NCLEX Exam Best Questions with Correct Answers Assured Success 2023, Exams of Nursing

Download NCLEX Exam Best Questions with Correct Answers Assured Success 2023 and more Exams Nursing in PDF only on Docsity! This response is correct because both the WBC count and the temperature are within the normal range. A normal WBC is 4000 to 11,000/μL. An elevated WBC count and elevated temperature are indicators of infection. Because fever can lead to excessive perspiration and evaporation of body fluid via the skin, the nurse should monitor the patient's overall intake and output to be sure that the NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 When assessing a patient who is receiving cefazolin (Ancef) for the treatment of a bacterial infection, which data suggest that treatment has been effective? A. White blood cell (WBC) count 8000/μL, temperature 101○ F B. White blood cell (WBC) count 4000/μL, temperature 100○ F C. White blood cell (WBC) count 8500/μL, temperature 98.4○ F Correct D. White blood cell (WBC) count 16,500/μL, temperature 98.8○ F 2. A patient is ordered to receive acetaminophen 650 mg per rectum every 6 hours as needed for fever greater than 102° F. Which parameter would the nurse monitor, other than temperature, if the patient requires this medication? A. Pain level Incorrect B. Intake and output Correct C. Oxygen saturation D. Level of consciousness The finding of an increased number of band neutrophils in circulation is called a shift to the left, which is commonly found in patients with acute bacterial infections. Platelets increase with tissue damage through the inflammatory process and for healing but are not the best indicator of infection. Blood urea nitrogen is unrelated to infection unless it is in the kidney. Myelocytes increase with infection and mature to form band neutrophils, but they are not NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 balance. Pain, oxygen saturation, and level of consciousness will also be monitored as with all patients, but intake and output are the priority for this patient. 3. The nurse determines that the patient may be suffering from an acute bacterial infection based upon which laboratory test result? A. Increased platelet count B. Increased blood urea nitrogen C. Increased number of band neutrophils Correct D. Increased number of segmented myelocytes 4. Which strategy by the nurse would be most helpful in treating a patient who is experiencing chills because of an infection? A. Provide a light blanket. Correct B. Encourage a hot shower. C. Monitor temperature every hour. D. Turn up the thermostat in the patient's room. With a black wound the immediate therapy should be debridement (surgical, mechanical, autolytic, or enzymatic) to prepare the wound bed for healing. Black wounds may have purulent drainage, but debridement is done first. The red wound is handled gently because it is granulating and reepithelializing, but it must be kept slightly moist to heal. The negative- pressure wound (vacuum) therapy is used to remove drainage and is more likely to be used NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 The systemic response to inflammation includes the manifestations of a shift to the left in the WBC count, malaise, nausea, anorexia, increased pulse and respiratory rate, and fever. The local response to inflammation includes redness, heat, pain, swelling, or loss of function at the site of inflammation. There is not an infectious response to inflammation, only an inflammatory response to infection. The acute inflammatory response is a type of inflammation that heals in 2 to 3 weeks and usually leaves no residual damage. 9. An older patient is transferred from the nursing home with a black wound on her heel. What should the nurse expect to be the first treatment of this wound? A. Dress it with an absorbent dressing for exudate. B. Handle the wound gently and let it dry out to heal. C. Debride the nonviable, eschar tissue to allow healing. Correct D. Use negativepressure wound (vacuum) therapy to facilitate healing. 10. A postoperative patient is now able to eat and is requesting a snack. What snack should the nurse recommend for the patient that will facilitate wound healing? A. Apple Incorrect B. Custard Correct Custard would be the best snack because it is made from milk, egg, sugar, and vanilla. Wound healing is facilitated by protein, carbohydrates, and B vitamins. Custard also contains calcium and a small amount of vitamin A and zinc. The other snacks do not offer this abundance of healing nutrients. Orange juice with the custard would be good to provide the Fluid is needed to replace fluid from insensible loss and from exudates as well as the increased metabolic rate. Protein corrects the negative nitrogen balance that results from the increased metabolic rate and that needed for synthesis of immune factors and healing. Vitamin C helps synthesize capillaries and collagen. Vitamin Bcomplex facilitates metabolism. Vitamin A aids in epithelialization. The health care provider should be notified if there are signs of infection. If prophylactic antibiotics