NCLEX-PN Test #12 1 — Questions and Answers
Question 1: A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which food should the nurse instruct the client to avoid?
- White rice
- Pasta with butter
- Baked potato with skin (Correct answer)
- Scrambled eggs
Correct answer: Baked potato with skin
Baked potatoes — especially with the skin — are high in potassium and should be avoided by clients with hyperkalemia or chronic kidney disease. White rice, plain pasta, and eggs are lower-potassium options generally acceptable on a renal diet. Clients with CKD must limit high-potassium foods to prevent cardiac complications.
Question 2: A nurse is reviewing a client's medication list and notes the client takes warfarin. The client asks if they can take ibuprofen for a headache. What is the most appropriate response?
- 'Ibuprofen is safe to take with warfarin in small doses.'
- 'You should avoid ibuprofen because it can increase your risk of bleeding when taken with warfarin.' (Correct answer)
- 'Take ibuprofen only at bedtime to reduce interaction risk.'
- 'Ibuprofen will reduce the effectiveness of your warfarin.'
Correct answer: 'You should avoid ibuprofen because it can increase your risk of bleeding when taken with warfarin.'
NSAIDs like ibuprofen inhibit platelet aggregation and can displace warfarin from protein-binding sites, significantly increasing bleeding risk. Clients on warfarin should use acetaminophen for pain relief instead. There is no safe time of day to take ibuprofen to avoid the interaction.
Question 3: A nurse is performing a focused assessment on a client who reports difficulty breathing. In which order should the nurse complete the assessment? (Place in priority order: 1=first)
- Inspect chest rise and respiratory rate
- Auscultate breath sounds
- Measure oxygen saturation (Correct answer)
- All of the above simultaneously using a systematic approach
Correct answer: Measure oxygen saturation
Oxygen saturation via pulse oximetry provides rapid, objective data about oxygenation status and should be obtained as an immediate priority in any client with respiratory distress. Visual inspection and auscultation follow. The systematic priority is: quick SpO2 check first, then inspection, then auscultation.
Question 4: The nurse is teaching a client how to use a metered-dose inhaler (MDI) without a spacer. Which instruction is correct?
- Inhale quickly and forcefully after activating the inhaler
- Hold the inhaler 1–2 inches from the open mouth, activate, and inhale slowly and deeply (Correct answer)
- Place the inhaler mouthpiece directly in the mouth and activate while inhaling rapidly
- Activate the inhaler twice in rapid succession for a full dose
Correct answer: Hold the inhaler 1–2 inches from the open mouth, activate, and inhale slowly and deeply
Correct MDI technique without a spacer includes holding the inhaler 1–2 inches in front of an open mouth (or lips sealed around it), activating once, and inhaling slowly and deeply over 3–5 seconds, then holding the breath for 10 seconds. Rapid inhalation causes the medication to deposit in the mouth rather than reach the airways.
Question 5: A nurse is caring for a client who had a thyroidectomy 12 hours ago. The client reports tingling around the mouth and in the fingertips. Which complication should the nurse suspect?
- Thyroid storm
- Hypocalcemia from accidental parathyroid removal (Correct answer)
- Hemorrhage at the surgical site
- Laryngeal nerve damage
Correct answer: Hypocalcemia from accidental parathyroid removal
Tingling around the mouth and in the extremities (perioral and peripheral paresthesias) are classic early signs of hypocalcemia, which can occur after thyroidectomy if the parathyroid glands are inadvertently removed or damaged. This is a priority assessment finding that requires immediate provider notification and calcium monitoring.
Question 6: A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to delegate?
- Performing a focused respiratory assessment on a client with pneumonia
- Educating a diabetic client about insulin injection technique
- Measuring and recording urinary output for a stable postoperative client (Correct answer)
- Evaluating the effectiveness of a pain medication given 30 minutes ago
Correct answer: Measuring and recording urinary output for a stable postoperative client
Measuring and recording urinary output on a stable postoperative client is a routine, non-complex task within the scope of a UAP. Assessment, client education, and evaluation of medication effectiveness require clinical judgment and are within the scope of licensed nursing practice only.
NCLEX-PN Test #12 1
A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L.
Which food should the nurse instruct the client to avoid?