Med Surg RN NCLEX Questions
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Question 1 of 5.
A client receiving vent-assisted mode ventilation begins to experience cluster breathing after recent intracranial occipital bleeding. The nurse should:
A. Count the rate to be sure that ventilations are deep enough to be sufficient.
B. Notify the physician of the client's breathing pattern.
C. Increase the rate of ventilations.
D. Increase the tidal volume on the ventilator.
Explanation: Cluster breathing, a sign of neurological deterioration, requires immediate physician notification for evaluation and possible intervention. Adjusting ventilator settings without medical orders is inappropriate, and simply counting the rate does not address the underlying issue.
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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