NCLEX RN Medical Surgical Questions
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Question 1 of 5.
A client who is recovering from chest trauma is to be discharged home with a chest tube drainage system intact. The nurse should instruct the client to call the physician for which of the following?
A. Respiratory rate greater than 16 breaths/minute.
B. Continuous bubbling in the water-seal chamber.
C. Fluid in the chest tube.
D. Fluctuation of fluid in the water-seal chamber.
Explanation: Continuous bubbling in the water-seal chamber indicates an air leak, requiring physician notification. A respiratory rate >16 is normal. Fluid in the tube and fluctuation are expected.
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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