Saunders NCLEX-RN Test Bank
Saunders NCLEX-RN Test Bank 2 Questions
And Answers(100% CORRECT ANSWERS)
WITH RATIONALES/ GUARANTEED PASS
GRADED A+
A client with acute gouty arthritis is being started on medication therapy with indomethacin.
The nurse provides medication instructions to the client. How does the nurse tell the client to
take the medication?
At bedtime
With food
A+ TEST BANK 1
, Saunders NCLEX-RN Test Bank
1 hour before meals
On an empty stomach –
Correct Answer :With food
Rationale:
The client is instructed to take the medication with food. Indomethacin is a nonsteroidal
antiinflammatory medication that produces analgesic and antiinflammatory effects by
inhibiting prostaglandin synthesis. Adverse effects include ulceration of the esophagus,
stomach, duodenum, and small intestine.
An emergency department (ED) nurse is monitoring a client who sustained a severe inhalation
burn injury during a fire in which the client was trapped in an enclosed space. The nurse
auscultates the client's trachea and notes that the previously heard wheezing sounds have
disappeared. What is the most appropriate action the nurse should take?
Continue monitoring the client
Notify the emergency department (ED) primary health care provider
Document the client's improvement in the medical record
Remove the oxygen mask and fit the client with a nasal –
Correct Answer :Notify the emergency department (ED) primary health care provider
Rationale:
The most appropriate action by the nurse would be to notify the ED primary health care
provider immediately. A client with a severe inhalation injury may sustain such progressive
obstruction that within a short time he/she cannot force air through the narrowed airways. As
a result, the wheezing sounds disappear. This finding indicates impending airway obstruction
and demands immediate intubation. A client with an inhalation burn injury is at risk for
respiratory complications. Upper-airway edema and inhalation injury are most notable in the
A+ TEST BANK 2
, Saunders NCLEX-RN Test Bank
trachea and main stem bronchi. Auscultation of these areas reveals wheezes, which are a
sign/symptom of obstruction. Continuing to monitor the client, documenting the client's
improvement in the medical record, and removing the oxygen mask and fitting the client with
a nasal cannula are all incorrect and would delay necessary interventions.
A nurse reviews arterial blood gas (ABG) values and notes a pH of 7.50 and a Pco2 of 30 mm
Hg. What does the nurse interpret these values as indicative of?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis –
Correct Answer :Respiratory alkalosis
Rationale:
The nurse interprets these values as indicative of respiratory alkalosis. The normal pH is 7.35
to 7.45. The normal Pco2 is 35 to 45 mm Hg. In respiratory alkalosis, the pH will be higher than
normal and the Pco2 will be low.
A nurse provides information to a client with chronic obstructive pulmonary disease (COPD)
about methods of alleviating shortness of breath while the client is eating. Which statement
by the client indicates a need for further instruction?
"I should rest before I eat."
"I should use my bronchodilator 30 minutes before I eat."
"Pursed-lip breathing will help relieve my shortness of breath."
A+ TEST BANK 3
, Saunders NCLEX-RN Test Bank
"I should eat three meals a day, and the biggest meal should be at suppertime." –
Correct Answer :"I should eat three meals a day, and the biggest meal should be at
suppertime."
Rationale:
There is a need for further instruction if the client states, "I should eat three meals a day, and
the biggest meal should be at suppertime." The biggest meal of the day is planned for the
time when the client is hungriest and most rested. Most clients are increasingly tired at the
end of the day. Four to six small meals per day are preferable to three larger ones. Pursed-lip
or abdominal breathing may alleviate dyspnea.Shortness of breath is the most common
problem related to eating for a client with COPD. The client can ease dyspnea by resting
before meals. A bronchodilator used 30 minutes before a meal may be helpful if the meal-
related dyspnea is a result of bronchospasm or secretions.
A postoperative client with deep-vein thrombosis is at risk for pulmonary embolism. For which
characteristic sign/symptom of this complication does the nurse monitor the client?
Pleuritic chest pain
Slowed heart rate
Chills and a high fever
Decreased respiratory rate –
Correct Answer :Pleuritic chest pain
Rationale:
The characteristic signs/symptoms of pulmonary embolism are dyspnea, tachypnea,
tachycardia, and pleuritic chest pain (sharp, stabbing pain on inspiration). Pulmonary
embolism, whch results in blockage of the main artery of the lung or one of its branches,
A+ TEST BANK 4
Saunders NCLEX-RN Test Bank 2 Questions
And Answers(100% CORRECT ANSWERS)
WITH RATIONALES/ GUARANTEED PASS
GRADED A+
A client with acute gouty arthritis is being started on medication therapy with indomethacin.
