NCLEX-RN
NCLEX RN Prioritization Questions
1. A patient has acute bronchitis with a nonproductive cough and wheezes. Which topic should the nurse plan to include in the teaching plan?
- A. Purpose of antibiotic therapy
- B. Ways to limit oral fluid intake
- C. Appropriate use of cough suppressants
- D. Safety concerns with home oxygen therapy
Correct answer: C
Rationale: In acute bronchitis, which is often viral, cough suppressants can help manage the symptoms of a nonproductive cough. Antibiotics are not typically used in acute bronchitis unless there are systemic symptoms indicating a bacterial infection. Limiting oral fluid intake is not recommended; in fact, maintaining adequate hydration is important. Safety concerns with home oxygen therapy may not be directly relevant to the management of acute bronchitis.
2. Which assessment information will be most important for the nurse to report to the healthcare provider about a patient with acute cholecystitis?
- A. The patient's urine is bright yellow
- B. The patient's stools are tan colored
- C. The patient has increased pain after eating
- D. The patient complains of chronic heartburn
Correct answer: B
Rationale: The correct answer is that the patient's stools are tan colored. Tan or grey stools indicate biliary obstruction, which requires rapid intervention to resolve in a patient with acute cholecystitis. This change in stool color is a critical sign that the healthcare provider needs to be informed about promptly. The other choices are less concerning and may be common symptoms in patients with acute cholecystitis, but tan-colored stools specifically indicate a potential serious complication that warrants immediate attention.
3. Which of these clients is likely to receive sublingual morphine?
- A. A 75-year-old woman in a hospice program
- B. A 40-year-old man who just had throat surgery
- C. A 20-year-old woman with trigeminal neuralgia
- D. A 60-year-old man who has a painful incision
Correct answer: A
Rationale: The correct answer is a 75-year-old woman in a hospice program. Sublingual morphine is commonly used in hospice care because patients may have difficulty swallowing, and intravenous access can be uncomfortable and not ideal for palliative care. Choice B, a 40-year-old man who just had throat surgery, is less likely to receive sublingual morphine as he may be able to swallow, and other pain management options may be more suitable. Choice C, a 20-year-old woman with trigeminal neuralgia, would typically require specific medications targeting neuropathic pain rather than sublingual morphine. Choice D, a 60-year-old man with a painful incision, may benefit from localized pain relief or other systemic pain management options, but sublingual morphine is not usually the first choice for this type of pain.
4. A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first?
- A. Prepare the child for an X-ray of the upper airways
- B. Examine the child's throat
- C. Collect a sputum specimen
- D. Notify the healthcare provider of the child's status
Correct answer: D
Rationale: The correct initial action is to notify the healthcare provider of the child's status. The presenting symptoms described, such as irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions, are indicative of epiglottitis, a potentially life-threatening condition. Immediate medical attention is crucial in such cases. While preparing for an X-ray or examining the throat may be necessary, the priority is to ensure prompt evaluation and intervention by the healthcare provider. Collecting a sputum specimen is not relevant in this situation and would cause unnecessary delay. Therefore, the nurse should prioritize communication with the healthcare provider to expedite appropriate management and treatment.
5. What preparation should be made for a client undergoing a KUB (Kidney, Ureter, Bladder) radiography test?
- A. Client must be NPO before the examination
- B. Enema should be administered before the examination
- C. Medicate the client with furosemide 20 mg IV 30 minutes before the examination
- D. No special orders are necessary for this examination
Correct answer: D
Rationale: The correct answer is that no special orders are necessary for a KUB radiography test. It is important to inform the client to remove any clothing, jewelry, or objects that may interfere with the test. Option A is incorrect because there is no need for the client to be NPO before this examination. Option B is incorrect as enemas are not routinely administered prior to a KUB radiography test. Option C is incorrect as there is no need to medicate the client with furosemide before this examination.
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