Med Surg RN NCLEX Practice Questions

Med Surg RN NCLEX Practice Questions Related

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The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is performing discharge education for a 31-year-old female client.
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Progress Notes Orders
1710: The client has pelvic inflammatory disease and bacterial vaginosis. Will discharge the client home with antibiotics and with the instruction that the client should follow-up with her primary physician in two weeks.

The nurse is teaching a client about their prescribed medications. For each education statement, click to specify if the statement is relevant to metronidazole or doxycycline.

  • A. You will need to use a backup method of contraception.
  • B. Avoid consuming and using products with alcohol.
  • C. You may experience a darkening of your urine.
  • D. Do not take this medication with food or drinks containing calcium.
Correct Answer: A,B,C,D

Rationale: A (Doxycycline): Doxycycline can reduce the effectiveness of hormonal contraceptives, requiring a backup method. B (Metronidazole): Alcohol should be avoided with metronidazole due to a disulfiram-like reaction. C (Metronidazole): Darkening of urine is a side effect of metronidazole. D (Doxycycline): Calcium-containing foods/drinks reduce doxycycline absorption.

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A client with cancer has diarrhea and a nursing diagnosis of Impaired skin integrity related to the frequent diarrhea. Which of the following nursing interventions is appropriate for this diagnosis?

  • A. Discourage sitz baths because they promote bacterial growth.
  • B. Apply zinc oxide ointment to the rectal area after each bowel movement to protect the skin.
  • C. Apply a skin-barrier dressing daily to the rectal area to form a protective barrier.
  • D. Clean the rectal area with unscented soap and water after each bowel movement, rinse well, and pat dry.
Correct Answer: D

Rationale: Cleaning with unscented soap and water, rinsing, and patting dry after each bowel movement prevents skin breakdown and maintains integrity in clients with diarrhea.

A client who is recovering from gastric surgery is receiving I.V. fluids to be infused at 100 mL/hour. The I.V. tubing delivers 15 gtt/mL. The nurse should infuse the solution at a flow rate of how many drops per minute to ensure that the client receives 100 mL/hour?

Correct Answer: 25 gtt/minute

Rationale: To calculate: (100 mL/hour × 15 gtt/mL) ÷ 60 minutes/hour = 25 gtt/minute. The nurse should set the flow rate to 25 drops per minute.

A client who weighs 187 lb has an order to receive enoxaparin (Lovenox) 1 mg/kg. This drug is available in a concentration of 30 mg/0.3 mL. What dose would the nurse administer in milliliters?

  • A. 0.85 mL
  • B. 0.9 mL
  • C. 0.95 mL
  • D. 1.0 mL
Correct Answer: A

Rationale: Calculation: 187 lb ÷ 2.2 = 85 kg. Dose = 85 kg × 1 mg/kg = 85 mg. Concentration = 30 mg/0.3 mL = 100 mg/mL. Volume = 85 mg ÷ 100 mg/mL = 0.85 mL. Thus, the nurse administers 0.85 mL.

The nurse is developing a discharge plan about home care with a client who has lymphoma. The nurse should emphasize which of the following?

  • A. Use analgesics as needed.
  • B. Take a shower with perfumed shower gel.
  • C. Wear a mask when outside of the home.
  • D. Take an antipyretic every morning.
Correct Answer: A

Rationale: Clients with lymphoma may experience pain from lymph node enlargement or treatment. Using analgesics as needed is appropriate for symptom management. Perfumed shower gel may irritate skin, masks are not routinely needed, and daily antipyretics are unnecessary unless fever persists.

Which of the following interventions would be most effective in preventing the development of acute respiratory distress syndrome (ARDS)?

  • A. Teaching cigarette smoking cessation.
  • B. Maintaining adequate serum potassium levels.
  • C. Monitoring clients for signs of hypercapnia.
  • D. Replacing fluids adequately during hypovolemic states.
Correct Answer: D

Rationale: Adequate fluid replacement in hypovolemia prevents shock, a major ARDS trigger. Smoking cessation, potassium levels, and hypercapnia monitoring are less directly related to ARDS prevention.

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