are prescribed, they must be taken until they are completely gone. Initially analgesics are taken throughout the day (e.g., every 3 to 4 hours) as needed. Infection must be avoided with aseptic procedures, including washing the hands NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 C. Popsicle D. Potato chips 11. A nurse is teaching a patient how to promote healing following abdominal surgery. What should be included in the teaching (select all that apply)? A. Take the antibiotic until the wound feels better. B. Take the analgesic every day to promote adequate rest for healing. C. Be sure to wash hands after changing the dressing to avoid infection. Incorrect D. Take in more fluid, protein, and vitamins C, B, and A to facilitate healing. Correct E. Notify the health care provider of redness, swelling, and increased drainage. Correct The most important thing to do for this patient is to prevent deterioration of the ulcer and eliminate factors that led to pressure ulcers. This would include eliminating pressure on the reddened area with repositioning every 2 hours in bed and every hour while up in the chair. The nurse must complete the assessment of the new reddened area as well as evaluation of the area. Massage is not used when there is the possibility of damaged blood vessels or fragile skin so the RN cannot advise the UAP to do this until the RN has assessed the patient and the area. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 12. After the unlicensed assistive personnel (UAP) bathed the patient, she then told the nurse about a reddened area on the patient's coccyx. After assessing the area, what should the nurse have the UAP do for the patient? A. Reposition every 2 hours. Correct B. Measure the size of the reddened area. C. Massage the area to increase blood flow. D. Evaluate the area later to see if it is better. 13. The unlicensed assistive personnel (UAP) is assisting the patient with Crohn's disease with perineal care. The UAP tells the nurse that the patient had feces coming from the vagina. What should the nurse do about this situation? A. Notify the health care provider. B. Document the fistula formation. C. Assess the patient and vaginal drainage. Correct The normal range for serum potassium is 3.5 to 5.0 mEq/L. This IV order provides a substantial amount of potassium. Thus the patient's potassium level must be low. The only The normal range for serum sodium is 135 to 145 mEq/L, and the normal range for potassium is 3.5 to 5.0 mEq/L. The change in the IV order decreases the amount of potassium and increases the amount of sodium. Therefore for this order to be appropriate, the potassium level must be near the high end and the sodium level near the low end of NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 C. 4.6 mEq/L D. 5.3 mEq/L 3. You receive a physician's order to change a patient's IV from D5½ NS with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which serum laboratory values on this same patient best support the rationale for this IV order change? A. Sodium 136 mEq/L, potassium 4.5 mEq/L Correct B. Sodium 145 mEq/L, potassium 4.8 mEq/L C. Sodium 135 mEq/L, potassium 3.6 mEq/L D. Sodium 144 mEq/L, potassium 3.7 mEq/L You are caring for a patient admitted with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L, PaO2 92 mm Hg, and O2 saturation of 99%. You interpret these results as The normal pH is 7.35 to 7.45. Normal PaCO2 levels are 35 to 45 mm Hg, and HCO3 is 22 to 26 mEq/L. Normal PaO2 is >80 mm Hg. Normal oxygen saturation is >95%. Since the patient's results all fall within these normal ranges, the nurse can conclude that the A low pH (normal 7.357.45) indicates acidosis. In the patient with respiratory disease such as COPD, the patient retains carbon dioxide (normal 3545 mm Hg), which acts as an acid in the body. For this reason, the patient has respiratory acidosis. The elevated HCO3 indicates a NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 E. slight metabolic acidosis. Incorrect F. slight respiratory acidosis. G. slight respiratory alkalosis. 4. You are caring for a patient admitted with a diagnosis of chronic obstructive pulmonary disease (COPD) who has the following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mEq/L, and O2 saturation of 92%. What is the correct interpretation of these results? A. Fully compensated respiratory alkalosis B. Partially compensated respiratory acidosis Correct C. Normal acidbase balance with hypoxemia D. Normal acidbase balance with hypercapnia 5. You are caring for a patient receiving calcium carbonate for the treatment of osteopenia. Which serum laboratory result would you identify as an adverse effect related to this therapy? A. Sodium falling to 138 mEq/L Incorrect Calcium has an inverse relationship with phosphorus in the body. When phosphorus levels fall, calcium rises, and vice versa. Since hypercalcemia rarely occurs as a result of calcium intake, the patient's phosphorus falling to 2.1 mg/dL (normal 2.44.4 mg/dL) may be a result of the phosphatebinding effect of calcium carbonate. Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the kidneys to excrete sodium and potassium. Thus administration of this type of medication at this time would worsen the hypokalemia, putting the patient at risk for dysrhythmias. The prescribing physician should be consulted for potassium replacement therapy, and the drug should be withheld until the potassium has returned to normal range. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. Potassium rising to 4.1 mEq/L C. Magnesium rising to 2.9 mg/dL D. Phosphorus falling to 2.1 mg/dL Correct 6. You are caring for a patient admitted with heart failure. The morning laboratory results reveal a serum potassium level of 2.9 mEq/L. Which classification of medications should you withhold until consulting with the physician? A. Antibiotics B. Loop diuretics Correct C. Bronchodilators D. Antihypertensives Incorrect Measuring weight is the most reliable means of detecting changes in fluid balance. Weight loss would indicate the dehydration is worsening, whereas weight gain would indicate restoration of fluid volume. Recall that a 1kg weight gain indicates a gain of approximately 1000 mL of The minimal urine output necessary to maintain kidney function is 30 mL/hr. If the output is less than this for 2 consecutive hours, the nurse should be notified so that additional fluid volume replacement therapy can be instituted. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. Monitor daily weight and intake and output. Correct C. Monitor diastolic blood pressure for increases. D. Encourage the patient to reduce sodium intake. 11. When planning the care of a patient with dehydration, what would the nurse instruct the unlicensed assistive personnel (UAP) to report? A. 60 mL urine output in 90 minutes B. 1200 mL urine output in 24 hours C. 300 mL urine output per 8hour shift D. 20 mL urine output for 2 consecutive hours Correct 12. When planning care for a patient with dehydration related to nausea and vomiting, the nurse would anticipate which fluid shift to occur because of the fluid volume deficit? A. Fluid movement from the blood vessels into the cells In dehydration, fluid is lost first from the blood vessels. To compensate, fluid moves out of the interstitial spaces into the blood vessels to restore circulating volume in that compartment. As the interstitial spaces then become volume depleted, fluid moves out of Daily fluid intake and output is usually 2000 to 3000 mL. This is sufficient to meet the needs of the body and replace both sensible and insensible fluid losses. These would include urine output and fluids lost through the respiratory system, skin, and GI tract. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. Fluid movement from the interstitial spaces into the cells Incorrect C. Fluid movement from the blood vessels into interstitial spaces D. Fluid movement from the interstitial space into the blood vessels Correct 13. When planning care for adult patients, which oral intake is adequate to meet daily fluid needs of a stable patient? A. 500 to 1500 mL B. 1200 to 2200 mL Incorrect C. 2000 to 3000 mL Correct D. 3000 to 4000 mL 14. While caring for a patient with metastatic bone cancer, which clinical manifestations would alert the nurse to the possibility of hypercalcemia in this patient? A. Weakness Correct Signs of hypercalcemia are lethargy, headache, weakness, muscle flaccidity, heart block, anorexia, nausea, and vomiting. Paresthesia, facial spasms, and muscle tremors are A daily fluid intake of 3000 to 4000 mL is necessary to enhance calcium excretion and prevent the formation of renal calculi, a potential complication of hypercalcemia. Tums are a calcium- based antacid that should not be used in patients with hypercalcemia. Weightbearing exercise NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. Paresthesia C. Facial spasms D. Muscle tremors 15. While performing patient teaching regarding hypercalcemia, which statements are appropriate (select all that apply)? A. Have patient restrict fluid intake to less than 2000 mL/day. B. Renal calculi may occur as a complication of hypercalcemia. Correct C. Weightbearing exercises can help keep calcium in the bones. Correct D. The patient should increase daily fluid intake to 3000 to 4000 mL. Correct E. Treatment of heartburn can best be managed with Tums as needed. Incorrect 16. The patient has chronic kidney disease and ate a lot of nuts, bananas, peanut butter, and chocolate. The patient is admitted with loss of deep tendon reflexes, somnolence, and altered respiratory status. What treatment should the nurse expect for this patient? After a paracentesis of 5 L or greater of ascites fluid, 25% albumin solution may be used as a volume expander. Normal saline, lactated Ringer's, and 5% dextrose in 0.45% saline will not be effective for this action. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 The cap off the central line could allow entry of air into the circulation. For an air emboli, oxygen is administered; the catheter is clamped; the patient is positioned on the left side with the head down. Then the physician is notified. 