Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 61

1. A client takes warfarin (Coumadin) 15 mg po daily. To evaluate the medication - s effectiveness, the nurse should monitor the:

A) prothrombin time (PT)
B) partial thromboplastin time (PTT)
C) PTT-C
D) Fibrin split products

2. Prior to administering digoxin to a client with congestive heart failure, the nurse needs to assess:

A) Respiratory rate for 1 minute
B) Radial pulse for 1 minute
C) Radial pulse for 2 minutes
D) Apical pulse for 1 minute

3. A client is diagnosed with Mycobacterium tuberculosis. He is placed in respiratory isolation, intubated, and receives mechanical ventilation. When performing suctioning, the nurse should:

A) Suction for a maximum of 20 seconds
B) Hyperoxygenate before and after suctioning
C) Suction for a maximum of 30 seconds
D) Maintain clean technique during suctioning

4. The physician prescribes a medical regimen of isoniazid, rifampin, and vitamin B6 for a tuberculosis client. The nurse instructs the client that B6 is given because it:

A) Increases activity of isoniazid
B) Increases activity of rifampin
C) Improves nutritional status
D) Reduces peripheral neuropathy

5. Which of the following nursing actions is essential to prevent drug-resistant tuberculosis?

A) Monitor liver function.
B) Monitor renal function.
C) Assess knowledge of respiratory isolation.
D) Monitor compliance with drug therapy.

1. Right Answer: A
Explanation: (A) PT evaluates adequacy of extrinsic clotting pathway. Adequacy of warfarin therapy is monitored by PT. (B) PTT evaluates adequacy of intrinsic clotting pathway. Adequacy of heparin therapy is monitored by PTT. (C) There is no such laboratory test. (D) Fibrin split products indicate fibrinolysis. This is a screening test for disseminated intravascular coagulation. Heparin therapy may increase fibrin split products.

2. Right Answer: D
Explanation: (A) Respiratory rate is not directly affected by digoxin therapy. (B) A radial pulse is not as accurate as an apical pulse. Dysrhythmias may not be detected. (C) A radial pulse is not as accurate as an apical pulse, regardless of assessment time. (D) Apical pulse should be measured for 1-minute prior to digoxin administration.Digoxin decreases the heart rate. Digoxin should be withheld if apical rates are <60 bpm or >120 bpm.

3. Right Answer: B
Explanation: (A) The maximum time for suctioning is 1015 seconds. (B) Supplemental O2should be administered before and after suctioning to reduce hypoxia. (C) The maximum time for suctioning is 1015 seconds. (D) Strict sterile technique should be used during suctioning.

4. Right Answer: D
Explanation: (A) Vitamin B6does not enhance the activity of isoniazid. (B) Vitamin B6does not enhance the activity of rifampin. (C) A vitamin alone does not improve nutritional status. (D) Isoniazid leads to Vitamin B6deficiency, which is manifested as peripheral neuropathy.

5. Right Answer: D
Explanation: (A) Monitoring liver function will not prevent the development of drug-resistant organisms. (B) Monitoring renal function will not prevent the development of drug- resistant organisms. (C) Knowledge of respiratory isolation will reduce transmission of tuberculosis but will not prevent development of drug-resistant organisms.(D) Noncompliance with prescribed antituberculosis drug regimen is the primary cause of drug-resistant organisms. Noncompliance permits the mutation of organisms.

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