NCLEX-RN
Med Surg RN NCLEX Questions Questions
Extract:
Question 1 of 5
A 62-year-old female is taking long-acting morphine 120 mg every 12 hours for pain from metastatic breast cancer. She can have 20 mg of immediate-release morphine every 3 to 4 hours as needed for breakthrough pain. The physician should be notified if the client uses more than how many breakthrough doses of morphine in 24 hours?
Correct Answer: B
Rationale: More than four breakthrough doses (80 mg additional morphine) in 24 hours indicates inadequate baseline pain control, requiring physician notification to adjust the long-acting morphine dose.
Question 2 of 5
A client on hemodialysis reports fatigue. The nurse should assess for:
Correct Answer: A
Rationale: Anemia is common in renal failure due to decreased erythropoietin.
Question 3 of 5
An adult client with type 2 diabetes is taking metformin (Glucophage) 1,000 mg two times every day. After the nurse provides instructions regarding the interaction of alcohol and metformin, the nurse evaluates that the client understands the instructions when the client says:
Correct Answer: A
Rationale: Alcohol combined with metformin increases the risk of lactic acidosis, a serious complication. The client should avoid alcohol while taking metformin.
Question 4 of 5
A health care provider has just inserted nasal packing for a client with epistaxis. The client is taking ramipril (Altace) for hypertension. What should the nurse instruct the client to do?
Correct Answer: D
Rationale: Avoiding rigorous aerobic exercise prevents increased blood pressure, which could worsen epistaxis. Aspirin increases bleeding risk. Omitting ramipril is not indicated without physician guidance. Removing packing is unsafe and should be done by a healthcare provider.
Question 5 of 5
What diet should be implemented for a client who is in the early stages of cirrhosis?
Correct Answer: A
Rationale: A high-calorie, high-carbohydrate diet (
A) supports energy needs in early cirrhosis without overloading the liver. High-protein (
B) risks encephalopathy, low-fat, low-protein (
C) is too restrictive, and low-sodium (
D) is for later stages with ascites.