NCLEX-RN
Medical Surgical NCLEX RN Questions
Extract:
Question 1 of 5
A client has the following arterial blood gas values: pH, 7.52; PaO2, 50 mm Hg; PaCO2, 28 mm Hg; HCO3ˆ’, 24 mEq/L. The nurse determines that which of the following is a possible cause for these findings?
Correct Answer: D
Rationale: The ABG shows respiratory alkalosis (high pH, low PaCO2) and severe hypoxia (PaO2 50). Pulmonary embolus causes hypoxia and hyperventilation, matching these findings. COPD causes CO2 retention. Ketoacidosis causes metabolic acidosis. Myocardial infarction is less likely to cause this pattern.
Question 2 of 5
A nurse is caring for a client who has just returned from surgery to treat a fractured mandible. Which of the following items should always be available at this client's bedside? Select all that apply.
Correct Answer: B,D
Rationale: For a client with a wired jaw due to a fractured mandible, wire cutters are essential in case of an emergency, such as vomiting, to quickly release the wires and prevent aspiration. Suction equipment is also critical to maintain a patent airway by removing secretions or vomit. A nasogastric tube, oxygen cannula, and code cart are not routinely required at the bedside unless specifically indicated.
Question 3 of 5
A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife does which of the following? Select all that apply.
Correct Answer: A,B,D,F
Rationale: Effective pain management includes around-the-clock long-acting opioids (
A), immediate-release opioids for breakthrough pain (
B), non-pharmacologic methods like music or heat/cold (
D), and using a pain scale to assess effectiveness (F). Avoiding long-acting opioids (
C) or substituting acetaminophen (E) is not appropriate for severe cancer pain.
Question 4 of 5
A client with ascites and peripheral edema is at risk for impaired skin integrity. To prevent skin breakdown, the nurse should:
Correct Answer: C
Rationale: An alternating air pressure mattress (
C) prevents pressure ulcers in clients with edema. ROM exercises (
A) and elevation (
D) are helpful but secondary. Abdominal massage (
B) is not indicated.
Question 5 of 5
Which of the following is an appropriate expected outcome for a client recovering from a total laryngectomy? The client will:
Correct Answer: C
Rationale: Communicating feelings about body image changes is an appropriate psychosocial outcome post-laryngectomy, addressing adaptation to altered appearance. Taste and smell may be impaired long-term. Gastrostomy tubes are not always required. Sterile suctioning is a nursing task, not a client outcome.