Questions 108

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Medical Surgical Questions Questions

Extract:


Question 1 of 5

What is the priority nursing action for a client with a suspected neurological deficit?

Correct Answer: C

Rationale: Monitoring vital signs is the priority to ensure stability and detect acute changes in a client with a suspected neurological deficit.

Question 2 of 5

Which of the following should be included in the teaching plan for a cancer client who is experiencing thrombocytopenia? Select all that apply.

Correct Answer: A,B,C,F

Rationale: Thrombocytopenia increases bleeding risk, so using an electric razor (
A), soft-bristle toothbrush (
B), avoiding flossing (
C), and reporting bleeding (F) are critical to prevent and monitor bleeding complications. NSAIDs (
D) are contraindicated, and temperature monitoring (E) is unrelated to thrombocytopenia.

Question 3 of 5

A client refuses to remove a religious necklace before surgery despite hospital policy. The nurse's best response is:

Correct Answer: B

Rationale: Taping the necklace securely respects the client's beliefs while ensuring safety by preventing the item from interfering with the surgical field.

Question 4 of 5

A young adult client has been diagnosed with type 1 diabetes. He has an insulin drip to aid in lowering the serum blood glucose level of 600 mg/dL. He is also receiving I.V. antibiotics for a urinary tract infection. After 4 hours, the physician orders discontinuation of the insulin drip. The nurse should next?

Correct Answer: C

Rationale: Discontinuing an insulin drip without initiating subcutaneous insulin risks rebound hyperglycemia in type 1 diabetes. The nurse should inform the physician to ensure a subcutaneous insulin order is in place.

Question 5 of 5

After a thoracotomy, the nurse instructs the client to perform deep-breathing exercises. Which of the following is an expected outcome of these exercises?

Correct Answer: D

Rationale: Deep breathing expands alveoli, increasing lung surface for ventilation and preventing atelectasis post-thoracotomy. It does not elevate the diaphragm, increase blood flow, or control airflow to prevent hyperinflation.

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