NCLEX-RN
Med Surg RN NCLEX Practice Questions Questions
Extract:
Question 1 of 5
A client with cancer develops superior vena cava syndrome (SVCS). Which of the following symptoms should the nurse assess for?
Correct Answer: A
Rationale: SVCS obstructs venous return, causing facial swelling and dyspnea due to compression of the superior vena cava, which the nurse should prioritize in assessment.
Question 2 of 5
The nurse should instruct the client with a platelet count of less than 150,000/µL to avoid which of the following activities?
Correct Answer: B
Rationale: A platelet count below 150,000/µL indicates thrombocytopenia, increasing bleeding risk. Valsalva's maneuver (e.g., straining during bowel movements) can raise intracranial pressure and cause bleeding, such as cerebral hemorrhage, and should be avoided. Ambulation, visiting children, and semi-Fowler's position are generally safe unless other conditions are present.
Question 3 of 5
The nurse is planning care for a client with a history of peripheral vascular disease who has symptoms of claudication. Nursing care should be directed to avoiding which of the following situations?
Correct Answer: A
Rationale: Claudication in PVD results from insufficient blood flow to muscles during activity, causing oxygen demand to exceed supply, leading to pain. Nursing care should aim to improve blood flow (e.g., through exercise programs or medications) and avoid situations where muscle oxygen demand outstrips supply. Balanced or excess supply is desirable, and complete oxygen absence is not typical in claudication.
Question 4 of 5
Clients who have had active tuberculosis are at risk for recurrence. Which of the following conditions increases that risk?
Correct Answer: C
Rationale: Physical and emotional stress can weaken the immune system, increasing the risk of tuberculosis recurrence. Weather, exercise, and rest do not directly influence recurrence.
Question 5 of 5
Nursing assessment of a 54-year-old client in the emergency department reveals severe back pain, Grey Turner's sign, nausea, blood pressure of 90/40, heart rate 128 beats per minute and respirations 28 per minute. The nurse should first:
Correct Answer: B
Rationale: Severe back pain, Grey Turner's sign (flank bruising), and hemodynamic instability (hypotension, tachycardia, tachypnea) suggest a ruptured abdominal aortic aneurysm. Placing a large-bore I.V. first ensures access for fluids and blood transfusion to stabilize the client. Urine output, positioning, and nasogastric tube are secondary.