NCLEX-RN

NCLEX-RN Review Study Guide

131.Current CPR guidelines emphasize the priority and importance of effective: a. Compressions b. Ventilations c. Defibrillation d. Medication delivery 132.You are walking down the street when you find a patient lying on the ground, unconscious. You establish there is no pulse, call for help and the AED, and begin chest compressions. You have a pocket mask and wish to give ventilations after the first round of compressions. Which method do you use to open the patient’s airway? a. Head tilt, chin lift b. Neck hyperextension c. Jaw thrust d. None of the above 133.Your sixth day post-op abdominal surgery patient hits her call button, and when you come to the room, you notice that the patient’s sheet is bloody. When you further investigate, it appears that the patient’s surgical wound has separated at the surgical line. She has bleeding and is complaining of pain. You call the doctor and tell them that the patient has a(an): a. Wound evisceration b. Wound dehiscence c. Wound infection d. Wound bleeding

134.The nurse is teaching her post-op patient to use the incentive spirometer. Which of the following statements by the patient indicates that further teaching is necessary? a. “I should sit upright when I use the spirometer for the best results.” b. “I should breath quickly in and out 10 times each hour.” c. “I should seal my lips tightly around the mouthpiece of the spirometer.” d. “The spirometer helps to prevent pneumonia.” 135.Mr. Brown has a chest tube inserted due to pneumothorax. He has a pleurevac self contained chest tube system attached. You come in to check the pleurevac and Mr. Brown and find that there are no fluctuations in the water seal chamber. What should your first action be? a. Assess the patient for any respiratory difficulty b. Call the doctor c. Check the tubing for kinks d. Assess breath sounds to determine whether reinflation of the lung has occurred. 136.What is the best position for a patient about to have a nasogastric tube inserted? a. Supine b. Semi fowler’s c. High fowler’s d. Side lying

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