NCLEX-RN
Medical Surgical Nursing NCLEX RN Questions Questions
Extract:
Question 1 of 5
The nurse teaches a client who had cystoscopy about the urge to void when the procedure is over. What other teaching should be included?
Correct Answer: D
Rationale: After cystoscopy, the client may feel an urge to void due to bladder irritation. Teaching to ring for assistance ensures safety, as ambulation may be unsteady post-procedure.
Question 2 of 5
The client is to take nothing by mouth after 4 a.m. The nurse recognizes that the client has deficient knowledge when he states that he:
Correct Answer: D
Rationale: Smoking after 4 a.m. violates the nothing-by-mouth (NPO) order, as it introduces substances into the body and can affect anesthesia safety. The other actions either comply with NPO (brushing teeth without swallowing, holding a washcloth) or occurred before the cutoff (gelatin at 3:30 a.m.).
Question 3 of 5
Which of the following is normal for a client during the icteric phase of viral hepatitis?
Correct Answer: B
Rationale: The icteric phase involves jaundice, causing yellowed sclera (
B) due to bilirubin buildup. Tarry stools (
A) indicate bleeding, not typical. Shortness of breath (
C) and frothy urine (
D) are unrelated.
Question 4 of 5
A client with a new ileostomy is concerned about returning to work. Which advice should the nurse provide to support the client's transition?
Correct Answer: A
Rationale: Wearing loose clothing helps conceal the ileostomy pouch, boosting the client's confidence at work. Avoiding activity is unnecessary, daily pouch changes are not required unless needed, and limiting fluids risks dehydration. CN: Psychosocial adaptation; CL: Synthesize
Question 5 of 5
A 250-lb male client recovering from general anesthesia has the following assessment findings: pulse, 150 bpm; blood pressure, 90/50 mm Hg; respiratory rate, 28 breaths/minute; tympanic temperature, 99.8°F (37.7°C); and rigid muscles. The nurse determines that the client is:
Correct Answer: C
Rationale: Tachycardia, hypotension, tachypnea, and muscle rigidity suggest malignant hyperthermia, a life-threatening reaction to anesthesia. Immediate action, including emergency medications like dantrolene, is required.