Naxlex Qbank

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Sample questions from Naxlex Qbank

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client is admitted to a medical-surgical unit with pneumonia. The nurse receives report that the client's oxygen saturation is 88% on 2 L/min by nasal cannula, respiratory rate is 30/min, and the client is newly restless. Which action should the nurse take first?

   • A.Document the findings and notify the provider at the end of the shift.
   • B.Call the client's family to obtain the client's baseline mental status.
   • C.Increase oxygen to 4 L/min and reassess in 15 minutes.
   • D.Assess the client's airway and breathing and promptly increase oxygen per protocol.

   Rationale: Restlessness, tachypnea, and hypoxemia suggest worsening oxygenation, so immediate respiratory assessment and prompt intervention are priorities. Increasing oxygen without first assessing the client may miss airway compromise or a need for more urgent support. Family input and documentation do not address the immediate threat, and delaying notification is unsafe.

2. 2.A 74-year-old client with heart failure is admitted to a medical unit with worsening dyspnea. The nurse is coordinating care with an RN, an LPN, and an unlicensed assistive personnel (UAP). Which tasks are appropriate to delegate to the UAP? Select all that apply.

   • A.Assess the client's lung sounds after the client reports new chest tightness.
   • B.Measure and record urine output from the collection hat.
   • C.Teach the client how to follow a low-sodium diet.
   • D.Assist the stable client with bathing and oral care.
   • E.Obtain and record the client's routine vital signs, and report abnormal results immediately.

   Rationale: A UAP may collect routine vital signs, assist with personal care, and measure and record output for a stable client; the nurse remains responsible for interpreting findings. Lung assessment is a nursing assessment and must not be delegated. Diet teaching also requires nursing judgment and evaluation of learning.

3. 3.A 63-year-old client with a new diagnosis of type 2 diabetes is being discharged from a clinic. The client says, "I do not know how to tell if my blood sugar is too low." Which nursing action best evaluates whether teaching was effective?

   • A.Ask the client to explain symptoms of hypoglycemia and what action to take if they occur.
   • B.Tell the client that the pharmacist will review the medication instructions.
   • C.Document that diabetes teaching was completed.
   • D.Give the client a brochure about hypoglycemia to read at home.

   Rationale: Teach-back lets the nurse evaluate the client's understanding of both symptoms and appropriate response. A brochure can supplement, but cannot confirm, learning. Deferring teaching to another professional or documenting completion without assessing understanding does not establish readiness for self-management.

4. 4.A 71-year-old client with chronic kidney disease is being discharged after a medication change. The client has prescriptions from several providers and is unsure which medicines to continue. Which action best supports safe care coordination?

   • A.Tell the client to follow the newest prescription label and discard all older medication lists.
   • B.Reconcile the medication list with the client and communicate discrepancies to the prescribing team before discharge.
   • C.Have the client choose which medicines seem most important to continue.
   • D.Ask the client to stop all medicines until the next primary care visit.

   Answer and rationale are in the full material.

5. 5.A 58-year-old client on a surgical unit has a new prescription for an intravenous opioid after abdominal surgery. The client is difficult to arouse, has a respiratory rate of 8/min, and an oxygen saturation of 89%. Which action should the nurse take first?

   • A.Administer the prescribed opioid and reassess pain in 30 minutes.
   • B.Document the sedation and wait for the next scheduled vital signs.
   • C.Hold the opioid, stimulate and assess the client, support ventilation, and activate the appropriate urgent response.
   • D.Give an oral sedative to reduce the client's anxiety.

   Answer and rationale are in the full material.