NCLEX-RN
NCLEX RN High-Yield Questions Questions
Extract:
Question 1 of 5
Which prescribed procedure should the nurse withhold until a comatose client is properly intubated?
Correct Answer: A
Rationale: Intubation should always precede gastric feeding to prevent pulmonary aspiration. The remaining options identify procedures that can be initiated before intubation of the client.
Question 2 of 5
A client was admitted to the hospital with a diagnosis of frequent symptomatic premature ventricular contractions (PVCs). After sitting up in a chair for a few minutes, the client reports feeling lightheaded. Which finding should the nurse anticipate on auscultation of the heartbeat?
Correct Answer: B
Rationale: The most accurate means of assessing pulse rhythm is by auscultation of the apical pulse. When a client has PVCs, the rate is irregular and if the radial pulse is taken, a true picture of what is occurring is not obtained. A very slow regular apical pulse indicates bradycardia. A very rapid regular apical pulse indicates tachycardia.
Question 3 of 5
A client has had an incisional cholecystectomy. Which of the following nursing interventions has the highest priority in postoperative care for this client?
Correct Answer: A
Rationale: Incentive spirometry prevents postoperative pulmonary complications, a significant risk after abdominal surgery, by promoting lung expansion.
Question 4 of 5
A client with a history of gout is prescribed allopurinol (Zyloprim). Which instruction should the nurse include?
Correct Answer: B
Rationale: Drinking plenty of fluids prevents uric acid crystal formation in the kidneys, a key consideration for clients taking allopurinol.
Question 5 of 5
A client takes aluminum hydroxide tablets as needed for heartburn. The nurse teaches the client that which is the most common side effect of this medication?
Correct Answer: D
Rationale: Because of the antacid's aluminum base, aluminum hydroxide causes constipation as a side effect. The other side effect is hypophosphatemia, which is noted by monitoring serum laboratory studies. The other options are not side effects of this medication.