive bleeding from esophageal varices. In what order should the nurse and care team provide care for this client?
Order the Items
Source Container
Correct Answer: D, A, B, C
Rationale: The priority is to maintain a patent airway, control hemorrhaging, replace fluids, and then address anxiety to stabilize the client.
Question 3 of 5
The physician orders I.V. cefazolin (Kefzol) 1g for a client. In preparing to administer the Kefzol, the nurse notes that the client is allergic to penicillin. Based on this information, what is an appropriate action for the nurse to take?
Correct Answer: B
Rationale: Cefazolin, a cephalosporin, has a risk of cross-reactivity in penicillin-allergic clients, so the nurse should notify the physician to consider an alternative. Administering or verifying with the pharmacist without physician consultation is unsafe.
Question 4 of 5
A client with a history of type 2 diabetes mellitus is prescribed exenatide (Byetta). The nurse should monitor the client for which of the following side effects?
Correct Answer: B
Rationale: Exenatide can cause pancreatitis, a serious side effect requiring monitoring for symptoms like abdominal pain.
Question 5 of 5
Which actions should the nurse implement to prevent ventilator-associated pneumonia (VAP) in the client who is intubated and on mechanical ventilation?
Correct Answer: A
Rationale: Because normal upper airway defenses are bypassed, clients who are intubated with mechanical ventilation are at risk for VAP. Prevention includes effective hand washing before and after suctioning, when touching ventilator equipment, and when in contact with respiratory secretions.
To prevent aspiration of colonized secretions from the oral cavity, the client will need more frequent oral cavity suctioning and at least 30 degrees head of the bed elevation. The more frequently the circuit is broken, the greater the risk for pathogen entry.