NCLEX-RN
NCLEX RN Medical Surgical Questions and Answers Questions
Extract:
Question 1 of 5
Which of the following clients is most at risk for potential hazards from the surgical experience?
Correct Answer: A
Rationale: The 68-year-old client is most at risk due to age-related declines in organ function, slower recovery, and higher likelihood of comorbidities, increasing surgical complications.
Question 2 of 5
The nurse administers a bolus tube feeding to a client with cancer. Which of the following nursing interventions is most appropriate to decrease the risk of aspiration?
Correct Answer: C
Rationale: Sitting upright in a chair for 1 hour after a bolus tube feeding minimizes aspiration risk by promoting gastric emptying and reducing reflux.
Question 3 of 5
Before surgery for a known aortic aneurysm, the client's pulse pressure begins to widen, suggesting increased aortic valvular insufficiency. If the branches of the aortic arch are involved, the nurse should assess the client for:
Correct Answer: D
Rationale: Widening pulse pressure and aortic arch involvement in an aortic aneurysm suggest possible dissection affecting cerebral perfusion (e.g., carotid artery involvement), leading to disorientation or neurologic changes. Low blood pressure, anxiety, and headache are less specific or unrelated.
Question 4 of 5
Which of the following reflects the principle on which a client's diet will most likely be based during the acute phase of myocardial infarction?
Correct Answer: B
Rationale: Small, easily digested meals reduce the metabolic demand on the heart and prevent gastrointestinal distress, which could exacerbate myocardial oxygen demand during the acute phase of MI.
Question 5 of 5
A client is to have a transfusion of packed red blood cells from a designated donor. The client asks if any diseases can be transmitted by this donor. The nurse should inform the client that which of the following diseases can be transmitted by a designated donor? Select all that apply.
Correct Answer: B,C,E
Rationale: Blood transfusions, even from designated donors, carry a risk of transmitting certain diseases. HIV, CMV, and malaria are known to be transmissible through blood transfusions if the donor is infected, as these pathogens can persist in blood. Epstein-Barr virus is less commonly associated with transfusion transmission, and hepatitis A is primarily transmitted via the fecal-oral route, not blood. The nurse should inform the client of the risks of HIV, CMV, and malaria.