Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 144

1. Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?

A) Urine output 22 mL/hr for 2 hours
B) Serum potassium level of 3.7
C) Small T wave of ECG
D) Serum glucose level of 180

2. A client is receiving IV morphine 2 days after colorectal surgery. Which of the following observations indicate that he may be becoming drug dependent?

A) The client requests pain medicine every 4 hours.
B) He is asleep 30 minutes after receiving the IV morphine.
C) He asks for pain medication although his blood pressure and pulse rate are normal.
D) He is euphoric for about an hour after each injection.

3. The nurse assesses a postoperative mastectomy client and notes that breath sounds are diminished in both posterior bases. The nurse - s action should be to:

A) Encourage coughing and deep breathing each hour
B) Obtain arterial blood gases
C) Increase O2 from 2 - 3 L/min
D) Remove the postoperative dressing to check for bleeding

4. Which of the following should the nurse anticipate receiving as an as-needed order for a postoperative carotid endarterectomy client?

A) Nifedipine 10 mg SL for B/P 140/90
B) Furosemide 20 mg/PO for decreased urine output
C) Magnesium salicylate to decrease inflammation
D) Nitroglycerin gr 1/150 for chest pain

5. Three hours postoperatively, a 27-year-old client complains of right leg pain after knee reduction. The first action by the nurse will be to:

A) Assess vital signs
B) Elevate the extremity
C) Perform a lower extremity neurovascular check
D) Remind the client that he has a client-controlled analgesic pump, and reinstruct him on its use

1. Right Answer: A
Explanation: (A) Adequate renal flow of 30 mL/hr is a necessity with potassium infusions because potassium is excreted renally. (B) Because potassium level will decrease during correction of diabetic ketoacidosis, potassium will be infused even if plasma levels of potassium are normal. (C) A small T wave is normal and desired on the electrocardiogram. A tall, peaked T-wave could indicate overinfusion of potassium and hyperkalemia. (D) Glucose levels of <200 are desirable.

2. Right Answer: D
Explanation: (A) Frequent requests for pain medication do not necessarily indicate drug dependence after complex surgeries such as colorectal surgery. (B) Sleeping after receiving IV morphine is not an unexpected effect because the pain is relieved. (C) A person may be in pain even with normal vital signs. (D) A subtle sign of drug dependency is the tendency for the person to appear more euphoric than relieved of pain.

3. Right Answer: A
Explanation: (A) Decreased or absent breath sounds are frequently indicators of postoperative atelectasis. (B) Arterial blood gases are not indicated because there is no other information indicating impendingdanger. (C) Increasing O2 rate is not indicated without additional information. (D) Removing the dressing is not indicated without additional information.

4. Right Answer: A
Explanation: (A) It is important to maintain a normal to slightly lower pressure to prevent the graft from blowing and excessive pressure to surgical vascular areas. (B, C, D)None of these drugs is related to managing the problem at hand. Also, none of the problems for which these drugs would be indicated is expected with this type of surgery, except if there is a prior history.

5. Right Answer: C
Explanation: (A) Vital signs may be altered if there is acute pain or complications related to bleeding or swelling, but they should not be assessed before checking the affected extremity. (B) The extremity will be elevated if ordered by the doctor. (C) Assessment of the postoperative area is important to determine if bleeding, swelling, or decreased circulation is occurring. (D) Reinforcement of teaching on use of the client-controlled analgesic pump is important, but not the first action.

80% DISCOUNT: NCLEX-RN PRACTICE EXAMS