NCLEX RN Practice Tests
Question 1 of 5.
The nurse administers ciproflaxin to a client and then realizes that the client is allergic to the medication. What nursing action is the priority for this client?
A. induce vomiting
B. obtain the client's vital signs
C. complete an incident report
D. notify the health care provider
Explanation: Notifying the health care provider is the priority to initiate immediate management of a potential allergic reaction, followed by monitoring and reporting.
Question 2 of 5.
Prochlorperazine maleate (Compazine) 10 mg IM has been ordered for a client. The client is also to receive Stadol 2 mg IM. Before administering these medications, the nurse should
A. obtain respirations and temperature.
B. dilute with 9 ml of NS.
C. draw the medications in separate syringes.
D. verify the route of administration.
Explanation: Compazine should be considered incompatible in a syringe with all other medications
Question 3 of 5.
When using restraints for an agitated/aggressive patient, which of the following statements should NOT influence the nurse’s actions during this intervention?
A. The restraints/seclusion policies set forth by the institution.
B. The patient’s competence.
C. The patient’s voluntary/involuntary status.
D. The patient’s nursing care plan.
Explanation: the need for restraints is based on patient’s behavioral status and condition, not the patient’s voluntary/involuntary status
Question 4 of 5.
A client has been taking perphenazine (Trilafon) by mouth for two days and now displays the following: head turned to the side, neck arched at an angle, stiffness and muscle spasms in neck. The nurse would expect to give which of the following as a PRN medication?
A. Promazine (Sparine).
B. Biperiden (Akineton).
C. Thiothixene (Navane).
D. Haloperidol (Haldol).
Explanation: is an antiparkinsonian agent, used to counteract extrapyramidal side effects the client is experiencing
Question 5 of 5.
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation. The nurse notes that the client has a respiratory rate of 28 breaths per minute, is using accessory muscles, and has oxygen saturation of 88% on 2 L/min of oxygen via nasal cannula. Which of the following actions should the nurse take FIRST?
A. Increase the oxygen flow to 4 L/min.
B. Administer a bronchodilator as ordered.
C. Place the client in a high Fowler’s position.
D. Obtain an arterial blood gas (ABG) sample.
Explanation: positioning in high Fowler’s facilitates breathing and improves oxygenation immediately; other actions may follow based on further assessment
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