20. The patient was admitted for a paracentesis to remove ascites fluid. Five liters of fluid was removed. What IV solution may be used to pull fluid into the intravascular space after the paracentesis? A. 0.9% sodium chloride B. 25% albumin solution Correct C. Lactated Ringer's solution D. 5% dextrose in 0.45% saline 1. What should the nurse expect to do to prepare a patient for an intravenous pyelogram (IVP)? A. Administer a cathartic or enema. Correct B. Assess patient for allergies to penicillin. C. Keep the patient NPO for 4 hours preprocedure. D. Advise the patient that a metallic taste may occur during procedure. In addition to urine formation, the kidneys release renin to maintain blood pressure, activate vitamin D to maintain calcium levels, and produce erythropoietin to stimulate RBC production. Carbohydrate metabolism and hemolysis of old RBCs are not physiologic functions that are NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 Nursing responsibilities in caring for a patient undergoing an IVP include administration of a cathartic or enema to empty the colon of feces and gas. The nurse will also assess the patient for iodine sensitivity, keep the patient NPO for 8 hours preprocedure, and advise the patient that warmth, a flushed face, and a salty taste during injection of contrast material 2. In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions important to the maintenance of homeostasis. Which physiologic processes are performed by the kidneys (select all that apply)? A. Production of renin Correct B. Activation of vitamin D Correct C. Carbohydrate metabolism Incorrect D. Erythropoietin production Correct E. Hemolysis of old red blood cells (RBCs) Incorrect 3. As a component of the headtotoe assessment of a patient who has been recently transferred to the clinical unit, the nurse is preparing to palpate the patient's kidneys. How should the nurse position the patient for this assessment? A. Prone B. Supine Correct To palpate the right kidney, the patient is positioned supine, and the nurse's left hand is placed behind and supports the patient's right side between the rib cage and the iliac crest. The right flank is elevated with the left hand, and the right hand is used to palpate deeply for the right kidney. The normalsized left kidney is rarely palpable because the spleen lies Painful and difficult urination is characterized as dysuria. Anuria is an absence of urine production, whereas oliguria is diminished urine production. Enuresis is involuntary nocturnal NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 C. Seated at the edge of the bed Incorrect D. Standing, facing away from the nurse 4. A 70yearold male patient has sought care because of recent difficulties in establishing and maintaining a urine stream as well as pain that occasionally accompanies urination. How should the nurse document this abnormal assessment finding? A. Anuria B. Dysuria Correct C. Oliguria D. Enuresis 5. A patient with a history of recurrent urinary tract infections has been scheduled for a cystoscopy. What teaching point should the nurse emphasize before the procedure? A. "You might have pinktinged urine and burning after your cystoscopy." Correct The patient's symptoms are typical of a urinary tract infection (UTI). To verify this, a clean catch urine specimen must be obtained for a specimen of urine to culture. Drinking less fluid will not improve the symptoms. Acetaminophen would not decrease the discomfort; an antibiotic would be needed. Avoiding caffeine and spicy food may decrease bladder If the patient is unable to void, the bladder may be palpated for distention, percussed for dullness if it is full, or a bladder scan may be done to determine the approximate amount of urine in the bladder. A cystometrogram visualizes the bladder and evaluates vesicoureteral NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 9. The patient called the clinic with manifestations of burning on urination, dysuria, and frequency. What is the best advice for the nurse to give the patient? A. "Drink less fluid so you don't have to void so often." B. "Take some acetaminophen to decrease the discomfort." C. "Come in so we can check a clean catch urine specimen." Correct D. "Avoid caffeine and spicy food to decrease inflammation." 10. The patient had surgery and a urinary catheter. Eight hours after catheter removal and drinking fluids, the patient has not been able to void. What should the nurse do first to assess for urinary retention? A. Bladder scan Correct B. Cystometrogram C. Residual urine test D. Kidneys, ureters, bladder (KUB) xray Bumetanide (Bumex) is a loop diuretic that acts in the loop of Henle to decrease reabsorption of sodium and chloride. Because the loop of Henle loses function with aging, the excretion of drugs becomes less and less efficient. Thus the circulating levels of drugs are increased and their effects prolonged. The benign enlargement of prostatic tissue, decreased sensation of bladder capacity, and loss of concentrating ability do not directly affect the action of loop NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 shape, and positions of kidneys