NCLEX-RN
NCLEX RN Questions Medical Surgical Nursing Questions
Extract:
Question 1 of 5
A client is having a blood transfusion reaction. The nurse must do the following in what order of priority from first to last?
Correct Answer: C,D,A,B
Rationale: In a transfusion reaction, the nurse must first stop the transfusion to prevent further infusion of the offending blood. Next, keep the IV line open with normal saline to maintain access and support circulation.
Then, notify the physician and blood bank for further evaluation and management. Finally, complete the transfusion reaction forms to document the incident.
Question 2 of 5
A client is receiving dopamine hydrochloride for treatment of shock. The nurse should:
Correct Answer: B
Rationale: Dopamine can cause significant changes in blood pressure due to its inotropic and vasopressor effects. Continuous blood pressure monitoring is essential to titrate the dose and prevent complications. Pain medication, arterial blood gases, and infection monitoring are not primary.
Question 3 of 5
Which position is best for a client with a hemorrhagic stroke?
Correct Answer: B
Rationale: Head elevation at 30 degrees reduces intracranial pressure while maintaining cerebral perfusion in hemorrhagic stroke.
Question 4 of 5
The nurse identifies deficient knowledge when the client undergoing induction therapy for leukemia makes which of the following statements?
Correct Answer: B
Rationale: During leukemia induction therapy, the client is at high risk for infection due to neutropenia. Pets like cats can carry pathogens (e.g.,
Toxoplasma), and the statement about returning to a cat indicates a knowledge deficit about infection risks. The other statements reflect appropriate self-care measures.
Question 5 of 5
A client post-amputation is experiencing depression. Which nursing action is most appropriate?
Correct Answer: B
Rationale: Encouraging participation in a support group fosters emotional coping and peer support.