Med Surg RN NCLEX Questions
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Question 1 of 5.
A 68-year-old male has been receiving monthly doses of chemotherapy for treatment of stage III colon cancer. He comes to the clinic for his fourth monthly dose. Which laboratory result(s) should be reported to the oncologist before the next dose of chemotherapy is administered? Select all that apply.
A. Hemoglobin of 14.5 g/dL.
B. Platelet count of 40,000/mm³.
C. Blood urea nitrogen (BUN) level of 12 mg/dL.
D. White blood cell count of 2,300/mm³.
E. Temperature of 101.2°F (38.4°C).
F. Urine specific gravity of 1.020.
Explanation: Low platelet count (B), low white blood cell count (D), and fever (E) indicate thrombocytopenia, neutropenia, and possible infection, respectively, which are contraindications for chemotherapy due to increased risk of bleeding and infection.
Question 2 of 5.
A client receives fibrinolytic therapy upon admission following a myocardial infarction. He is now receiving an I.V. infusion of heparin sodium at 1,200 units/hour. The dilution is 25,000 units/500 mL. How many milliliters per hour will this client receive?
Answer: 24 mL/hour
Explanation: To calculate: (1,200 units/hour ÷ 25,000 units) × 500 mL = 24 mL/hour. This is a calculation question, not multiple-choice, so no choices or correct answer letter is provided.
Question 3 of 5.
Which of the following is an expected outcome when a client is receiving an I.V. administration of furosemide?
A. Increased blood pressure.
B. Increased urine output.
C. Decreased pain.
D. Decreased premature ventricular contractions.
Explanation: Furosemide, a loop diuretic, promotes diuresis, increasing urine output to reduce fluid overload in conditions like heart failure or post-MI.
Question 4 of 5.
During the previous few months, a 56-year-old woman felt brief twinges of chest pain while working in her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and treatment, the client is discharged from the hospital. At her follow-up appointment, she is discouraged because she is experiencing pain with increasing frequency. She states that she visits an invalid friend twice a week and now cannot walk up the second flight of steps to the friend's apartment without pain. Which of the following measures that the nurse could suggest would most likely help the client prevent this problem?
A. Visit her friend early in the day.
B. Rest for at least an hour before climbing the stairs.
C. Take a nitroglycerin tablet before climbing the stairs.
D. Lie down once she reaches the friend's apartment.
Explanation: Taking sublingual nitroglycerin before exertion (e.g., climbing stairs) prevents angina by dilating coronary arteries, increasing myocardial oxygen supply.
Question 5 of 5.
The nurse should be especially alert for signs and symptoms of digoxin toxicity if serum levels indicate that the client has a:
A. Low sodium level.
B. High glucose level.
C. High calcium level.
D. Low potassium level.
Explanation: Low potassium (hypokalemia) increases the risk of digoxin toxicity by enhancing digoxin's binding to cardiac cells, leading to arrhythmias.
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