NCLEX Quiz: Generate Solutions (NCJMM) for Nursing

1. A client with depression is started on an SSRI. When should the nurse advise the client that mood improvement may occur?

Within 24 hours

Within 2-4 weeks

Within 3-5 days

Immediately after first dose

2. A client with Alzheimer's disease becomes agitated in the evening. What nursing strategy is most effective?

Increase medications to sedate

Provide calm environment and familiar routines

Restrict activities and isolation

Encourage stimulating activities

3. A postpartum client reports severe headache and visual changes. BP is 160/110. What is the suspected diagnosis?

Migraine headache

Postpartum preeclampsia

Dehydration

Tension headache

4. A client on long-term corticosteroid therapy requires which important monitoring?

Blood glucose and bone density

Liver function only

Renal function only

Thyroid function only

5. A client with pneumonia has a respiratory rate of 32 and uses accessory muscles. What intervention is priority?

Position upright and provide oxygen therapy

Lay client flat to rest

Restrict fluids

Administer sedatives

6. A client with acute appendicitis presents with rebound tenderness and guarding. What is the appropriate action?

Provide heat to the abdomen

Give laxatives to promote bowel movement

Prepare for immediate surgical consultation

Administer oral pain medication

7. A client is prescribed warfarin for atrial fibrillation. What teaching is most critical?

Avoid vitamin K-rich foods completely

Maintain consistent vitamin K intake and report bleeding

Take double dose if a dose is missed

Stop medication if bruising appears

8. A client with hepatic cirrhosis develops ascites. What dietary modification should be implemented?

Increase protein to 100 g/day

Restrict sodium and fluid intake

Increase carbohydrates only

No dietary restrictions needed

9. Which finding in a client's urinalysis suggests a urinary tract infection?

Clear, pale yellow color

Presence of nitrites and white blood cells

Specific gravity 1.010

Negative protein and glucose

10. A client with a femur fracture develops sudden dyspnea and chest pain. SpO2 drops to 88%. What complication is suspected?

Pneumonia

Pulmonary embolism

Aspiration

Atelectasis

11. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. What is the priority nursing intervention?

Administer calcium gluconate IV

Encourage high-potassium foods

Increase fluid intake

Monitor vital signs only

12. A client reports chest pain radiating to the left arm and jaw. Heart rate is 110 and BP is 165/95. What is the first action?

Administer aspirin and call for EKG

Tell client to rest and reassess in 10 minutes

Administer nitroglycerin sublingually

Have client walk to the restroom

13. A client with COPD is admitted with an acute exacerbation. What oxygen delivery method is safest?

Non-rebreather mask at 15 L/min

Nasal cannula at 1-2 L/min

High-flow oxygen to maintain SpO2 > 95%

Mechanical ventilation immediately

14. Which sign indicates a client is developing septic shock?

Warm, flushed skin with tachycardia

Cool, clammy skin with decreased urine output

Bradycardia with hypertension

Slow respirations with alertness

15. A client receiving chemotherapy develops severe nausea and vomiting. What is the priority nursing action?

Withhold all fluids temporarily

Administer antiemetic medication and assess hydration

Encourage solid foods immediately

Position flat in bed

16. A client has a new diagnosis of hypertension. Which patient education is essential?

Restrict all sodium intake completely

Lifestyle changes and medication adherence

Avoid all physical activity

Increase caffeine intake for alertness

17. Which intervention is most appropriate for a client in acute pain who cannot take oral medications?

Apply warm compresses

Administer IV or IM analgesia

Teach relaxation techniques

Elevate the affected area

18. A client with Type 2 diabetes reports blurred vision and polyuria. Blood glucose is 450 mg/dL. What condition is most likely?

Hypoglycemia

Hyperglycemic hyperosmolar state

Diabetic ketoacidosis

Dawn phenomenon

19. A postoperative client receives morphine 10 mg IV. Thirty minutes later, respiratory rate drops to 8 breaths/min. What is the appropriate action?

Continue monitoring; rate may stabilize

Administer naloxone and notify provider

Increase oxygen flow rate only

Document and reassess in 30 minutes

20. Which assessment finding suggests a client is experiencing left-sided heart failure?

Peripheral edema and jugular venous distension

Orthopnea and crackles in lung bases

Hepatomegaly and ascites

Dependent edema in lower extremities

NCLEX Quiz: Can You Generate the Best Solution?