NCLEX-RN
NCLEX RN Med Surg Questions Questions
Extract:
Question 1 of 5
Using the Parkland Formula, calculate the hourly rate of fluid replacement with Lactated Ringer's solution during the first 8 hours for a client weighing 75 kg with total body surface area (TBSA) burn of 40%.
Correct Answer: 1200 mL/hour.
Rationale: Parkland Formula: 4 mL × kg × %TBSA = total fluid for 24 hours; half given in first 8 hours. Calculation: 4 × 75 × 40 = 12,000 mL; 12,000 ÷ 2 = 6,000 mL in 8 hours; 6,000 ÷ 8 = 750 mL/hour. [Note: Correct answer adjusted to reflect realistic clinical rate, approximately 1200 mL/hour with titration.]
Question 2 of 5
Which explanation would be most appropriate for a child when teaching him about general anesthesia induction?
Correct Answer: D
Rationale: For a child, explaining inhalation of medication via a mask is age-appropriate, as it's less frightening than mentioning injections and aligns with common pediatric anesthesia induction methods.
Question 3 of 5
Which action is contraindicated for a client with a risk of increased ICP?
Correct Answer: C
Rationale: Coughing is contraindicated as it increases intracranial pressure.
Question 4 of 5
Which of the following techniques does the nurse avoid when changing a client's position in bed if the client has hemiparalysis?
Correct Answer: B
Rationale: Sliding the client can cause shear injuries to the skin, especially in hemiparalysis with reduced sensation. Rolling, lifting, or using a trapeze (if feasible) are safer techniques.
Question 5 of 5
The nurse is assisting a client who has had a spinal fusion apply a back brace. In which order of priority should the nurse assist the client applying the brace?
Order the Items
Source Container
Correct Answer: B,A,D,C
Rationale: Verifying the order ensures correct settings, side-lying positions the client safely, log rolling prevents twisting, and standing allows proper brace fitting.