NCLEX-RN
Free NCLEX RN Questions for Med Surg Questions
Extract:
Question 1 of 5
A client with advanced ovarian cancer takes 150 mg of long-acting morphine orally every 12 hours for abdominal pain. When the client develops a small bowel obstruction, the physician discontinues the oral morphine and begins morphine 6 mg/hour I.V. After calculating the equianalgesic conversion from oral to intravenous morphine, the nurse should:
Correct Answer: B
Rationale: The equianalgesic conversion from 150 mg oral morphine every 12 hours (300 mg/day oral) to I.V. morphine (1:3 ratio) is approximately 100 mg/day I.V., or 4.2 mg/hour. The ordered 6 mg/hour is too high, and the nurse should contact the physician to adjust the dose.
Question 2 of 5
Three hours ago a client was thrown from a car into a ditch, and he is now admitted to the emergency department in a stable condition with vital signs within normal limits, alert and oriented with good coloring and an open fracture of the right tibia. For which signs and symptoms should the nurse be especially alert?
Correct Answer: C
Rationale: An open fracture increases the risk of infection and deformity, but shock is a critical systemic complication that can develop rapidly due to blood loss or pain, requiring vigilant monitoring.
Question 3 of 5
A client with Graves' disease is treated with radioactive iodine (RAI) in the form of sodium iodide 131I. Which of the following statements by the nurse will explain to the client how the drug works?
Correct Answer: D
Rationale: Radioactive iodine (RAI) works by destroying thyroid tissue, which reduces or eliminates the production of thyroid hormones, treating hyperthyroidism in Graves' disease.
Question 4 of 5
A client with acute renal failure has a low calcium level. The nurse should monitor for:
Correct Answer: A
Rationale: Low calcium can cause tetany, manifesting as muscle cramps or spasms.
Question 5 of 5
Which position would most help to decrease a client's discomfort when the client's spouse injects vitamin B12 using the ventrogluteal site?
Correct Answer: B
Rationale: The ventrogluteal site is best accessed when the client lies on their abdomen with toes pointed inward, as this position relaxes the gluteal muscles and minimizes discomfort during injection. The other positions do not optimally relax the muscle or provide access to the ventrogluteal site.