Example Nursing Register (RN) Questions with Answer and Rationale 59th Edition

Example Nursing Register (RN) Questions with Answer and Rationale 59th Edition (Pharmacology & Maternity Questions)

1. A nurse is caring for a client receiving growth hormone replacement therapy. The nurse monitors the client for which side effect associated with this therapy?

A. Hyperglycemia
B. Hyperthyroidism
C. Hypoglycemia
D. Hypocalciuria

Answer: A. Hyperglycemia

Rationale: Hyperglycemia can occur from the administration of growth hormone, particularly in clients with diabetes mellitus. Growth hormone therapy is associated with a decline in thyroid function. Hypercalciuria can occur, particularly during the first 2 to 3 months of therapy. Glucose and thyroid hormone levels should be monitored.

Test-Taking Strategy: Knowledge regarding the side effects associated with growth hormone replacement therapy is required to answer the question. Remember that hyperglycemia can occur from the administration of growth hormone. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 633.

2. A client with diabetes mellitus calls the clinic and tells the nurse that she has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which of the following is the appropriate nursing response?

A. Omit the insulin
B. Administer half of the prescribed dose
C. Administer the full dose as prescribed
D. Wait until noon before making a decision

Answer: C. Administer the full dose as prescribed

Rationale: When the diabetic client becomes ill, control is more difficult. Insulin is not omitted, and the client is encouraged to consume liquid carbohydrates if unable to eat regular meals. The client is instructed to notify the physician if vomiting or diarrhea occurs, or if the illness progresses past 2 days.

Test-Taking Strategy: Use the process of elimination. You can eliminate options 1, 2, and 4 because it is not within the legal parameters of nursing responsibilities to adjust or alter medication dosages. If you had difficulty with this question, review the client teaching points related to the administration of insulin on “sick days.”

Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Black, J., & Hawks, J. (2005). Medical-surgical nursing: Clinical management for positive outcomes (7th ed.). Philadelphia: W.B. Saunders, p. 1286.

3. A nurse is providing instructions to a pregnant woman regarding measures that will strengthen the perineal floor muscles. The nurse instructs the client to:

A. Drink 8 ounces of fluid 6 times per day
B. Wipe the perineal area anterior to posterior after toileting
C. Perform Kegel exercises in 10 repetitions, 3 times per day
D. Perform pelvic tilt exercises in 10 repetitions, 3 times per day

Answer: C. Perform Kegel exercises in 10 repetitions, 3 times per day

Rationale: Kegel exercises strengthen the pelvic floor. Option 1 relates to hydration that is important for normal physiological body functioning. Option 2 will help prevent urinary tract infections. Pelvic tilt exercises will reduce backache.

Test-Taking Strategy: Focus on the issue—how to strengthen the perineal floor muscles. Knowledge of the purpose of Kegel exercises will assist you in selecting the correct option. Review this information if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Maternity/Antepartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 55.

4. A client is 8-weeks pregnant and has waves of nausea accompanied by vomiting throughout the day. Food odors consistently precipitate the nausea. Her husband has an important business dinner planned, and she is reluctant to attend because of the nausea and vomiting. This has placed a strain on the husband-wife relationship. Which of the following statements by the nurse indicates an understanding of the problem?

A. “You feel you are having difficulty fulfilling your role as a wife.”
B. “You are afraid your husband will go to dinner without you.”
C. “You are not physically able to go to dinner and should stay at home.”
D. “You should go to dinner. Others will understand if you don’t feel well.”

Answer: A. “You feel you are having difficulty fulfilling your role as a wife.”

Rationale: There are no data to support the fear that the wife will be left at home. Options 3 and 4 are examples of giving advice and do not lead to open communication with the pregnant woman. Option 1 reflects a feeling that the woman may be having. By identifying this feeling, the nurse provides the opportunity for further discussion.

Test-Taking Strategy: Use the process of elimination. Focus on the issue—the role relationship of the husband and wife. Use therapeutic communication techniques, such as reflection. Note the relationship of the word “role” in the correct option and with the word “relationship” in the question. Review therapeutic communication techniques if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Maternity/Antepartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 4.

Source : NCLEX example quiz and answer

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