NCLEX-RN
Adult Health Med Surg NCLEX Test Bank Questions
Extract:
Question 1 of 5
A health care provider orders 0.5 mg of protamine sulfate for a client who is showing signs of bleeding after receiving a 100-unit dose of heparin. The nurse should expect the effects of the protamine sulfate to be noted in which of the following time frames?
Correct Answer: C
Rationale: Protamine sulfate neutralizes heparin rapidly, with effects typically seen within 20 minutes of administration. This allows for quick reversal of heparin's anticoagulant effects in cases of bleeding. The other time frames are either too short or too long.
Question 2 of 5
A nurse notes that a client has kyphosis and generalized muscle atrophy. Which of the following problems is a priority when the nurse develops a nursing plan of care?
Correct Answer: C
Rationale: Kyphosis and muscle atrophy impair chest expansion and cough effectiveness, increasing pneumonia complications. Ineffective coughing and deep breathing is the priority to clear secretions and prevent worsening infection. Infection is already present. Confusion and chewing difficulties are less immediate concerns.
Question 3 of 5
The client is scheduled to have a kidney, ureter, and bladder (KUB) radiograph. To prepare the client for this procedure, the nurse should explain to the client that:
Correct Answer: D
Rationale: A KUB radiograph requires no special preparation, as it is a non-invasive imaging test to locate renal calculi.
Question 4 of 5
The nurse is developing a program on skin cancer prevention for a community group. Which of the following should be included in the program? Select all that apply.
Correct Answer: A,B
Rationale: Sunscreen with benzophenones and SPF 15 or higher protects against UVA/UVB rays. Genetic screening is not routine, sunscreen should be used daily, shave biopsies are inappropriate, and baby oil increases UV damage.
Question 5 of 5
The nurse's best explanation for why the severely neutropenic client is placed in reverse isolation is that reverse isolation helps prevent the spread of organisms:
Correct Answer: A
Rationale: Reverse isolation protects severely neutropenic clients by preventing the introduction of pathogens from external sources, such as staff, visitors, or equipment. It is not about preventing spread from the client or specific disposal/handling techniques.