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MISCELLANEOUS- NCLEX ACCURATE QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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MISCELLANEOUS- NCLEX ACCURATE QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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MISCELLANEOUS - NCLEX ACCURATE QUESTIONS AND ANSWER S WITH SOLUTIO NS 2024 Blood should hang no longer than _______ hours. - ANSWER 4 How often should v/s be taken when transfusing blood products? - ANSWER A baseline set of vital signs are taken, then again 5 minutes after the initiation of the transfusion, then 15 minutes after transfusion started and every 15 minutes for one hour, then every 30 minutes for one hour, then hourly until infusion complete. A client prescribed oral iron medication is reporting nausea after administration. What should the nurse teach the client to d ecrease this symptom? - ANSWER Iron is best absorbed on an empty stomach, however, if nausea and vomiting occur, drink orange juice with the iron. It will help decrease nausea and vomiting, and will enhance absorption of the iron. Don't take iron with milk , calcium and antacids. Foods that affect absorption and should not be eaten at the same time include: high fiber foods such as whole grains, bran, and raw vegetables. Also avoid foods and drinks with caffeine. The nurse is caring for a client post corona ry artery bypass grafting. The nurse educates the client that the prescribed medication indomethacin is used to manage which symptoms? - ANSWER Indomethacin is a nonsteroidal anti -inflammatory drug (NSAID). Used to treat pain, inflammation, and fever. The client with ulcerative colitis calls the clinic and reports increasing abdominal pain and increased frequency of loose stools. He asks the nurse to clarify the type of diet he is to follow. Which diet is best for clients with ulcerative colitis? - ANSWER Low fiber. This client should not have much fiber. A low residual diet decreases irritation of the GI tract. A client has a prescription for digoxin 0.125 mg IV push every morning. Prior to administering digoxin, the nurse notes that the digoxin level dra wn this morning was 0.9 ng/mL. Which action would be most important for the nurse to take? - ANSWER This is a normal digoxin level. The nurse would administer the prescribed digoxin. The therapeutic serum levels of digoxin range from 0.5 to 2 ng/mL. Which interventions are appropriate for the nurse to identify for a client admitted to the psychiatric unit for management of anorexia nervosa? 1. Weigh daily 2. Allow only 20 minutes of exercise daily 3. Allow the client to bargain for privileges as long as the client eats. 4. Stay with the client during the established time for meals. 5. Maintain visual observation for 1 hour following meals. - ANSWER 1.,4. & 5. Correct: Weigh daily, immediately upon rising and following morning void, using same scale if possible. The established time for meals is usually 30 minutes. This takes the focus off of food and eating and provides the client with attention and reinforcement. The hour following meals may be used to discard food stashed from tray or to engage in sel f-induced vomiting. A client has been taking tranylcypromine for approximately two weeks. The client is visiting the nurse at the local mental health center for follow up and group therapy. Which client comment indicates a lack of understanding of the med ication that could result in a medical emergency? 1. I know that I must take this medication until my primary healthcare provider tells me to stop. 2. It is frustrating to have to follow dietary restrictions. 3. I am getting a cold, and I am going to ta ke some over the counter cold medicine. 4. I am going to have broccoli salad and roasted turkey for lunch today. - ANSWER 3. This is an MAOI medication. OTC cold medications could result in hypertensive crisis when combined with the monoamine oxidase inhi bitor. Warnings are placed on cold preparations and other medicines that are not to be taken with the MAOIs. Which signs/symptoms would lead a nurse to suspect Fifth disease in a child brought into a pediatric clinic? 1. Erythema on the cheeks. 2. Joint pain. 3. Temperature 102°F (38.88° C). 4. Swollen knees. 5. Pruritic rash on soles of feet. - ANSWER 1., 2., 4., & 5. Correct. These are common signs/symptoms of Fifth disease. **Extra info: Fifth disease, which is especially common in kids between the ages of 5 and 15, usually produces a distinctive red rash on the face that makes a child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs. Viral illness, caused by parvovirus B19. Fi fth disease begins with a low -grade fever, headache, and mild cold -like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later. The bright red rash usually begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash. A client is diagnosed with new onset grand mal seizures. Which nursing interventions should the nurse implement for this client? 1. Have an unlicensed assisitve person nel (UAP) stay with the client. 2. Pad the side rails with blankets. 3. Place the bed in low position. 4. Keep a padded tongue blade at the bedside. 5. Instruct client to call for help when ambulating. - ANSWER 2., 3., & 5. Correct: These interventions will help to protect the client from injury. The nurse is caring for a hypertensive client who has been taking a loop diuretic while hospitalized. Upon discharge, the nurse must teach the client about the need for adequate electrolyte intake through food s and/or dietary supplements. Since the client is taking a loop diuretic, which foods should the nurse suggest to the client? 1. Cereals and breads 2. Avocados and milk 3. Table salt and spinach 4. Blueberries and summer squash - ANSWER 2. Correct: Avo cados, milk, fruit juices, bananas and cantaloupe are good sources of potassium. Loop diuretics deplete the electrolyte potassium. 1. Incorrect: Cereals and breads are good sources of B vitamins. 3. Incorrect: Table salt and spinach are good sources of s odium, but the hypertensive client usually should limit intake of sodium. 4. Incorrect: Blueberries and summer squash both are very low in potassium. A client's last two central venous pressure (CVP) readings were 23 cm of water. The nurse would expect the client to manifest which associated signs and symptoms? 1. 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