and possibly a full bladder. Neither of these would be useful in this situation. A residual urine test requires urination before catheterizing the patient to determine the amount of urine left in the bladder, so this assessment would not be helpful for 11. Which effect of aging on the urinary system is most likely to affect the action of bumetanide (Bumex)? A. Benign enlargement of prostatic tissues Incorrect B. Decreased sensation of bladder capacity C. Decreased function of the loop of Henle Correct D. Less absorption in the Bowman's capsule 1. A nurse is admitting a patient with the diagnosis of advanced renal carcinoma. Based upon this diagnosis, the nurse will expect to find what clinical manifestations as the "classic triad" occurring in patients with renal cancer? A. Fever, chills, flank pain B. Hematuria, flank pain, palpable mass Correct C. Hematuria, proteinuria, palpable mass There are no characteristic early symptoms of renal carcinoma. The classic manifestations of gross hematuria, flank pain, and a palpable mass are those of PKD is one of the most common genetic diseases. The adult form of PKD may range from a relatively mild disease to one that progresses to chronic kidney disease. Polyuria, deafness, and blindness are not associated with PKD. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 D. Flank pain, palpable abdominal mass, and proteinuria 2. Which nursing intervention is most appropriate in providing care for an adult patient with newly diagnosed adult onset polycystic kidney disease (PKD)? A. Help the patient cope with the rapid progression of the disease. Incorrect B. Suggest genetic counseling resources for the children of the patient. Correct C. Expect the patient to have polyuria and poor concentration ability of the kidneys. D. Implement appropriate measures for the patient's deafness and blindness in addition to the renal problems. 3. An older male patient visits his primary care provider because of burning on urination and production of urine that he describes as "foul smelling." The health care provider should assess the patient for what factor that may put him at risk for a urinary tract infection (UTI)? A. Highpurine diet B. Sedentary lifestyle Incorrect C. Benign prostatic hyperplasia (BPH) Correct Although all the manifestations are evident with urinary tract infections (UTIs), pain location is useful in differentiating among pyelonephritis, cystitis, and urethritis because flank pain is characteristic of pyelonephritis, but dysuria is characteristic of cystitis and urethritis. Urethral discharge is indicative of urethritis, not pyelonephritis or cystitis. Fever and chills and mental confusion are nonspecific indicators of UTIs. Urinary hesitancy and postvoid dribbling may occur with a UTI but may also occur with prostate enlargement in the male This UTI is a complicated UTI because the patient has type 2 diabetes and the UTI is recurrent. Ciprofloxacin (Cipro) would be used for a complicated UTI. Fosfomycin (Monurol), nitrofurantoin (Macrodantin), and trimethoprim/sulfamethoxazole (Bactrim) NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 C. Mental confusion D. Urinary hesitancy Incorrect E. Urethral discharge Correct F. Postvoid dribbling Incorrect 8. The patient with type 2 diabetes has a second UTI within one month of being treated for a previous UTI. Which medication should the nurse expect to teach the patient about taking for this infection? A. Ciprofloxacin (Cipro) Correct B. Fosfomycin (Monurol) C. Nitrofurantoin (Macrodantin) Incorrect D. Trimethoprim/sulfamethoxazole (Bactrim) Hypertension occurs with chronic glomerulonephritis that may be found in patients with scleroderma. Obstructive uropathy, Goodpasture syndrome, and calcium oxalate urinary calculi are not related to scleroderma and do not cause hypertension. Of the options listed, only salad made with fresh vegetables would be acceptable for the diet that limits sodium and protein as well as saturated fat if hyperlipidemia is present. Peanut butter and crackers are processed so they contain significant sodium, and peanut butter contains some protein. A pork chop is a highprotein food with saturated fat. Canned NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 9. The patient has scleroderma and is experiencing hypertension. The nurse should know that this could be related to which renal problem? A. Obstructive uropathy Incorrect B. Goodpasture syndrome C. Chronic glomerulonephritis Correct D. Calcium oxalate urinary calculi 10. When caring for a patient with nephrotic syndrome, the nurse should know the patient understands dietary teaching when the patient selects which food item? A. Peanut butter and crackers Incorrect B. One small grilled pork chop C. Salad made of fresh vegetables Correct D. Spaghetti with canned spaghetti sauce To teach pelvic floor exercises, or Kegel exercise, the nurse should instruct the patient (without contracting the legs, buttocks, or abdomen) to contract the muscles around the rectum (pelvic floor muscles) as if stopping a stool, which should result in a pelvic lifting ESWL is noninvasive, but anesthesia is used to maintain the patient's position. The other types of lithotripsy are invasive. Laser lithotripsy uses an ureteroscope and small fiber to reach the stone. Electrohydraulic lithotripsy positions a probe directly on the stone; then NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 11. Which instruction should the nurse provide when teaching a patient to exercise the pelvic floor? A. Tighten both buttocks together. B. Squeeze thighs together tightly. C. Contract muscles around rectum. Correct D. Lie on back and lift legs together. 