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Silvestri, L. A., & Silvestri, A. E. (2025). Saunders Comprehensive Review for the NCLEX-PN® Examination (9th ed.). Elsevier.

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 31 pages. Originally published on StudyMerit.

Pages
31
Academic year
2025/2026
Language
English

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Test Bank for Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th Edition by Linda Anne Silvestri and Angela Silvestri – Complete Questions and Answers (Pass Guaranteed) || Updated 2025 1. A nurse is caring for a client with heart failure who has 3+ pitting edema. Which nursing intervention is the highest priority? A. Encourage ambulation B. Elevate the legs C. Administer diuretics as prescribed D. Restrict fluid intake Answer: C Rationale: Diuretics help remove excess fluid and reduce edema, directly addressing the underlying pathophysiology. Elevating legs is supportive but not the highest priority. 2. A client with diabetes mellitus has a blood glucose of 320 mg/dL and fruity breath. Which complication is most likely? A. Hypoglycemia B. Diabetic ketoacidosis (DKA) C. Hyperosmolar hyperglycemic state (HHS) D. Insulin shock Answer: B Rationale: Hyperglycemia with fruity breath and polyuria suggests DKA, a complication of uncontrolled type 1 diabetes.

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3. Which of the following is the most appropriate action for a nurse caring for a client who suddenly develops shortness of breath and wheezing after taking penicillin? A. Document the reaction B. Administer an antihistamine C. Withhold the next dose D. Call for emergency assistance Answer: D Rationale: Sudden wheezing after penicillin indicates a possible anaphylactic reaction, which is life-threatening. Emergency intervention is required. 4. The nurse is teaching a client with COPD about pursed-lip breathing. Which statement by the client indicates understanding? A. “I inhale quickly through my mouth and exhale through my nose.” B. “I exhale slowly through pursed lips.” C. “I hold my breath as long as possible.” D. “I exhale quickly through my mouth.” Answer: B Rationale: Pursed-lip breathing prolongs exhalation and prevents airway collapse, improving ventilation in COPD. 5. A nurse is caring for a client receiving IV vancomycin. Which lab value is most important to monitor? A. WBC B. Serum creatinine C. ALT D. Platelets Answer: B Rationale: Vancomycin is nephrotoxic; monitoring kidney function (serum creatinine) is crucial to prevent renal damage.

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6. A client is post-op day 1 after abdominal surgery. Which assessment finding requires immediate intervention? A. Pain rated 7/10 B. Incision slightly reddened C. No bowel sounds D. Abdominal distention with absent bowel sounds and vomiting Answer: D Rationale: Abdominal distention with absent bowel sounds and vomiting may indicate postoperative ileus or obstruction, which requires immediate attention. 7. Which action is appropriate when administering a subcutaneous injection? A. Insert the needle at 45–90° B. Aspirate before injecting C. Massage the site after injection D. Use a 25-gauge, 2-inch needle Answer: A Rationale: Subcutaneous injections are typically given at 45°–90°, depending on the amount of subcutaneous tissue. Aspirating is not recommended for most subcutaneous injections. 8. A client is taking furosemide. Which statement indicates the client understands the teaching? A. “I will take it in the evening.” B. “I may need to eat more potassium-rich foods.” C. “I should avoid drinking fluids.” D. “I do not need to monitor my weight.” Answer: B Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Clients should include potassium-rich foods in their diet.

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