NCLEX-style practice questions

An adult client is scheduled to receive digoxin. The apical pulse, counted for one full minute, is 52 beats/min. What is the nurse's best action?

1. A. Give the dose and recheck the pulse in 1 hour
2. B. Hold the dose and notify the provider per protocol
3. C. Give the dose with food to reduce side effects
4. D. Give a double dose at the next scheduled time

Which client should the nurse assess first?

1. A. A client 6 hours after thyroidectomy who reports new hoarseness and has audible stridor
2. B. A client after appendectomy rating incision pain 6/10
3. C. A client with type 2 diabetes whose blood glucose is 180 mg/dL
4. D. A client with a new arm cast who reports itching under the cast

Which ECG change is most characteristic of hyperkalemia?

1. A. Tall, peaked T waves
2. B. Prominent U waves
3. C. Prolonged QT from a low magnesium level
4. D. Delta waves

A client taking warfarin has an elevated INR with active bleeding. Which medication should the nurse anticipate to reverse warfarin's effect?

1. A. Protamine sulfate
2. B. Vitamin K (phytonadione)
3. C. Naloxone
4. D. Flumazenil

A client is diagnosed with Clostridioides difficile infection. Which precaution is most appropriate?

1. A. Airborne precautions in a negative-pressure room
2. B. Droplet precautions with a surgical mask
3. C. Contact precautions with soap-and-water hand hygiene
4. D. Contact precautions with alcohol-based hand rub only