RN NCLEX Practice Questions
Question 1 of 5.
A student nurse is precepting on the unit and caring for a client with a Dobbhoff nasoenteric tube. Which statement by the student nurse indicates the need for further teaching on caring for a client with this tube? Select all that apply.
A. I should wait for X-ray confirmation before using the tube.
B. I can confirm placement by auscultating over the epigastric area.
C. I can mix liquid medications in with the tube feeding for administration.
D. I will flush the tube with 20 to 30 mL of water every 4 hours during continuous tube feeding.
E. I will observe the client for diarrhea, abdominal distention, nausea and vomiting, and tube dislodgement.
Explanation: Auscultation is not a reliable method for confirming tube placement; X-ray is required. Mixing medications with feedings can cause clogs or interactions. The other statements are correct.
Question 2 of 5.
After abdominal surgery, a client has a nasogastric tube attached to low suctioning. The client becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions. Which of the following nursing interventions would be MOST appropriate?
A. Irrigate the nasogastric tube with distilled water.
B. Aspirate the gastric contents with a syringe.
C. Administer an antiemetic medicine.
D. Insert a new nasogastric tube.
Explanation: to confirm placement, nurse should aspirate and test the pH of the aspirate, results should be 0-4
Question 3 of 5.
The nurse is administering terbutaline (Brethine) to a client in labor. Prior to administration of the medication, the nurse assesses the client’s pulse to be 144. The nurse’s priority action should be to
A. withhold the medication.
B. decrease the dose by half.
C. administer the medication.
D. wait 15 minutes, then recheck the rate.
Explanation: maternal tachycardia is a side effect of Brethine; other maternal side effects include nervousness, tremors, headache, and possible pulmonary edema; fetal side effects include tachycardia and hypoglycemia; Brethine is usually preferred over ritodrine (Yutopar) because it has minimal effects on blood pressure
Question 4 of 5.
The nurse in the outpatient clinic teaches the mother of a 10-year-old boy with asthma how to prevent future asthmatic attacks. The nurse would be MOST concerned if the mother made which of the following statements?
A. My son plays the tuba in the grade school band.
B. My son loves to help his dad rake leaves.
C. My son participates in after-school activities three days a week.
D. My son walks one mile to school every day with his friends.
Explanation: main cause of asthma is inhaled allergens (animal dander, mold, pollen, dust), would expose child to pollen and dust from leaves
Question 5 of 5.
The nurse is caring for a client receiving peritoneal dialysis. Which of the following assessment findings would require an intervention by the nurse?
A. Abdominal discomfort during infusion of dialysate.
B. Presence of constipation.
C. Cloudy dialysate output.
D. Ecchymosis around peritoneal catheter.
Explanation: indicates peritonitis, also will see nausea and vomiting, anorexia, abdominal pain, tenderness, rigidity