Free NCLEX-RN Practice Questions Test #5 – RN Questions & Answers

The supplied rationale states that taking antibiotics with oral contraceptives can decrease contraceptive effectiveness. The key nursing teaching point is that the client should recognize the potential for reduced contraceptive protection while receiving antibiotic therapy and follow appropriate additional contraceptive guidance. This is a medication-teaching and pregnancy-prevention issue, so it should be discussed clearly rather than assumed to be harmless.

Prednisone is a corticosteroid, and the supplied rationale explains that morning administration mimics the body’s natural secretion pattern of corticosteroids. Giving the medication at this time follows the physiologic rhythm described in the source and is the reason morning dosing is recommended in this question. The rationale is therefore based on matching medication administration to normal endogenous corticosteroid secretion.

Rifampin can produce a characteristic red or orange discoloration of urine and other body fluids. The supplied rationale identifies this color change as an expected medication effect that should be explained to the client. Preparing the client for this finding helps prevent unnecessary alarm and supports adherence to the prescribed tuberculosis treatment.

Cyclophosphamide can cause hemorrhagic cystitis, meaning inflammation and bleeding of the urinary bladder. The supplied rationale therefore emphasizes generous fluid intake, specifically at least eight large glasses of water daily, to help reduce the urinary complications associated with the medication. Hydration is an important preventive teaching measure for a client receiving Cytoxan.

Visible crystals in an IV chemotherapy solution indicate that the preparation should not be administered. The supplied rationale directs the nurse to discard the solution and obtain a new bag rather than attempting to correct the problem by warming it, continuing the infusion, or independently discontinuing therapy without replacing the medication. Safe medication administration requires the IV preparation to be suitable and free of abnormal precipitates or crystals.

Theo-Dur (theophylline) is a bronchodilator, and the supplied rationale identifies tachycardia as an important adverse effect. Checking the pulse before administration therefore provides essential information about the client’s cardiovascular response and helps identify excessive heart-rate elevation. Marked tachycardia should be recognized and reported because it may indicate significant medication toxicity or intolerance.

The supplied rationale connects meningitis during infancy with the diagnosis of cerebral palsy. Cerebral palsy is a neurologic disorder that may be associated with early infections affecting the brain or spinal column, as described in the source. Thus, a history of meningitis at six months provides the relevant neurologic history among the choices.

The supplied rationale identifies push-pull toys as an expected developmental activity at approximately 18 months. This makes pulling a toy behind the child the appropriate milestone for the age in the question. The other developmental abilities listed in the options are described by the source as occurring at later ages, so they would not be the best expected finding for an 18-month-old.

Constant swallowing after tonsillectomy can indicate postoperative bleeding. A child may repeatedly swallow blood rather than visibly expectorate it, making frequent or constant swallowing an important warning sign. The supplied rationale therefore identifies this finding as the complication requiring attention, whereas decreased appetite and a low-grade temperature may occur after surgery.

Gingival hyperplasia, or enlargement and overgrowth of the gums, is a classic adverse effect associated with phenytoin (Dilantin) therapy. The mother’s observation that the gums look too large for the teeth therefore directly matches the medication effect described in the supplied rationale. Recognizing this finding is important because oral care and follow-up may be needed during long-term phenytoin therapy.

Tranylcypromine is an MAOI, and the supplied rationale states that eating foods high in tyramine can precipitate severe hypertension. Tyramine-containing foods can interact with MAO inhibition and produce a dangerous increase in blood pressure. The nurse should therefore emphasize avoidance of the high-tyramine foods identified in the source, because the complication can be serious and requires prompt treatment.

Quinidine can produce myocardial toxicity and conduction abnormalities. The supplied rationale specifically identifies a widened or prolonged QT interval as an ECG finding that should be monitored while the client receives quinidine. ECG surveillance is therefore important because changes in cardiac conduction can signal medication-related toxicity and an increased risk of serious dysrhythmias.

Lidocaine is an antiarrhythmic medication used for ventricular dysrhythmias, and the supplied rationale specifically identifies ventricular tachycardia as the condition for which it is frequently ordered. Its action helps suppress abnormal ventricular electrical activity. It is not being selected here for atrial tachycardia, heart block, or ventricular bradycardia.

Nitroglycerin ointment should be applied using rotating sites to reduce local skin irritation. The supplied rationale also explains that it may be applied to appropriate areas such as the back and upper arms, should not be rubbed into the skin, and should be covered with the prepared dressing rather than ordinary gauze. Rotating sites is therefore the appropriate administration technique among the choices.