The nurse provides medication instructions to the client. How does the nurse tell the client to
take the medication?
At bedtime
With food
A+ TEST BANK 1
, Saunders NCLEX-RN Test Bank
1 hour before meals
On an empty stomach –
Correct Answer :With food
Rationale:
The client is instructed to take the medication with food. Indomethacin is a nonsteroidal
antiinflammatory medication that produces analgesic and antiinflammatory effects by
inhibiting prostaglandin synthesis. Adverse effects include ulceration of the esophagus,
stomach, duodenum, and small intestine.
An emergency department (ED) nurse is monitoring a client who sustained a severe inhalation
burn injury during a fire in which the client was trapped in an enclosed space. The nurse
auscultates the client's trachea and notes that the previously heard wheezing sounds have
disappeared. What is the most appropriate action the nurse should take?
Continue monitoring the client
Notify the emergency department (ED) primary health care provider
Document the client's improvement in the medical record
Remove the oxygen mask and fit the client with a nasal –
Correct Answer :Notify the emergency department (ED) primary health care provider
Rationale:
The most appropriate action by the nurse would be to notify the ED primary health care
provider immediately. A client with a severe inhalation injury may sustain such progressive
obstruction that within a short time he/she cannot force air through the narrowed airways. As
a result, the wheezing sounds disappear. This finding indicates impending airway obstruction
and demands immediate intubation. A client with an inhalation burn injury is at risk for
respiratory complications. Upper-airway edema and inhalation injury are most notable in the
A+ TEST BANK 2
, Saunders NCLEX-RN Test Bank
trachea and main stem bronchi. Auscultation of these areas reveals wheezes, which are a
sign/symptom of obstruction. Continuing to monitor the client, documenting the client's
improvement in the medical record, and removing the oxygen mask and fitting the client with
a nasal cannula are all incorrect and would delay necessary interventions.
A nurse reviews arterial blood gas (ABG) values and notes a pH of 7.50 and a Pco2 of 30 mm
Hg. What does the nurse interpret these values as indicative of?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis –
Correct Answer :Respiratory alkalosis
Rationale:
The nurse interprets these values as indicative of respiratory alkalosis. The normal pH is 7.35
to 7.45. The normal Pco2 is 35 to 45 mm Hg. In respiratory alkalosis, the pH will be higher than
normal and the Pco2 will be low.
A nurse provides information to a client with chronic obstructive pulmonary disease (COPD)
about methods of alleviating shortness of breath while the client is eating. Which statement
by the client indicates a need for further instruction?
"I should rest before I eat."
"I should use my bronchodilator 30 minutes before I eat."
"Pursed-lip breathing will help relieve my shortness of breath."
A+ TEST BANK 3
, Saunders NCLEX-RN Test Bank
"I should eat three meals a day, and the biggest meal should be at suppertime." –
Correct Answer :"I should eat three meals a day, and the biggest meal should be at
suppertime."
Rationale:
There is a need for further instruction if the client states, "I should eat three meals a day, and
the biggest meal should be at suppertime." The biggest meal of the day is planned for the
time when the client is hungriest and most rested. Most clients are increasingly tired at the
end of the day. Four to six small meals per day are preferable to three larger ones. Pursed-lip
or abdominal breathing may alleviate dyspnea.Shortness of breath is the most common
problem related to eating for a client with COPD. The client can ease dyspnea by resting
before meals. A bronchodilator used 30 minutes before a meal may be helpful if the meal-
related dyspnea is a result of bronchospasm or secretions.
A postoperative client with deep-vein thrombosis is at risk for pulmonary embolism. For which
characteristic sign/symptom of this complication does the nurse monitor the client?
Pleuritic chest pain
Slowed heart rate
Chills and a high fever
Decreased respiratory rate –
Correct Answer :Pleuritic chest pain
Rationale:
The characteristic signs/symptoms of pulmonary embolism are dyspnea, tachypnea,
tachycardia, and pleuritic chest pain (sharp, stabbing pain on inspiration). Pulmonary
embolism, whch results in blockage of the main artery of the lung or one of its branches,
A+ TEST BANK 4
