NCLEX-RN
NCLEX RN Exam Questions
1. A client is scheduled for an Intravenous Pyelogram (IVP). In order to prepare the client for this test, the nurse would:
- A. Instruct the client to maintain a regular diet the day prior to the examination.
- B. Restrict the client's fluid intake 4 hours prior to the examination.
- C. Administer a laxative to the client the evening before the examination.
- D. Inform the client that only 1 x-ray of his abdomen is necessary.
Correct answer: C
Rationale: The correct preparation for an Intravenous Pyelogram (IVP) involves administering a laxative to the client the evening before the examination. This is crucial to ensure adequate bowel preparation, which in turn allows for better visualization of the bladder and ureters during the procedure. An IVP is an x-ray exam that utilizes contrast material to evaluate the kidneys, ureters, and bladder, aiding in the diagnosis of conditions like blood in the urine or pain in the side or lower back. Administering a laxative helps in achieving optimal imaging quality, which is essential for accurate diagnosis and subsequent treatment planning. Choice A is incorrect because maintaining a regular diet is not the standard preparation for an IVP. Choice B is incorrect as fluid intake is not typically restricted for this procedure. Choice D is incorrect as an IVP involves multiple x-rays to assess the urinary system, not just one of the abdomen.
2. Which of the following conditions most commonly causes acute glomerulonephritis?
- A. A congenital condition leading to renal dysfunction.
- B. Prior infection with group A Streptococcus within the past 10-14 days.
- C. Viral infection of the glomeruli.
- D. Nephrotic syndrome.
Correct answer: B
Rationale: Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis.
3. A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms?
- A. Inadequate tissue perfusion leading to nerve damage.
- B. Fluid overload leading to compression of nerve tissue.
- C. Sensation distortion due to psychiatric disturbance.
- D. Inflammation of the skin on the hands and feet.
Correct answer: A
Rationale: Patients with the peripheral vascular disease often sustain nerve damage as a result of inadequate tissue perfusion. Ischemic rest pain is more worrisome; it refers to pain in the extremity that is due to a combination of PVD and inadequate perfusion. Ischemic rest pain often is exacerbated by poor cardiac output. The condition is often partially or fully relieved by placing the extremity in a dependent position, so that perfusion is enhanced by the effects of gravity.
4. While receiving normal saline infusions to treat a GI bleed, the nurse notes that the patient's lower legs have become edematous and auscultates crackles in the lungs. What should the nurse do first?
- A. Stop the saline infusion immediately
- B. Notify the physician
- C. Elevate the patient's legs
- D. Continue the infusion, as these findings are normal
Correct answer: A
Rationale: The correct answer is to stop the saline infusion immediately. The patient is showing signs of fluid volume overload due to rapid fluid replacement, indicated by lower leg edema and lung crackles. Continuing the infusion could worsen the overload and potentially lead to complications. Notifying the physician is important but should come after stopping the infusion to address the immediate issue. Elevating the patient's legs may help with edema but is not the priority in this situation. Continuing the infusion when the patient is already showing signs of fluid overload is contraindicated and can be harmful.
5. A female patient is prescribed metformin for glucose control. The patient is on NPO status pending a diagnostic test. The nurse is most concerned about which side effect of metformin?
- A. Diarrhea and Vomiting
- B. Dizziness and Drowsiness
- C. Metallic taste
- D. Hypoglycemia
Correct answer: D
Rationale: The correct answer is 'Hypoglycemia.' When a patient is on NPO status (nothing by mouth) and prescribed metformin, there is an increased risk of hypoglycemia due to the absence of oral intake. Metformin, as an anti-glycemic drug, can lower blood sugar levels, and without food intake, the risk of hypoglycemia is higher. Diarrhea and vomiting are common gastrointestinal side effects of metformin but are not the main concern in this scenario. Dizziness and drowsiness are potential side effects of some medications but are not typically associated with metformin. Metallic taste is a known side effect of metformin but is not the primary concern in this situation where hypoglycemia is more critical to monitor due to the patient's NPO status.
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