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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q657-Q662):

NEW QUESTION # 657
Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?

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

Answer: C Explanation:
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.
NEW QUESTION # 658
When assessing the client 6 hours postpartum, the fundus is found to be U +3, displaced to the right of midline, and slightly boggy. The nurse would first:

• A. Give methergine IM
• B. Assess for a full bladder
• C. Grasp the uterus and massage vigorously
• D. Increase the IV oxytocin drip rate

Answer: D Explanation:
(A)Oxytocin may not be necessary if the bladder is emptied and if the uterus remains firm, midline, and at about U11 after massage. (B) The same rationale as for answer "A" applies.
(C)A full bladder is the most common cause of uterine atony. If the bladder is full, it should be emptied and the uterus reassessed before further intervention. (D) If the bladder is full, the uteruswill not stay contracted or return to a normal position. Overly vigorous massage also encourages uterine atony.
NEW QUESTION # 659
A client undergoes a transurethral resection, prostate (TURP). He returns from surgery with a three-way continuous Foley irrigation of normal saline in progress. The purpose of this bladder irrigation is to prevent:

• A. Bladder spasms
• B. Scrotal edema
• C. Clot formation
• D. Prostatic infection

Answer: C Explanation:
(A) The purpose of bladder irrigation is not to prevent bladder spasms, but to drain the bladder and decrease clot formation and obstruction. (B) A three-way system of bladder irrigation will cleanse the bladder and prevent formation of blood clots. A catheter obstructed by clots or other debris will cause prostatic distention and hemorrhage. (C) Scrotal edema seldom occurs after TURP. Bladder irrigation will not prevent this complication. (D) Prostatic infection seldom occurs after TURP. Bladder irrigation will not prevent this complication.
NEW QUESTION # 660
For the past several months, an elderly female client with Alzheimer's disease has experienced paranoia; hallucinations; and aggressive, disruptive behavior. The family is utilizing haloperidol as needed to control her behavior. On nursing assessment, you note that the client demonstrates involuntary movements of the tongue and fingers. This may most likely indicate:

• A. Early symptoms of Parkinson's disease
• B. The need to change her medication from haloperidol to another antipsychotic drug to lessen symptoms
• C. Tardive dyskinesia, which may be a side effect of antipsychotic medication
• D. A more advanced stage of Alzheimer's disease than previously experienced by the client

Answer: C Explanation:
Explanation
(A) Tardive dyskinesia is a common side effect of antipsychotic medications such as haloperidol.
Discontinuing the medication can alleviate symptoms. (B) Although mild tremors are an early sign of Parkinson's disease, haloperidol must be discontinued first and the client further evaluated. (C) These symptoms do not necessarily indicate a more advanced stage of Alzheimer's disease. (D) Most antipsychotic drugs are chemically similar and will produce the same side effects.
NEW QUESTION # 661
A 26-year-old male client is brought by his wife to the emergency department (ED) unconscious. Blood is drawn for a stat blood count (CBC), fasting blood sugar level, and electrolytes. An indwelling urinary catheter is inserted. He has a history of type 1 diabetes (insulindependent diabetes mellitus [IDDM]). A diagnosis of ketoacidosis is made. Stat lab values reveal a blood sugar level of 520 mg/dL. Which of the following should the nurse expect to administer in the ER?

• A. Sweetened grape juice by mouth
• B. D50W by IV push
• C. Regular insulin by IV infusion
• D. NPH insulin SC

Answer: C Explanation:
Section: Questions Set F
Explanation:
(A) This action would further increase the client's blood sugar. (B) NPH insulin is an intermediate-acting insulin, with an average of 4-6 hours before onset of action. The client needs insulin that will act immediately. During a ketoacidotic state, the client is dehydrated, so any insulin administered SC will be poorly absorbed. (C) Regular insulin is the fastest acting-insulin; when given IV, it will immediately act to decrease blood sugar. Regular insulin is given to decrease blood glucose levels by promoting metabolism of glucose, inhibiting lipolysis and formation of ketone bodies. (D) This action would further increase the client's blood sugar.
NEW QUESTION # 662
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