NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Question 1 of 5
The nurse is preparing to administer a dose of morphine sulfate IV to a client for pain. Which assessment is most important before administration?
Correct Answer: A
Rationale: Morphine, an opioid, can cause respiratory depression. Assessing the respiratory rate is critical before administration to ensure it is above 12 breaths per minute, preventing overdose risk. Other vital signs are monitored but are less critical.
Question 2 of 5
A client with ovarian cancer is receiving fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals in the IV medication?
Correct Answer: A
Rationale: Crystals in IV fluorouracil indicate precipitation, which can cause embolism or infusion issues. The nurse should discard the solution and obtain a new bag. Warming may not dissolve crystals safely, and continuing or discontinuing without replacement is incorrect.
Question 3 of 5
A client with a history of a fractured femur is in skeletal traction. The nurse should:
Correct Answer: B
Rationale: Cleaning pin sites with saline (or per protocol) prevents infection in skeletal traction. Turning is limited, lotion is unnecessary, and removing weights disrupts traction.
Question 4 of 5
Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?
Correct Answer: C
Rationale: The tension pneumothorax acts like a one-way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline. Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.
Question 5 of 5
A pregnant client experiences a precipitous delivery. The nursing action during a precipitous delivery is to:
Correct Answer: A
Rationale: Guiding the fetus's expulsion during a precipitous delivery minimizes injury and perineal trauma.