Free NCLEX RN Exam Practice Questions

Free NCLEX RN Exam Practice Questions Related

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The nurse assesses a client with a diagnosis of rib fractures to identify the risk for potential complications. The nurse notes that the client has a history of emphysema. After the assessment, the nurse ensures that which interventions are documented in the plan of care? Select all that apply.

  • A. Maintain the client in a position of comfort.
  • B. Collect sputum specimens at the hour of sleep.
  • C. Offer medication to suppress the cough as needed.
  • D. Administer small, frequent meals with plenty of fluids.
  • E. Have the client cough and breathe deeply 20 minutes after pain medication is given.
  • F. Administer 4 to 6 liters of oxygen when the client's pulse oximetry drops below 90%.
Correct Answer: A,D,E

Rationale: Clients with a diagnosis of rib fractures need interventions focused on their ability to maintain an effective breathing pattern and support the body in the healing process. Breathing effort is supported when the client is maintained in a comfortable position. Giving the client small frequent meals with plenty of fluids prevents the client from doing too much eating activity at one time and provides hydration to keep sputum liquefied for easier expectoration. Giving the client prescribed pain medication first and then having the client cough and deep breathe will encourage the client to complete these actions while limiting the amount of pain from doing them. If sputum specimen collection is prescribed, the specimen should be collected early in the morning upon the client's awakening. Clients with emphysema are not given cough suppressants because expectoration of sputum is essential to airway clearance. Giving the client with emphysema a high flow of oxygen could halt the hypoxic drive and cause apnea. A prescription is needed for changes in the oxygen flow.

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A client with a suspected stroke is admitted to the emergency department. What is the nurse's priority action?

  • A. Administer aspirin as ordered.
  • B. Assess neurological status.
  • C. Prepare for a CT scan.
  • D. Monitor blood pressure.
Correct Answer: B

Rationale: Assessing neurological status is the priority to establish a baseline and detect changes in a suspected stroke, guiding urgent interventions.

A client has polycystic kidney disease. The client asks the nurse, 'How did I get these fluid-filled bubbles on my kidneys? I have not had any X-ray type tests.' How should the nurse respond to help the client understand risk factors for this disease process?

  • A. Second-hand smoke puts you at greater risk for developing cysts.'
  • B. Exposure to dyes used to color fruits and vegetables increases the risk of polycystic kidney disease.'
  • C. There is a higher incidence of polycystic kidney disease among blood relatives.'
  • D. Drinking alcohol daily allows the kidneys to develop cysts.'
Correct Answer: C

Rationale: Polycystic kidney disease is primarily genetic, with a higher incidence among blood relatives due to autosomal dominant or recessive inheritance patterns.

A client with a history of anxiety is prescribed buspirone (Buspar). The nurse should instruct the client that:

  • A. The medication may take 2–4 weeks to be effective.
  • B. The medication should be taken with grapefruit juice.
  • C. The medication should be stopped if anxiety resolves.
  • D. The medication is taken as needed for anxiety.
Correct Answer: A

Rationale: Buspirone requires 2–4 weeks to achieve therapeutic effects, unlike as-needed anxiolytics.

A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). The nurse should instruct the client to:

  • A. Use the inhaler as needed for shortness of breath.
  • B. Rinse the mouth after using the inhaler.
  • C. Shake the inhaler before use.
  • D. Take two puffs twice daily.
Correct Answer: B

Rationale: Rinsing the mouth after using tiotropium prevents oral candidiasis, a common side effect of inhaled anticholinergics.

The nurse is conducting walking rounds and observes the client (see figure). The nurse should do which of the following?

  • A. Loosen the bed restraints so the client can sit up.
  • B. Raise the side rails to full upright position.
  • C. Assess the client to determine why she wants to sit up.
  • D. Elevate the head of the bed.
Correct Answer: C

Rationale: The nurse should fi rst determine why the client wants to sit up, and then, if needed delegate someone to assist the client. Loosening the restraints will not keep the client safe in bed. Raising theside rails and elevating the head of the bed do not address the client’s needs.

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