xNR 304 NCLEX-RN Exit Exam Practice Examination (30 Questions & Answers)

1. Question 1 point(s) Category: Pharmacological and Parenteral Therapies The nurse is caring for a 65-year-old male client with a history of ischemic heart disease who has been admitted to the ICU following a myocardial infarction. The client is currently receiving lidocaine I.V. to manage his ventricular ectopy, which has been persistent. Which of the following factors would be most important for the nurse to consider in relation to the administration of this medication? A. Decrease in arterial oxygen saturation (SaO2) when measured with a pulse oximeter B. Increase in systemic blood pressure C. Presence of premature ventricular contractions (PVCs) on a cardiac monitor D. Increase in intracranial pressure (ICP) E. A drop in serum potassium levels as indicated in the latest lab results F. Observation of a widening QRS complex on the ECG 137096476864Incorrect Correct Answer: C. Presence of premature ventricular contractions (PVCs) on a cardiac monitor. In the context of acute myocardial infarction, the priority is to manage life-threatening arrhythmias. Lidocaine is specifically indicated for the treatment of ventricular arrhythmias, such as PVCs, which can be indicative of an increased risk for more serious arrhythmias like ventricular tachycardia or ventricular fibrillation. The presence of PVCs on a cardiac monitor would be the most immediate concern that lidocaine can address in this scenario. While the other factors listed are important to monitor, they are not the primary indications for lidocaine administration in the context of arrhythmia management. Incorrect Correct Answer: C. Presence of premature ventricular contractions (PVCs) on a cardiac monitor. In the context of acute myocardial infarction, the priority is to manage life-threatening arrhythmias. Lidocaine is specifically indicated for the treatment of ventricular arrhythmias, such as PVCs, which can be indicative of an increased risk for more serious arrhythmias like ventricular tachycardia or ventricular fibrillation. The presence of PVCs on a cardiac monitor would be the most immediate concern that lidocaine can address in this scenario. While the other factors listed are important to monitor, they are not the primary indications for lidocaine administration in the context of arrhythmia management. 2. Question point(s) Category: Pharmacological and Parenteral Therapies A 72-year-old male patient with a history of atrial fibrillation and controlled hypertension has been initiated on warfarin therapy. Upon assessment of the patient’s history, it was revealed that he has a history of peptic ulcer. This patient also has a recent history of a peptic ulcer. Given the client’s medical history and current medication regimen, which of the following instructions should the nurse prioritize when providing discharge teaching? A. Report incidents of diarrhea B. Avoid foods high in vitamin K C. Use a straight razor when shaving D. Take aspirin for pain relief E. Monitor for signs of bleeding, such as bruising or black tarry stools F. Check blood pressure regularly at home G. Inform all healthcare providers about the anticoagulant therapy 137096478390Incorrect Correct Answer: B. Avoid foods high in vitamin K Clients taking warfarin should be educated about maintaining a consistent intake of vitamin K, as it is