NCLEX-RN
Health Care of the Older Adult NCLEX Questions
Extract:
Question 1 of 5
The client who does not respond adequately to fluid replacement has an order for an I.V. infusion of dopamine hydrochloride at 5 µg/kg/minute. To determine that the drug is having the desired effect, the nurse should assess the client for:
Correct Answer: B
Rationale: Dopamine at 5 µg/kg/minute primarily increases cardiac output by enhancing myocardial contractility and heart rate, improving perfusion in shock. Renal/mesenteric flow occurs at lower doses, vasoconstriction at higher doses, and preload/afterload reduction is not a primary effect.
Question 2 of 5
A client with a history of systemic lupus erythematosus was admitted with a severe viral respiratory tract infection and diffuse petechiae. Based on these data, it is most important that the nurse further evaluate the client's recent:
Correct Answer: D
Rationale: Systemic lupus erythematosus (SLE) can cause thrombocytopenia, and diffuse petechiae suggest a low platelet count. Heavy menstrual bleeding is a common manifestation of thrombocytopenia in women and should be evaluated to assess the extent of bleeding and guide treatment. Food, fluid intake, and fatigue are less directly related to the petechiae.
Question 3 of 5
Which of the following clients with burns will most likely require an endotracheal or tracheostomy tube?
Correct Answer: B
Rationale: Thermal burns to the head, face, and airway can cause swelling and obstruction, leading to hypoxia and requiring airway management like endotracheal intubation or tracheostomy.
Question 4 of 5
Regular oral hygiene is essential for the client who has had a stroke. Which of the following nursing measures is not appropriate when providing oral hygiene?
Correct Answer: A
Rationale: Placing the client on their back increases the risk of aspiration, especially in stroke patients with impaired swallowing. Suction equipment, padded tongue blades, and toothbrushing are appropriate for safe oral hygiene.
Question 5 of 5
The client with an intestinal obstruction continues to have acute pain even though the nasoenteric tube is patent and draining. Which action by the nurse would be most appropriate?
Correct Answer: B
Rationale: Persistent acute pain despite a patent nasoenteric tube suggests a complication like peritonitis, indicated by a rigid abdomen, which requires immediate assessment. Reassurance, opioids, or repositioning may delay addressing a serious issue. CN: Physiological adaptation; CL: Synthesize