NSG524 Study Guide

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Sample questions from NSG524 Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.A client admitted with pneumonia becomes confused. Respiratory rate is 32/min, blood pressure is 84/46 mm Hg, and urine output has decreased. Which action should the RN take first?

   • A.Activate the emergency response pathway and begin immediate supportive assessment and care
   • B.Give the prescribed antipyretic and reassess in 1 hour
   • C.Ask an assistant to determine whether the client needs oxygen
   • D.Complete routine discharge teaching before contacting the provider

   Rationale: A is correct because infection with hypotension, altered mentation, and reduced urine output suggests sepsis with impaired perfusion requiring immediate escalation and stabilization. B delays treatment of organ dysfunction. C improperly delegates assessment and judgment. D gives a nonurgent task priority over a potentially life-threatening change.

2. 2.A conscious client with diabetes has a glucose of 58 mg/dL and can swallow safely. Which intervention is most appropriate?

   • A.Provide a high-fat snack and recheck glucose at bedtime
   • B.Withhold treatment because the client is conscious
   • C.Administer the scheduled rapid-acting insulin
   • D.Give approximately 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes

   Rationale: B is correct because rapid carbohydrate followed by a 15-minute recheck is appropriate initial treatment for hypoglycemia with safe swallowing. A would worsen the low glucose. C provides slower absorption and inadequate reassessment timing. D is incorrect because consciousness does not eliminate the need for prompt treatment.

3. 3.A client with severe asthma is increasingly drowsy. Wheezing that was loud 20 minutes ago is now barely audible, and air movement is poor. How should the nurse interpret this change?

   • A.The client is experiencing an expected sedating effect of oxygen
   • B.The bronchodilator has resolved the exacerbation
   • C.The client may be developing respiratory failure
   • D.The client is ready for discharge teaching

   Rationale: C is correct because a quiet chest with poor air movement and drowsiness suggests critically reduced airflow and fatigue. A confuses reduced airflow with improvement. B is unsafe during deterioration. D is incorrect because oxygen does not normally produce this pattern as an expected sedating effect.

4. 4.Which task is most appropriate for the RN to delegate to a trained nursing assistant?

   • A.Determine whether chest pain is cardiac in origin
   • B.Obtain a scheduled weight for a stable client and report the result
   • C.Assess new shortness of breath after a transfusion
   • D.Teach a newly diagnosed client how to inject insulin

   Answer and rationale are in the full material.

5. 5.A client being treated for diabetic ketoacidosis has a potassium level of 3.1 mEq/L before the insulin infusion begins. Which action is appropriate?

   • A.Administer potassium by intravenous push
   • B.Delay insulin and initiate prescribed potassium replacement according to protocol
   • C.Ignore the potassium because total-body potassium is always elevated in ketoacidosis
   • D.Begin insulin immediately because the glucose is elevated

   Answer and rationale are in the full material.