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2023/2024 NCLEX FINAL EXAM READINESS STUDY GUIDE 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
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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
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,https://www.stuvia.com/user/lectkeshi
A cervical cerclage is placed to prevent preterm delivery, usually in
clients with histories of second trimester loss or premature birth. A
heavy suture is placed transvaginally or transabdominally to keep the
internal cervical os closed. Placement occurs at 12–14 weeks
gestation for clients with a history of cervical insufficiency (ie,
painless, premature cervical dilation and miscarriage or preterm
delivery) or up to 23 weeks gestation if signs of cervical insufficiency
(eg, short cervix) are noted.
Discharge instructions include activity restriction and recognition of signs of
preterm
labor (eg, low back aches, contractions, pelvic pressure) and rupture
of membranes (Option 2).
(Option 1) Bed rest is usually recommended for a few days after the
procedure. Long-term bed rest is individualized but uncommon and
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, https://www.stuvia.com/user/lectkeshi
increases the risk for complications (eg, deep vein thrombosis). Pelvic
rest (eg, avoiding sexual intercourse) is determined by the health care
provider.
(Option 3) Mild abdominal cramping following cerclage placement is
common; however, regular contractions, pelvic pressure, and low back
aches may indicate preterm labor.
(Option 4) The cerclage remains in place until 36–37 weeks gestation.
Early removal is indicated by rupture of membranes (to prevent
infection) or preterm labor (to prevent damage to the cervix as it
dilates).
Educational objective:
Following cerclage placement, discharge teaching includes recognizing
and reporting signs of preterm labor (eg, low back aches, contractions,
pelvic pressure) or rupture of membranes and understanding activity
restrictions (eg, bed rest for a short time after placement)
Question: 3
https://www.stuvia.com/user/lectkeshi
2023/2024 NCLEX FINAL EXAM READINESS STUDY GUIDE 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
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
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
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
A cervical cerclage is placed to prevent preterm delivery, usually in
clients with histories of second trimester loss or premature birth. A
heavy suture is placed transvaginally or transabdominally to keep the
internal cervical os closed. Placement occurs at 12–14 weeks
gestation for clients with a history of cervical insufficiency (ie,
painless, premature cervical dilation and miscarriage or preterm
delivery) or up to 23 weeks gestation if signs of cervical insufficiency
(eg, short cervix) are noted.
Discharge instructions include activity restriction and recognition of signs of
preterm
labor (eg, low back aches, contractions, pelvic pressure) and rupture
of membranes (Option 2).
(Option 1) Bed rest is usually recommended for a few days after the
procedure. Long-term bed rest is individualized but uncommon and
https://www.stuvia.com/user/lectkeshi
, https://www.stuvia.com/user/lectkeshi
increases the risk for complications (eg, deep vein thrombosis). Pelvic
rest (eg, avoiding sexual intercourse) is determined by the health care
provider.
(Option 3) Mild abdominal cramping following cerclage placement is
common; however, regular contractions, pelvic pressure, and low back
aches may indicate preterm labor.
(Option 4) The cerclage remains in place until 36–37 weeks gestation.
Early removal is indicated by rupture of membranes (to prevent
infection) or preterm labor (to prevent damage to the cervix as it
dilates).
Educational objective:
Following cerclage placement, discharge teaching includes recognizing
and reporting signs of preterm labor (eg, low back aches, contractions,
pelvic pressure) or rupture of membranes and understanding activity
restrictions (eg, bed rest for a short time after placement)
Question: 3
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