ATI RN
NCLEX Questions Oxygen Therapy Questions
Question 1 of 5
A nurse is caring for a patient who has just received a dose of insulin. The patient reports feeling shaky. Which is the priority action?
Correct Answer: B
Rationale: The correct answer is B: Administer dextrose. When a patient who has received insulin reports feeling shaky, it indicates hypoglycemia. Administering dextrose helps raise blood sugar levels quickly, addressing the immediate concern. Administering glucagon (choice A) is appropriate for severe hypoglycemia but is not the priority in this case. Assessing the patient's blood glucose level (choice C) is important, but the patient's symptoms already suggest hypoglycemia, so immediate intervention is needed. Administering insulin therapy (choice D) would worsen the hypoglycemia and is inappropriate in this situation.
Question 2 of 5
A patient is admitted to the emergency department with an open stab wound to the left chest. What action should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Administer a vasodilator. Administering a vasodilator would help in stabilizing the patient's condition by reducing blood pressure and improving blood flow. This can be crucial in managing hypotension and preventing further complications. A: Covering the wound tightly with an occlusive dressing may trap air inside the chest cavity, leading to tension pneumothorax. B: Taping a nonporous dressing on three sides can also lead to tension pneumothorax by preventing air from escaping the chest. C: Positioning the patient so that the left chest is dependent is not appropriate in this scenario as it does not address the underlying issue of the stab wound.
Question 3 of 5
A nurse is caring for a patient with a history of hypertension. The patient is experiencing dizziness and lightheadedness. What is the priority action?
Correct Answer: A
Rationale: The correct answer is A: Administer antihypertensive medication. The priority action is to address the underlying cause of symptoms, which is likely elevated blood pressure causing dizziness and lightheadedness. Administering antihypertensive medication will help lower the blood pressure and alleviate the symptoms. Monitoring blood pressure (option C) is important but addressing the immediate symptoms is the priority. Administering IV fluids (option B) may not be necessary unless there are signs of dehydration. Administering insulin therapy (option D) is not indicated for dizziness and lightheadedness in a patient with hypertension.
Question 4 of 5
A nurse is caring for a patient with chronic kidney disease (CKD). What is the priority nursing intervention?
Correct Answer: D
Rationale: The correct answer is D: Administer IV morphine. In CKD, pain management is crucial due to associated complications. Administering IV morphine helps alleviate pain effectively. Diuretics (A) are not indicated in CKD as they can worsen kidney function. Administering IV fluids (B) should be done cautiously to prevent fluid overload. Encouraging mobility and range of motion (C) is important for overall health but not the priority in this case.
Question 5 of 5
A nurse is caring for a patient with a history of asthma. The patient is complaining of wheezing. What is the priority intervention?
Correct Answer: A
Rationale: The correct answer is A: Administer albuterol (Ventolin). The priority intervention is to administer albuterol, a fast-acting bronchodilator that helps relieve bronchoconstriction and wheezing in asthma. Albuterol works quickly to open the airways and improve breathing, which is crucial in managing acute asthma symptoms. Oral medications (choice B) may take longer to take effect and are not the first-line treatment for acute wheezing. Nebulized bronchodilators (choice C) are effective but albuterol is preferred for its faster onset of action. Corticosteroids (choice D) are used for long-term asthma management and are not the immediate priority in treating acute wheezing.