NCLEX-RN
Med Surg RN NCLEX Questions Questions
Extract:
Question 1 of 5
A client with iron deficiency anemia is refusing to take the prescribed oral iron medication because the medication is causing nausea. The nurse should do which of the following? Select all that apply.
Correct Answer: A,B,E
Rationale: Nausea and vomiting are common adverse effects of oral iron preparations. The nurse should first ask the client why she does not want to take the oral medication, and then suggest ways to decrease the nausea and vomiting. Ginger may help minimize the nausea and the client can try this remedy and evaluate its effectiveness. Iron should be taken on an empty stomach but can be taken with orange juice to enhance absorption and potentially reduce nausea. The client can evaluate if this helps the nausea. Stool softeners are not typically recommended for iron deficiency anemia, as constipation is better managed with a high-fiber diet. Intramuscular iron is a last resort and not appropriate unless oral administration is ineffective.
Question 2 of 5
During the previous few months, a 56-year-old woman felt brief twinges of chest pain while working in her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and treatment, the client is discharged from the hospital. At her follow-up appointment, she is discouraged because she is experiencing pain with increasing frequency. She states that she visits an invalid friend twice a week and now cannot walk up the second flight of steps to the friend's apartment without pain. Which of the following measures that the nurse could suggest would most likely help the client prevent this problem?
Correct Answer: C
Rationale: Taking sublingual nitroglycerin before exertion (e.g., climbing stairs) prevents angina by dilating coronary arteries, increasing myocardial oxygen supply.
Question 3 of 5
A client who is scheduled for an open cholecystectomy has a 20-pack-year history of smoking. For which postoperative complication is the client most at risk?
Correct Answer: B
Rationale: Smoking impairs lung function and ciliary clearance, increasing the risk of atelectasis and pneumonia post-surgery due to reduced lung expansion and mucus clearance.
Question 4 of 5
The nurse teaches a client with chronic obstructive pulmonary disease for signs and symptoms of right-sided heart failure. Which of the following signs and symptoms should be included in the teaching plan?
Correct Answer: C
Rationale: Right-sided heart failure (cor pulmonale) in COPD causes peripheral edema due to increased venous pressure. Clubbing reflects chronic hypoxia, not heart failure. Hypertension and increased appetite are unrelated.
Question 5 of 5
The nurse is monitoring a client who received ketamine for anesthesia induction. Which side effect should the nurse prioritize?
Correct Answer: C
Rationale: Ketamine can cause vivid dreams or hallucinations, which may distress the client during recovery. Monitoring and reassuring the client are critical to manage this psychological side effect.