NR 226 Exam 2 Practice NCLEX questions with answers and rationales 2023

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NR 226 Exam 2 Practice NCLEX questions with answers and rationales 1. A nurse assesses a patient with hypoparathyroidism. The nurse notes a positive Chvostek’s sign and recognizes that it indicate... s with electrolyte imbalance? a. Hyperkalemia b. Hypermagnesemia c. Hypocalcemia d. Hyponatremia Explanation: Serum calcium levels are maintained through dietary intake and the parathyroid hormone. When more calcium is needed, parathyroid hormone is released to absorb calcium from bone, stimulate vitamin D activation, inhibit kidney excretion of calcium and stimulate kidney reabsorption of calcium. In hypoparathyroidism, the parathyroid gland does not produce adequate parathyroid hormone to maintain serum calcium levels, causing hypocalcemia. Hypocalcemia is an electrolyte imbalance in which total serum calcium is less than 8.5 mg/dL. Hypocalcemia can cause neuromuscular excitability, as seen in positive Chvostek sign. A positive Chvostek sign occurs when the nurse taps on the facial nerve at the angle of the jaw, resulting in contraction of the facial muscles. 2. A nurse receives a laboratory report for a client indicating a potassium level of 5.3 mEq/L. When notifying the provider, the nurse should expect which of the following actions? A. Starting an IV infusion of 0.9% sodium chloride B. Consulting with the dietician to increase intake of potassium C. Initiate continuous cardiac monitoring D. Prepare the client for gastric lavage 3. A nurse is collecting data from a client who is receiving IV therapy and reports pain in the arm, chills, and “not feeling well.” The nurse notes warmth, induration, and red streaking on the client’s arm close to the IV insertion site. Which of the following actions should the nurse plan to take first? A. Obtain a specimen for culture B. Apply a warm compress C. Administer analgesics D. Discontinue the IV infusion 4. A nurse initiates a blood transfusion at 1100 for an elderly client who is anemic. The nurse sets the infusion rate to ensure the transfusion is complete by what time? A. 1200 B. 1300 C. 1500 D. 1600 5. A nurse administers PRBCs to a client. Fifteen minutes after beginning the transfusion, the client reports pain in the back, burning at the IV site, and chills. Which actions does the nurse take? (Select all that apply) A. Decrease the blood transfusion flow rate B. Finish the transfusion and then notify the blood bank C. Notify the health care provider of the client’s status D. Save the blood bag and tubing and call the blood bank E. Stop the blood transfusion immediately [Show More]

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