2023 Nclex Final Exam Readiness Study Guide (May-August QTR). With 100% Correct Answers & Rationale Graded A+ (Guaranteed Pass)

Question: 1 Correct Answer: 2 What intervention is essential prior to starting a client on atorvastatin therapy? 1. Assessing for muscle strength 2. Assessing the client's dietary intake 3. Determining if the client is on digoxin therapy 4. Monitoring liver function tests Rationale The client's central venous pressure (CVP) is elevated (normal value 2-8 mm Hg), indicating increased systemic circulation volume and increased right ventricular preload. Pulmonary artery wedge pressure (PAWP) is also elevated (normal value 6-12 mm Hg), indicating increased left ventricular preload. In the presence of increased CVP and PAWP, coarse crackles indicate left- sided failure. The treatment goal is to decrease fluid volume and preload. Furosemide is a loop diuretic that will decrease both left- and right-sided preload. (Option 1) A fluid bolus of 500 mL of sodium chloride is contraindicated in a client with increased left and right ventricular preload as it would exacerbate fluid overload. (Option 3) Beta blockers (eg, metoprolol, atenolol, esmolol) will decrease both blood pressure and afterload. However, they will not decrease preload. (Option 4) Vancomycin is an antibiotic used to treat gram-positive bacterial infections (eg, methicillin- resistant Staphylococcus aureus); it has no effect on fluid status. Educational objective: Loop diuretics (eg, furosemide, bumetanide, torsemide) are effective in decreasing both right ventricular preload and left ventricular preload. Question: 2 Correct Answer: 2 The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage. Which client statement indicates an understanding of teaching? 1. "I need to be on bed rest for the duration of my pregnancy." 2. "I will notify my health care provider if I start having low back aches." 3. "Pelvic pressure is to be expected after cerclage placement." 4. "The cerclage will be removed once my baby is at 28 weeks." Rationale