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Med Surg RN NCLEX Questions Questions

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Question 1 of 5

To prepare the irrigation solution used for removal of cerumen, the nurse should use:

Correct Answer: A

Rationale: Normal saline is the preferred solution for ear irrigation, as it is isotonic and safe for the ear canal, minimizing irritation or risk of infection.

Question 2 of 5

A 58-year-old client with pancreatic cancer, who has been bed-bound for 3 weeks, has just returned from having a left subclavian, long-term, tunneled catheter inserted for administration of analgesics. The nurse has not yet received radiographic results for confirmation of placement. The client becomes diaphoretic and complains of chest pain radiating to the middle of his back. Physical assessment reveals tachycardia and absent breath sounds in the left lung. The nurse should further assess the client for:

Correct Answer: B

Rationale: Absent breath sounds, chest pain, and tachycardia post-catheter insertion suggest a pneumothorax, a known complication of subclavian catheter placement, requiring urgent assessment.

Question 3 of 5

The nurse interprets which of the following as an early sign of acute respiratory distress syndrome (ARDS) in a client at risk?

Correct Answer: B

Rationale: Hypoxia unresponsive to oxygen therapy is an early ARDS sign due to impaired gas exchange. Elevated CO2, metabolic acidosis, and electrolyte imbalances occur later or are unrelated.

Question 4 of 5

A client on hemodialysis reports fatigue. The nurse should assess for:

Correct Answer: A

Rationale: Anemia is common in renal failure due to decreased erythropoietin.

Question 5 of 5

A 66-year-old female who is usually meticulous about her appearance and dress arrives today for her 23rd day of radiation therapy and appears disheveled and emotionally labile, and her responses to the usual questions are a little inappropriate. Her heart rate is 124 bpm, her respirations are 32 breaths/minute, and her skin is cold and clammy. These findings would suggest that the nurse should further assess the client for which of the following conditions?

Correct Answer: D

Rationale: Disheveled appearance, emotional lability, inappropriate responses, and physical symptoms (tachycardia, tachypnea, clammy skin) suggest delirium, a medical emergency requiring urgent assessment.

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