Medical Surgical Nursing NCLEX RN Questions
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Question 1 of 5.
For a client with rib fractures and a pneumothorax, the physician prescribes morphine sulfate, 1 to 2 mg/hour, given I.V. as needed for pain. The nursing care goal is to provide adequate pain control so that the client can breathe effectively. Which of the following outcomes would indicate successful achievement of this goal?
A. Pain rating of 0 on a scale of 0 to 10 by the client.
B. Respiratory rate of 26 breaths/minute.
C. PaO2 of 70 mm Hg.
D. None of the above
Explanation: A pain rating of 0 indicates adequate pain control, enabling effective breathing. A respiratory rate of 26 is elevated, and a PaO2 of 70 mm Hg suggests mild hypoxemia, neither confirming pain control.
Question 2 of 5.
A 60-year-old male client comes into the emergency department with a complaint of crushing substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction (MI). Immediate admission orders include oxygen by nasal cannula at 4 L/minute, blood work, a chest radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of morphine sulfate given I.V. The nurse should first:
A. Administer the morphine.
B. Obtain a 12-lead ECG.
C. Obtain the blood work.
D. Order the chest radiograph.
Explanation: Administering morphine first relieves pain, reducing myocardial oxygen demand and stabilizing the client. ECG and blood work follow to confirm diagnosis, but pain management is the priority.
Question 3 of 5.
If a client displays risk factors for coronary artery disease, such as smoking cigarettes, eating a diet high in saturated fat, or leading a sedentary lifestyle, techniques of behavior modification may be used to help the client change the behavior. The nurse can best reinforce new adaptive behaviors by:
A. Explaining how the old behavior leads to poor health.
B. Withholding praise until the new behavior is well established.
C. Rewarding the client whenever the acceptable behavior is performed.
D. Instilling mild fear into the client to extinguish the behavior.
Explanation: Positive reinforcement, such as rewarding adaptive behaviors, encourages the client to continue healthy habits. Fear or delayed praise is less effective for behavior modification.
Question 4 of 5.
Which of the following is not a risk factor for the development of atherosclerosis?
A. A family history of early heart attack.
B. Late onset of puberty.
C. Total blood cholesterol level greater than 220 mg/dL.
D. Elevated fasting blood glucose concentration.
Explanation: Late onset of puberty is not a risk factor for atherosclerosis. Family history, high cholesterol, and elevated glucose are established risk factors.
Question 5 of 5.
The nurse's discharge teaching plan for the client with heart failure should stress the importance of which of the following?
A. Maintaining a high-fiber diet.
B. Walking 2 miles every day.
C. Obtaining daily weights at the same time each day.
D. Remaining sedentary for most of the day.
Explanation: Daily weights at the same time detect fluid retention early, a key strategy to prevent heart failure exacerbations.