Question 1: A client with suspected meningitis presents with a fever, headache, and nuchal rigidity. What is the nurse’s priority action?
Rationale: Implementing droplet precautions is the priority to prevent the spread of infectious meningitis.
Question 2: A client with chronic kidney disease has a potassium level of 7.0 mEq/L. Which finding is most concerning?
Rationale: Tall, peaked T waves on ECG indicate life-threatening hyperkalemia and require immediate intervention.
Question 3: A nurse is caring for a postoperative client who reports severe pain despite receiving prescribed pain medication. What is the nurse’s next action?
Rationale: Performing a focused assessment is essential to identify the cause of the pain and ensure there is no underlying complication.
Question 4: A client with a history of coronary artery disease is experiencing chest pain. Which medication should the nurse administer first?
Rationale: Nitroglycerin is the first-line treatment to relieve chest pain by dilating coronary arteries and improving blood flow.
Question 5: A nurse is educating a client on newly prescribed furosemide. Which statement indicates the need for further teaching?
Rationale: Furosemide should be taken in the morning to prevent nocturia and disruption of sleep.