A persistent cough is a recognized adverse reaction to captopril, an ACE inhibitor. The supplied rationale identifies this cough as the important medication-related finding in the question. A persistent cough during captopril therapy should be recognized as potentially drug-related and communicated to the healthcare provider so the medication regimen can be evaluated.

The supplied rationale states that IV furosemide should be administered over approximately 1–2 minutes to reduce the risk of excessive hypotension. The medication does not need to be administered as an IV piggyback, exclusively with normal saline, or through a filter for the reason given in the source. Correct IV administration rate is therefore an important safety consideration.

Protamine sulfate is the reversal agent for heparin identified in the supplied rationale. When heparin’s anticoagulant effect needs to be reversed, recognizing protamine sulfate allows the nurse to respond appropriately to excessive anticoagulation or significant bleeding. The other medications listed have different pharmacologic purposes and do not reverse heparin.

The supplied rationale identifies linear accelerator therapy as appropriate for assignment to the pregnant nurse because the client receiving this external radiation treatment does not pose the same ongoing radiation exposure risk as clients with internal radioactive implants. By contrast, radium, brachytherapy, and implanted iridium sources require radiation precautions. Assignment decisions should therefore consider the type and source of radiation.

Cushing’s disease involves excess corticosteroid effects and increased susceptibility to infection. The supplied rationale therefore identifies the client with Cushing’s disease as the priority for the available private room. The other conditions listed do not carry the same infection-susceptibility rationale described in the source.

The supplied rationale defines the inappropriate striking or touching of a client as assault. Because the nursing assistant is witnessed hitting an elderly client, the conduct corresponds to assault. The source distinguishes this from negligence, which involves failure to provide required care; tort, which is a broader wrongful act; and malpractice, which concerns professional failure or improper action resulting in harm.

The supplied rationale identifies starting a blood transfusion as the assignment that should not be delegated to the LPN in this question. The LPN can assist with tasks such as client identification with the RN and obtaining vital signs, but initiation of the transfusion is not the delegated task identified as appropriate. Safe delegation requires matching the task with the nurse’s permitted responsibilities and the client’s level of risk.

The postoperative vital signs—blood pressure 90/50, pulse 132, and respirations 30—are markedly abnormal and indicate possible acute deterioration. The supplied rationale states that the physician should be contacted immediately rather than simply continuing routine monitoring or relying only on subjective symptoms. Prompt communication is necessary because the combination of hypotension, tachycardia, and tachypnea can signal a serious postoperative problem.

β-thalassemia major causes severe anemia because affected red blood cells have a shortened life span. The supplied rationale identifies frequent blood transfusions as the treatment used to manage the anemia and improve oxygen delivery to tissues. IV fluids, oxygen alone, and iron therapy do not correct the underlying severe anemia in the manner described by the source; iron should not be given simply to treat this inherited disorder.

The supplied rationale identifies doxycycline (Vibramycin) as an antibiotic used to treat N. gonorrhea in this question. The medication listed in option B is therefore the treatment choice supported by the source. The other medications are associated with different infectious or dermatologic conditions and are not the treatment identified for gonorrhea in the supplied material.

The supplied rationale identifies frequent urination and vaginal discharge as clinical symptoms associated with Chlamydia. These findings provide the combination that best matches the source’s description. The other options do not represent the symptoms identified in the supplied rationale for this infection.

The supplied rationale states that an alkaline ash diet includes rhubarb, legumes, milk and milk products, and green vegetables. Rhubarb is therefore the appropriate choice among the listed foods. Cranberries, grapes, and plums are identified in the source as foods associated with an acid ash diet and should be limited when the prescribed diet is alkaline.

Clostridium difficile is transmitted through contamination involving stool, and contaminated objects can contribute to spread. The supplied rationale emphasizes that poor hand hygiene is a major source of transmission in healthcare settings. Therefore, contamination of objects with stool is the transmission route that best matches the source.

The supplied rationale identifies the client who is only two hours post-lobectomy as the first priority for assessment. This client is in the immediate postoperative period and has ongoing chest drainage, so the nurse should assess promptly for potential complications. The other clients described are considered more stable in the supplied rationale and can be assessed afterward.

The supplied rationale recommends Trendelenburg positioning for removal of a PICC line because the position helps reduce the risk of air entering the venous circulation and causing an air embolus. The other positions listed are not the position identified by the source for PICC removal. Proper positioning is therefore an important safety measure during the procedure.

The supplied rationale states that many cold medications contain alcohol, which should be avoided by a client taking naltrexone. Therefore, cold medicine is the best answer among the listed over-the-counter choices. The source specifically identifies acetaminophen, ibuprofen, and antihistamines as medications the client may take, making them less appropriate as the answer to this question.