Saunders NCLEX Questions

The nurse reinforces medication instructions on therapy with cyclosporine to a client who has received a kidney transplant. Which statement by the client would indicate a need for further instruction? 1. "I need to obtain a yearly influenza vaccine." 2. "I need to have dental checkups every 3 months." 3. "I need to self-monitor my blood pressure at home." 4. "I need to call the primary health care provider if my urine volume decreases or it becomes cloudy."

1. "I need to obtain a yearly influenza vaccine."

A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone. The nurse anticipates that which adjustments in medication dosage will be made? 1. An increased dose of NPH insulin 2. A change to oral diabetic medications 3. A lower dose of dexamethasone than usual 4. An increase in the amount of daily dietary calories

1. An increased dose of NPH insulin

A client who is in the postanesthesia care unit (PACU) has received a dose of ondansetron. The nurse evaluates that an adverse effect is occurring if which problem arises? 1. Headache 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

1. Headache

The nurse is administering senna to an older client. What is the expected result of this medication? 1. It increases peristalsis. 2. It lines the wall of the bowel. 3. It adds fiber and bulk to the stool. 4. It stimulates the vagus nerve to improve bowel tone.

1. It increases peristalsis.

The nurse teaches the client, who is newly diagnosed with diabetes insipidus, about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply. 1. "This medication will turn my urine orange." 2. "I need to decrease my oral fluids when I start this medication." 3. "The amount of urine I make would increase if this medicine is working." 4. "I need to follow a low-fat diet to avoid pancreatitis when taking this medicine." 5. "I need to report headache and drowsiness to my primary health care provider since these symptoms could be related to my desmopressin."

2. "I need to decrease my oral fluids when I start this medication." 5. "I need to report headache and drowsiness to my primary health care provider since these symptoms could be related to my desmopressin."

Atenolol has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "I need to rise slowly from a lying to a sitting position." 2. "If I feel that my heart rate is too low, I need to stop the medication." 3. "It will take 1 to 2 weeks before my blood pressure becomes controlled." 4. "I need to avoid tasks that require alertness until I know how the medication will affect my body."

2. "If I feel that my heart rate is too low, I need to stop the medication."

Topical azelaic acid is prescribed for a client, and the clinic nurse provides instructions regarding the use of this medication. Which statement by the client indicates a need for further instruction? 1. "I need to apply the medication twice daily." 2. "The medication is used to treat my eczema." 3. "I need to massage a thin film gently into the affected area." 4. "I need to wash and dry my skin before I apply the medication."

2. "The medication is used to treat my eczema."

A client with multiple sclerosis is receiving baclofen. The nurse assessing the client monitors for which finding as an indication of a primary therapeutic response to the medication? 1. Decreased nausea 2. Decreased muscle spasms 3. Increased muscle tone and strength 4. Increased range of motion of all extremities

2. Decreased muscle spasms

The nurse is administering a dose of morphine sulfate to a client via an epidural catheter after nephrectomy. Before administering the medication, what would the nurse plan to do? 1. Place the head of the bed flat. 2. Ensure that naloxone is readily available. 3. Flush the catheter with 6 mL of sterile water. 4. Aspirate with a syringe to ensure a cerebrospinal fluid (CSF) return.

2. Ensure that naloxone is readily available.

A client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution. The client complains to the nurse about a brassy taste in the mouth when taking the medication. Which instruction would the nurse provide to the client? 1. Dilute the medication in 8 oz of water. 2. Report the symptom to the primary health care provider (PHCP). 3. Continue to take the medication because the symptom is normal. 4. Take one-half dose of the prescribed medication for the next 2 days.

