the nurse is reviewing the lab results of a patient who has presented in the emergency room the lab results show that the bnp b type natriuretic pepti
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Nursing Elites

NCLEX-RN

NCLEX RN Exam Review Answers

1. The healthcare provider is reviewing the lab results of a patient who has presented in the Emergency Room. The lab results show that the BNP (B-type Natriuretic Peptide) value is 615 pg/ml. What would the healthcare provider take as the priority action?

Correct answer: B

Rationale: An elevated BNP level is indicative of decreased cardiac output, suggesting potential heart failure. In this scenario, the priority action is to check the patient's oxygen saturation. Oxygen saturation assessment is crucial to ensure adequate oxygenation and respiratory function, which is essential in managing cardiac conditions. Calling for a cardiac evaluation and implementing appropriate measures may be necessary but is not the immediate priority without assessing oxygen saturation. Informing the physician about the elevated BNP level can be important for further management but is not the immediate action needed in this situation. Encouraging the patient to limit physical activity might be a consideration later but is not the priority action when dealing with a potential cardiac emergency.

2. A patient is being visited at home by a healthcare professional. The patient has been taking Naproxen for back pain. Which statement made by the patient most indicates that the healthcare professional needs to contact the physician?

Correct answer: D

Rationale: The correct answer is 'I have ringing in my ears.' Ringing in the ears is a severe adverse effect of Naproxen, indicating potential toxicity. This symptom warrants immediate medical attention. Choices A, B, and C are less concerning and do not directly indicate a severe adverse effect or toxicity related to Naproxen. Upset stomach, mild back pain, and occasional headaches are common side effects that may not require immediate physician contact.

3. A man is prescribed lithium to treat bipolar disorder. The nurse is most concerned about lithium toxicity when he notices which of these assessment findings?

Correct answer: B

Rationale: The correct answer is when the patient states he has been having diarrhea every day. Persistent diarrhea can lead to dehydration, which can increase the risk of lithium toxicity. The other options, such as a manic episode, severe depression, or rash and pruritus, are not directly associated with an increased risk of lithium toxicity.

4. In educating clients on ways to manage pain, which topic can be appropriately delegated to an LPN/LVN who will continue under supervision?

Correct answer: C

Rationale: The correct answer is 'Alternating Rest/Activity.' This topic falls within the nursing scope of practice and is typically covered in the training and education of all nurses, including LPN/LVNs. Educating clients on alternating rest and activity is safe, straightforward, and a standard non-pharmacological pain management strategy. Acupuncture (Choice A) and Guided Imagery (Choice B) involve specific skills and techniques that are typically outside the scope of practice for LPN/LVNs. Over-the-counter medications (Choice D) may require additional assessment, monitoring, and considerations that are beyond the usual delegation for LPN/LVNs.

5. Which patient poses the least infection risk to an immunosuppressed patient who had a liver transplant?

Correct answer: C

Rationale: The patient with a healing leg wound poses the least infection risk to an immunosuppressed patient who had a liver transplant. Chronic pancreatitis can lead to complications such as infections that can pose a risk to immunosuppressed individuals. Patients infected with respiratory viruses or urinary tract infections are actively infectious, which can put immunosuppressed patients at a higher risk of acquiring infections. Therefore, the patient with a healing leg wound is the least likely to pose an immediate infection risk.

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