NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. Your patient has been diagnosed with acute bronchitis. You should expect that all of the following will be ordered EXCEPT:
- A. Increased fluid intake
- B. Cough medications
- C. Antibiotics
- D. Use of a vaporizer
Correct answer: C
Rationale: In the management of acute bronchitis, antibiotics are not typically prescribed unless there is a confirmed bacterial infection. Acute bronchitis is usually caused by a virus, so antibiotics are not effective in treating it. The primary focus is on symptom management and supportive care. Increased fluid intake helps keep the airway moist and liquefy secretions, aiding in their removal. Cough medications can help relieve cough symptoms. The use of a vaporizer can help moisten the air, making breathing more comfortable for the patient. It is crucial to differentiate between viral and bacterial causes of respiratory infections to avoid unnecessary antibiotic use and prevent antibiotic resistance. Therefore, the correct answer is 'Antibiotics.' Increased fluid intake, cough medications, and the use of a vaporizer are commonly recommended for managing symptoms and improving comfort in patients with acute bronchitis.
2. The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is:
- A. Verify correct placement of the tube
- B. Check that the feeding solution matches the dietary order
- C. Aspirate gastric contents to determine the amount of the last feeding remaining in the stomach
- D. Ensure that the feeding solution is at room temperature
Correct answer: A
Rationale: The most crucial action for the nurse when preparing to administer enteral feeding via a nasogastric tube is to verify the correct placement of the tube. Proper placement of the tube is vital to prevent complications such as aspiration into the lungs. The definitive methods to confirm the position of the nasogastric tube include visualization through an x-ray or aspirating stomach contents and checking their pH (usually pH 1 to 5). Aspirated stomach content can also be tested for bilirubin to confirm placement in the stomach. Choice B, checking that the feeding solution matches the dietary order, is important for ensuring the correct nutrition is provided but is not as critical as verifying tube placement to prevent potential harm. Choice C, aspirating gastric contents to determine the amount of the last feeding remaining in the stomach, is a common nursing practice but is not the most crucial action when compared to ensuring correct tube placement. Choice D, ensuring that the feeding solution is at room temperature, is relevant for patient comfort and preventing thermal injury but is not as essential as confirming correct tube placement to prevent serious complications.
3. Based on the information given, which patient would be an appropriate candidate for a closed MRI without contrast?
- A. A 20-year-old woman with unexplained joint pain and a low BMI.
- B. A 35-year-old woman with Multiple Sclerosis who is trying to conceive.
- C. A 67-year-old man who had open-heart surgery 4 years ago.
- D. A 40-year-old woman in a hypomanic state for the last 2 days.
Correct answer: A
Rationale: The correct answer is the 20-year-old woman with unexplained joint pain and a low BMI. MRI can be used to diagnose musculoskeletal disorders, and this patient has no contraindications to an MRI. Choice B is incorrect because using MRI without contrast may not be ideal for a patient trying to conceive. Choice C is incorrect as the patient's past open-heart surgery may pose risks for an MRI without contrast. Choice D is incorrect since the patient's hypomanic state does not indicate a need for an MRI without contrast for joint pain.
4. A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?
- A. CBC (Complete Blood Count)
- B. ECG (Electrocardiogram)
- C. Thyroid Function Tests
- D. CT Scan
Correct answer: D
Rationale: A CT scan is most likely to be performed in this scenario. A CT scan would be done to further investigate the cause of the left hemiparesis. Noncontrast CT scanning is commonly used in the acute evaluation of patients with suspected acute stroke to assess for ischemic changes or hemorrhage in the brain. While a CBC may provide information on blood cell counts and general health status, it is not the primary test for evaluating hemiparesis. An ECG is used to assess heart function and rhythm, which is not the main concern in this case. Thyroid function tests evaluate thyroid hormone levels and are not typically the initial tests for evaluating hemiparesis and confusion.
5. A patient is scheduled for a computed tomography (CT) of the chest with contrast media. Which assessment finding should the nurse immediately report to the health care provider?
- A. Patient is claustrophobic.
- B. Patient is allergic to shellfish.
- C. Patient recently used a bronchodilator inhaler.
- D. Patient is not able to remove a wedding band.
Correct answer: B
Rationale: The correct answer is that the patient is allergic to shellfish. This is crucial because the contrast media used in CT scans is iodine-based, and individuals with iodine allergies, such as those allergic to shellfish, are at risk of adverse reactions. It is important to identify and address this allergy to prevent potential complications. The other options do not directly impact the safety or effectiveness of the CT scan with contrast media. Claustrophobia can be managed with patient support, the recent use of a bronchodilator inhaler does not typically affect the CT procedure, and not being able to remove a wedding band is not a critical concern for the scan itself.
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