NCLEX RN Med Surg Questions
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Question 1 of 5.
A client with type 1 diabetes is admitted to the emergency department with dehydration following the flu. The client has a blood glucose level of 325 mg/dL and a serum potassium level of 3.5 mEq. The physician has ordered 1,000 mL 5% dextrose in water to be infused every 8 hours. Prior to implementing the physician orders, the nurse should contact the physician, explain the situation, provide background information, report the current assessment of the client, and:
A. Suggest adding potassium to the fluids.
B. Request an increase in the volume of intravenous fluids.
C. Verify the order for 5% dextrose in water.
D. Determine if the client should be placed in isolation.
Explanation: 5% dextrose in water is inappropriate for a hyperglycemic client (325 mg/dL), as it may worsen hyperglycemia. The nurse should verify the order, likely suggesting normal saline instead.
Question 2 of 5.
A 65-year-old client is admitted to the emergency department with a fractured hip. The client has chest pain and shortness of breath. The health care provider orders nitroglycerin tablets. Which should the nurse instruct the client to do?
A. Put the tablet under the tongue until it is dissolved.
B. Swallow the tablet with 120 mL of water.
C. Chew the tablet until it is dissolved.
D. Place the tablet between his cheek and gums.
Explanation: Sublingual nitroglycerin is administered under the tongue for rapid absorption to relieve chest pain. Other methods (swallowing, chewing, or buccal placement) are incorrect for this medication.
Question 3 of 5.
After a myocardial infarction, the hospitalized client is taught to move the legs while resting in bed. This type of exercise is recommended primarily to help:
A. Prepare the client for ambulation.
B. Promote urinary and intestinal elimination.
C. Prevent thrombophlebitis and blood clot formation.
D. Decrease the likelihood of pressure ulcer formation.
Explanation: Leg exercises prevent venous stasis, reducing the risk of thrombophlebitis and deep vein thrombosis, common complications post-MI due to immobility.
Question 4 of 5.
The client who experiences angina has been told to follow a low-cholesterol diet. Which of the following meals should the nurse tell the client would be best on her low-cholesterol diet?
A. Hamburger, salad, and milkshake.
B. Baked liver, green beans, and coffee.
C. Spaghetti with tomato sauce, salad, and coffee.
D. Fried chicken, green beans, and skim milk.
Explanation: Spaghetti with tomato sauce, salad, and coffee is low in cholesterol, unlike hamburger, liver, or fried chicken, which contain higher cholesterol or saturated fats.
Question 5 of 5.
Which of the following foods should the nurse teach a client with heart failure to limit when following a 2-g sodium diet?
A. Apples.
B. Tomato juice.
C. Whole wheat bread.
D. Beef tenderloin.
Explanation: Tomato juice is high in sodium, which should be limited on a 2-g sodium diet to prevent fluid retention in heart failure.