Questions 108

NCLEX-RN

NCLEX-RN Test Bank

Med Surg RN NCLEX Questions Questions

Extract:


Question 1 of 5

A client has returned to the medical surgical unit after having surgery to create an ileostomy. Which goal has the highest priority at this time?

Correct Answer: C

Rationale: Maintaining fluid and electrolyte balance is the highest priority post-ileostomy due to the risk of dehydration from high-output ileostomy effluent. Constipation is not a concern, and self-care or odor control are secondary to physiological stability. CN: Physiological adaptation; CL: Synthesize

Question 2 of 5

Before undergoing a transsphenoidal hypophysectomy, the client asks the nurse how the surgeon will close the incision made in the dura. The nurse should respond based on the knowledge that:

Correct Answer: C

Rationale: A fascial patch is commonly used to repair the dura during transsphenoidal hypophysectomy to prevent CSF leaks.

Question 3 of 5

The nurse is teaching a client with a new colostomy about dietary modifications. Which of the following foods should the client avoid to prevent excessive gas?

Correct Answer: A

Rationale: Broccoli, a cruciferous vegetable, can cause excessive gas in clients with a colostomy, which may lead to pouch ballooning. Chicken, rice, and yogurt are less likely to produce significant gas. CN: Physiological adaptation; CL: Synthesize

Question 4 of 5

Which statement by a client with acute renal failure indicates understanding of dietary restrictions?

Correct Answer: A

Rationale: Oranges are high in potassium, which should be avoided in acute renal failure.

Question 5 of 5

In planning care for the client who has had a stroke, the nurse should obtain a history of the client's functional status before the stroke because?

Correct Answer: A

Rationale: A pre-stroke functional status history guides the rehabilitation plan by setting realistic goals based on prior abilities. Predicting outcomes, recognizing limitations, or expecting full recovery are secondary or unrealistic.

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