NCLEX Practice Test RN
Question 1 of 5.
A female client is started on warfarin (Coumadin) 5 mg po bid. To adequately evaluate the effectiveness of the warfarin therapy, the nurse must know that this medication:
A. Dissolves any clots already formed in the arteries
B. Prevents the conversion of prothrombin to thrombin
C. Interferes with the synthesis of vitamin K-dependent clotting factors
D. Stimulates the manufacturing of platelets
Explanation: Thrombolytic agents (e.g., streptokinase) directly activate plasminogen, dissolving fibrin deposits, which in turn dissolves clots that have already formed. Heparin prevents the formation of clots by potentiating the effects of antithrombin III and the conversion of prothrombin to thrombin. Warfarin prevents the formation of clots by interfering with the hepatic synthesis of the vitamin K-dependent clotting factors. Platelets initiate the coagulation of blood by adhering to each other and the site of injury to form platelet plugs.
Question 2 of 5.
A healthcare worker is referred to the nursing office with a suspected latex allergy. The first symptom of latex allergy is usually:
A. Oral itching after eating bananas
B. Swelling of the eyes and mouth
C. Difficulty in breathing
D. Swelling and itching of the hands
Explanation: Latex allergy often first presents as localized skin reactions, such as swelling and itching of the hands, due to direct contact with latex products.
Question 3 of 5.
During the change of shift report, a nurse writes in her notes that she suspects illegal drug use by a client assigned to her care. During the shift, the notes are found by the client's daughter. The nurse could be sued for:
A. Libel
B. Slander
C. Malpractice
D. Negligence
Explanation: Libel involves written defamatory statements, such as unverified suspicions of drug use in notes accessible to others, potentially harming the client's reputation.
Question 4 of 5.
A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
A. Decreased blood pressure and constricted pupils
B. Increased heart rate and increased respirations
C. Increased respirations and increased blood pressure
D. Anoxia and absence of the cough reflex
Explanation: Cholinergic crisis, often from excessive anticholinesterase medication, causes parasympathetic overstimulation, leading to decreased blood pressure and constricted pupils.
Question 5 of 5.
During morning assessments, the nurse finds that a client's nephrostomy tube has been clamped. The nurse's first action should be to:
A. Assess the drainage bag.
B. Check for bladder distention.
C. Unclamp the tubing.
D. Irrigate the tubing.
Explanation: Unclamping the nephrostomy tube is the priority to restore urine flow and prevent complications like hydronephrosis or infection.
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