Questions 108

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Medical Surgical Practice Questions Questions

Extract:


Question 1 of 5

A client with multiple sclerosis (MS) lives with her daughter and 3-year-old granddaughter. The daughter asks the nurse what she can do at home to help her mother. Which of the following measures would be most beneficial?

Correct Answer: B

Rationale: Regular exercise is most beneficial, as it maintains mobility, strength, and overall health in MS. Psychotherapy, daycare, or peer visits may help but are less directly impactful.

Question 2 of 5

A male client who has been taking warfarin (Coumadin) has been admitted with severe acute rectal bleeding and the following laboratory results: International Normalized Ratio (INR), 8; hemoglobin, 11 g/dL; and hematocrit, 33%. Which of the following physician orders should the nurse expect to implement initially? Select all that apply.

Correct Answer: C,D

Rationale: An INR of 8 indicates excessive anticoagulation from warfarin, causing severe bleeding. Initial management includes administering fresh frozen plasma (FFP) to replace clotting factors and vitamin K to reverse warfarin's effects. Dextrose/saline, sigmoidoscopy preparation, and enemas are not immediate priorities.

Question 3 of 5

A client who has been diagnosed with renal calculi reports that the pain is intermittent and less colicky. Which of the following nursing actions is most important at this time?

Correct Answer: B

Rationale: Straining urine is critical when pain becomes intermittent, indicating possible stone passage, to confirm stone expulsion and guide treatment.

Question 4 of 5

The nurse has calculated a low PaO2/FIO2 (P/F) ratio <150 for a client with acute respiratory distress syndrome (ARDS). The nurse should place the client in which position to improve oxygenation, ventilation distribution, and drainage of secretions?

Correct Answer: D

Rationale: Prone positioning in ARDS with a low P/F ratio (<150) improves oxygenation, ventilation distribution, and secretion drainage by recruiting dependent lung regions. Other positions are less effective.

Question 5 of 5

Which of the following are expected outcomes for a client with pulmonary disease?

Correct Answer: A

Rationale: A matched ventilation-to-perfusion ratio is the goal in pulmonary disease for efficient gas exchange. Low or high ratios indicate mismatch. Equal PaO2 and PaCO2 is not a standard outcome.

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