NCLEX RN Medical Surgical Questions
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Question 1 of 5.
A client from a Mediterranean country is admitted with thalassemia, jaundice, splenomegaly, and hepatomegaly. Which of the following should be the primary focus of nursing care for this client?
A. Providing activities of daily living on the time schedule that the client wishes.
B. Offering foods that the client enjoys in order to increase the intake of calories.
C. Decreasing cardiac demands by promoting rest.
D. Listening to concerns about the hospitalization.
Explanation: Thalassemia, a hemolytic anemia, causes increased cardiac workload due to chronic anemia and tissue hypoxia. Promoting rest is the primary focus to decrease cardiac demands and prevent complications like heart failure. While client preferences, nutrition, and emotional support are important, reducing cardiac strain is critical.
Question 2 of 5.
The nurse notices that a client's heart rate decreases from 63 to 50 beats per minute on the monitor. The nurse should first:
A. Administer Atropine 0.5 mg I.V. push.
B. Auscultate for abnormal heart sounds.
C. Prepare for transcutaneous pacing.
D. Take the client's blood pressure.
Explanation: A heart rate of 50 bpm may indicate bradycardia. Taking the blood pressure first assesses hemodynamic stability, guiding whether immediate intervention (e.g., atropine or pacing) is needed.
Question 3 of 5.
The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?
A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.
B. A 43-year-old male with a family history of CAD and cholesterol level of 158.
C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).
D. A 65-year-old female who is obese with an LDL of 188.
Explanation: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.
Question 4 of 5.
The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains to the client that this procedure is being used in this specific case to:
A. Open and dilate blocked coronary arteries.
B. Assess the extent of arterial blockage.
C. Bypass obstructed vessels.
D. Assess the functional adequacy of the valves and heart muscle.
Explanation: Cardiac catheterization in unstable angina assesses the extent of coronary artery blockage to guide interventions like angioplasty or bypass surgery.
Question 5 of 5.
The nurse finds the apical impulse below the fifth intercostal space. The nurse suspects:
A. Left atrial enlargement.
B. Left ventricular enlargement.
C. Right atrial enlargement.
D. Right ventricular enlargement.
Explanation: An apical impulse below the fifth intercostal space suggests left ventricular enlargement, common in heart failure due to ventricular dilation.
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