2. Report the symptom to the primary health care provider (PHCP).

A client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess? 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. Whether the client is experiencing fatigue and joint pain 4. Whether the client is experiencing a metallic taste in the mouth and a loss of appetite

2. The white blood cell counts and platelet counts

The nurse has a prescription to administer diazepam 5 mg by the intravenous (IV) route to a client. The nurse would administer the medication over a period of at least how long? 1. 15 seconds 2. 30 seconds 3. 1 minute 4. 5 minutes

3. 1 minute

The nurse in the primary health care provider's office is reviewing the results of a client's phenytoin level determination performed that morning. The nurse identifies that a therapeutic medication level has been achieved if which result is noted? 1. 3 mcg/mL (11.9 mmol/L) 2. 8 mcg/mL (31.74 mmol/L) 3. 15 mcg/mL (59.52 mmol/L) 4. 24 mcg/mL (95.23 mmol/L)

3. 15 mcg/mL (59.52 mmol/L)

A client with diabetes mellitus received 20 units of Humulin N insulin subcutaneously at 0800. At what time would the nurse plan to assess the client for a hypoglycemic reaction? 1. 1000 2. 1100 3. 1700 4. 2400

3. 1700

A client has been prescribed codeine sulfate. The nurse has given the client instructions for its use. The nurse concludes that the client understands the instructions if the client verbalizes to self-assess for which side effect? 1. Excitability 2. Rapid pulse 3. Constipation 4. Excessive urination

3. Constipation

The client with peptic ulcer disease is prescribed medication therapy. The nurse explains the medications to the client and explains that sucralfate will help to heal the ulcer by doing what? 1. Reducing gastric acidity 2. Treating bacterial infection 3. Enhancing mucosal defenses 4. Eradicating Helicobacter pylori

3. Enhancing mucosal defenses

The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine. The nurse interprets that the client may have the medication discontinued by the primary health care provider if which elevated result is noted? 1. Serum protein level 2. Blood glucose level 3. Serum amylase level 4. Serum creatinine level

3. Serum amylase level

The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction? 1. "I need to change positions slowly." 2. "I will monitor my blood pressure every week." 3. "I will report signs and symptoms of infection immediately." 4. "I can use salt substitutes freely and eat foods high in potassium."

4. "I can use salt substitutes freely and eat foods high in potassium."

The home care nurse is making a monthly visit to a client with a diagnosis of pernicious anemia who has been receiving a monthly injection of cyanocobalamin. Before administering the injection, the nurse evaluates the effects of the medication and determines that a therapeutic effect is occurring if the client makes which statement? 1. "I feel really light-headed." 2. "I no longer have any nausea." 3. "I have not had any pain in a month." 4. "I feel stronger and have a much better appetite."

4. "I feel stronger and have a much better appetite."

A client with acquired immunodeficiency syndrome (AIDS) experiences nausea, vomiting, and muscle aches after taking efavirenz. The ambulatory care nurse would provide which response as telephone advice to this client? 1. "Take crackers and milk with each dose of the medication." 2. "Decrease the dose of the medication until the next clinic visit." 3. "This is an uncomfortable but expected side or adverse effect of the medication." 4. "Report to the health care clinic to be seen by the primary health care provider."

4. "Report to the health care clinic to be seen by the primary health care provider."

The nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride for the treatment of muscle spasms. The nurse questions the prescription if which disorder is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma

4. Angle-closure glaucoma

A client is scheduled to have heparin sodium 5000 units subcutaneously. What is the most appropriate nursing intervention? 1. Inject via an infusion device. 2. Inject ½ inch (1.25 cm) from the umbilicus. 3. Massage the injection site after administration. 4. Avoid aspirating prior to injecting the medication.

4. Avoid aspirating prior to injecting the medication.

Muromonab-CD3 is prescribed for a client to manage allograft rejection after renal transplantation. The nurse plans care, knowing that the primary mechanism of action of this medication is what? 1. Suppresses B lymphocytes 2. Inhibits the proliferation of B lymphocytes 3. Crosslinks DNA, causing cell injury and death 4. Binds to the CD3 site and blocks all T-cell functions

4. Binds to the CD3 site and blocks all T-cell functions

Meperidine hydrochloride is prescribed for a client with pain. What would the nurse monitor for as a side or adverse effect of this medication? 1. Diarrhea 2. Bradycardia 3. Hypertension 4. Urinary retention

4. Urinary retention

A primary health care provider (PHCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? 1. Count the radial and carotid pulses every morning. 2. Check the blood pressure every morning and evening. 3. Stop taking the medication if the pulse is faster than 100 beats/min. 4. Withhold the medication and call the PHCP if the pulse is slower than 60 beats/min.

4. Withhold the medication and call the PHCP if the pulse is slower than 60 beats/min.