NCLEX-PN
NCLEX Respiratory Questions Questions
Question 1 of 5
A patient, who is receiving continuous IV Heparin for the treatment of a DVT, has an aPTT of 110 seconds. What is your next nursing action per protocol?
Correct Answer: D
Rationale: The aPTT is 110 seconds, which is too high. Any aPTT value greater than 80 seconds places the patient at risk for bleeding. Most Heparin protocols dictate that the nurse would hold the infusion for 1 hour and to decrease the rate of infusion. If the aPTT is less than 60 seconds, the dose would need to be increased and a bolus may be needed. aPTT values should be around 60-80 seconds to achieve a therapeutic response for Heparin.
Question 2 of 5
Which health measure is most important to emphasize when instructing the client on ways to prevent transmitting tuberculosis?
Correct Answer: C
Rationale: Covering the nose and mouth when coughing prevents the spread of tuberculosis, an airborne disease, to others.
Question 3 of 5
Until the client can be examined later that morning, which advice by the nurse would be most helpful?
Correct Answer: B
Rationale: Resting the voice reduces strain on the vocal cords, which is beneficial for laryngitis and helps prevent further irritation.
Question 4 of 5
The nurse is caring for a client diagnosed with a cold. Which is an example of an alternative therapy?
Correct Answer: A
Rationale: Vitamin C (
A) is an alternative therapy for colds, with unproven efficacy. Bedrest (
B), humidification (
C), and decongestants (
D) are standard supportive measures.
Question 5 of 5
As the nurse you know that one of the reasons for an increase in multidrug-resistant tuberculosis is:
Correct Answer: D
Rationale: Patients must be on medication treatment for about 6-12 months (depending on the type of TB the patient has). This leads to noncompliant issues. DOT (directly observed therapy) is now being instituted so compliance is increased. This is where a public health nurse or a trained DOT worker will deliver the medication and watch the patient swallow the pill until treatment is complete.