NCLEX-Style: Advanced Application Set 1–33

Front

The nurse reviews a patient's chart: - Serum Na+ 116 mEq/L - Urine specific gravity 1.032 - Complains of headache and confusion. Which order should the nurse question?

Back

Give desmopressin 0.3 mcg IV q12h

Front

A patient receiving IV vasopressin for DI reports chest pain. Which action is priority?

Back

Obtain a 12-lead ECG

Front

The nurse provides discharge teaching for Addison’s disease. Which statement indicates the need for more teaching? Options: I’ll carry hydrocortisone with me for emergencies. If I get sick, I’ll double my steroid dose. If I feel weak and dizzy, I’ll skip my steroid until I’m better. I’ll wear my medical alert bracelet.

Back

If I feel weak and dizzy, I’ll skip my steroid until I’m better.

Front

The nurse assesses a post-thyroidectomy client who becomes suddenly restless with stridor and drooling. What's the priority action?

Back

Call rapid response

Front

A type 1 diabetic who took insulin this morning is now diaphoretic and trembling. The nurse finds BG 52 mg/dL. The correct response is to:

Back

Give ½ cup juice and recheck in 15 min

Front

Which new insulin order should the nurse clarify? Options: Lispro 10 U subQ before meals, NPH 30 U subQ Q0900, Glargine 10 U subQ at HS, Mix glargine with lispro in one syringe

Back

Mix glargine with lispro in one syringe

Front

The nurse evaluates a patient on metformin. Which finding requires immediate action? Options: Mild diarrhea, GFR 28 mL/min, BMI 36 kg/m², A1C 8.0 %

Back

GFR 28 mL/min

Front

A patient with DKA receives insulin IV infusion. Which lab warrants the nurse to hold the infusion? K+ 3.0 mEq/L, pH 7.25, HCO3- 18 mEq/L, Glucose 240 mg/dL

Back

K+ 3.0 mEq/L

Front

The nurse cares for a patient with cirrhosis and ascites. Which new order requires clarification? Options: Spironolactone 25 mg PO daily, Ibuprofen 600 mg q6h PRN pain, 2 g sodium diet, Daily weight

Back

Ibuprofen 600 mg q6h PRN pain

Front

Which statement about Lactulose indicates understanding? Options: "It will help me have soft stools to get rid of ammonia." "It will raise my potassium levels." "It will strengthen my liver enzymes." "I can skip doses when I feel bloated."

Back

"It will help me have soft stools to get rid of ammonia."