SNLE practice questions

Question 1

A nurse is preparing to reposition a 78-year-old bedbound patient who has a Braden Scale score of 12. Which nursing action best prevents pressure injury development over the sacrum?

Accepted Answer

Reposition the patient onto a 30-degree lateral tilt position

Answer

Massage the sacral area vigorously to stimulate circulation

Answer

Elevate the head of the bed to 60 degrees continuously for comfort

Answer

Place a ring-shaped (donut) foam cushion under the sacrum

Question 2

A nurse measures the vital signs of an adult patient who weighs 70 kg: BP 88/54 mmHg, pulse 118/min, respirations 24/min, temperature 38.9°C. Urine output has been 15 mL/hr for the last three hours. Which of these findings most directly measures perfusion of an end organ?

Accepted Answer

Urine output of 15 mL/hr

Answer

Temperature of 38.9°C

Answer

Respiratory rate of 24/min

Answer

Pulse of 118/min

Question 3

A patient receiving continuous nasogastric enteral feeding suddenly develops coughing, dyspnea, and oxygen saturation falling from 97% to 88%. What is the nurse's first action?

Accepted Answer

Stop the feeding at once and reposition the patient to protect the airway

Answer

Obtain a stat chest radiograph to confirm aspiration before acting

Answer

Check the gastric residual volume before deciding whether to continue

Answer

Flush the feeding tube with 30 mL of water to confirm correct placement

Question 4

A 62-year-old patient with type 2 diabetes presents with a serum glucose of 640 mg/dL, serum osmolality of 330 mOsm/kg, pH 7.36, and negative serum ketones. Which nursing intervention should the nurse anticipate as the initial priority?

Accepted Answer

Begin isotonic intravenous fluid resuscitation

Answer

Administer intravenous sodium bicarbonate

Answer

Administer a subcutaneous rapid-acting insulin sliding scale dose

Answer

Restrict oral fluids and monitor hourly blood glucose only

Question 5

A patient is admitted with an acute exacerbation of chronic obstructive pulmonary disease. Arterial blood gas on room air shows pH 7.31, PaCO2 62 mmHg, HCO3 30 mEq/L, PaO2 52 mmHg. Which oxygen therapy approach is most appropriate?

Accepted Answer

Titrate controlled oxygen to a target saturation of 88 to 92 percent

Answer

Withhold oxygen to avoid suppressing the hypoxic respiratory drive

Answer

Apply a non-rebreather mask at 15 L/min

Answer

Target an oxygen saturation of 98 to 100 percent with a simple face mask

Question 6

Two days after a total thyroidectomy, a patient reports tingling around the mouth and in the fingertips. On assessment, carpal spasm occurs when the blood pressure cuff is inflated. Which action should the nurse take first?

Accepted Answer

Notify the physician and prepare to administer intravenous calcium gluconate

Answer

Reassure the patient that paresthesia is an expected postoperative finding

Answer

Encourage deep breathing into a paper bag to correct respiratory alkalosis

Answer

Administer the scheduled levothyroxine dose several hours early

Question 7

A patient receiving intravenous vancomycin develops flushing and erythema of the face, neck, and upper torso 20 minutes into the infusion. Blood pressure is 96/58 mmHg. What is the nurse's most appropriate immediate action?

Accepted Answer

Stop the infusion, give an antihistamine, and resume at a slower rate

Answer

Continue the infusion at the same rate and document the reaction

Answer

Administer intramuscular epinephrine and call the rapid response team

Answer

Permanently document vancomycin as a drug allergy in the record

Question 8

A physician orders 250 mg of an antibiotic to be given orally. The pharmacy supplies a suspension labeled 125 mg per 5 mL. How many milliliters should the nurse administer?

Accepted Answer

10 mL

Answer

5 mL

Answer

12.5 mL

Answer

2.5 mL

Question 9

A patient stabilized on warfarin for atrial fibrillation has an INR of 6.5 with no bleeding. Which action should the nurse anticipate?

Accepted Answer

Withhold the warfarin doses and recheck the INR

Answer

Administer intravenous vitamin K 10 mg immediately

Answer

Administer protamine sulfate to reverse the anticoagulation

Answer

Continue the usual warfarin dose and recheck the INR in one week

Question 10

Thirty minutes after a vaginal delivery, a nurse finds that a woman has saturated one perineal pad within the past 15 minutes. The fundus is boggy and palpable above the umbilicus, deviated to the right. What is the nurse's first action?

Accepted Answer

Massage the fundus until it becomes firm

Answer

Assist the woman to empty her bladder before doing anything else

Answer

Place the woman in Trendelenburg position

Answer

Apply firm continuous pressure to the perineum with a sterile pad

Every option explained.Including the ones you didn’t pick.

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