12. The patient is wondering why anesthesia is needed when the lithotripsy being done is noninvasive. The nurse explains that the anesthesia is required to ensure the patient's position is maintained during the procedure. The nurse knows that this type of lithotripsy is called A. laser lithotripsy. Incorrect B. electrohydraulic lithotripsy. C. percutaneous ultrasonic lithotripsy. D. extracorporeal shockwave lithotripsy (ESWL). Correct Chancres appear in the primary stage of the bacterial invasion of Treponema pallidum, the causative organism of syphilis. The other findings do not appear until the secondary stage of syphilis, occurring a few weeks after the chancres appear. Teaching for patients with an STI should include the treatment of all sexual partners; cotton undergarments are more comfortable; sexual abstinence is needed during the communicable phase of the infection to prevent spread, and condoms should be used for sexual activity during and after treatment to prevent spread and reinfection. Douching may spread the infection or alter the local immune responses and is therefore contraindicated in patients with NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 D. Regional adenopathy 2. What should teaching for patients with a sexually transmitted infection (STI) include (select all that apply)? A. Treatment of sexual partners Correct B. Douching may help to provide relief of itching. C. Cotton undergarments are preferred over synthetic materials. Correct D. Sexual abstinence is indicated during the communicable phase of the disease. Correct E. Condoms should be used during as well as after treatment during sexual activity.* Correct 3. A 22yearold male is being treated at a college health care clinic for gonorrhea. Which teaching point should the nurse include in patient teaching? Treatment for gonorrhea necessitates abstinence from sexual activity (to prevent infection of partners) and alcohol (to avoid urethral irritation). The disease is not selflimiting, nor does successful treatment confer future resistance. Because of the potential for infertility, routine screening for Chlamydia is recommended for women sexually active under age 25 and annually for those over 25 with one or more risk NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 A. "While being treated for the infection, you will not be able to pass this infection on to your sexual partner." B. "While you're taking the antibiotics, you will need to abstain from participating in sexual activity and drinking alcohol." Correct C. "It's important to complete your full course of antibiotics in order to ensure that you become resistant to reinfection." D. "The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring." 4. A 24yearold patient is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. She is sexually active and has multiple partners. What should the nurse explain to the patient as the rationale for screening her for Chlamydia? A. Chlamydia is frequently comorbid with HIV. B. Chlamydial infections may progress to sepsis. C. Untreated chlamydial infections can lead to infertility. Correct D. Chlamydial infections are treatable only in the early stages of infection. Incorrect A primary episode of genital herpes is often marked by multiple small, vesicular lesions on the genitals. This symptomatology is not commonly associated with HIV, gonorrhea, or Chlamydia. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 is not a primary risk for sepsis and is not noted to be strongly correlated with HIV infection. The disease is treatable at all stages of infection. 5. A 30yearold female patient has sought care because of the recent appearance of itchy lesions on her vulva, some of which have recently burst. What problem should the nurse first suspect related to the patient's description of her problem? A. HIV B. Gonorrhea C. Chlamydia D. Genital herpes Correct 6. The physical assessment and history of a 29yearold female patient are indicative of human papillomavirus (HPV) infection. What teaching should the nurse provide to the patient? A. Gardasil Incorrect B. Antibiotic therapy C. Wart removal options Correct D. Treatment with antiviral drugs Abstinence and then condom use are the best prevention of STIs. Spermicidal jellies or creams do not reduce the risk of contracting STIs. Most STIs are curable, but complications are serious and costly if they are not cured. Douches may spread the infection, undermine local immune responses, and do not prevent STIs. Cleansing of the penis will provide comfort Dimpling of the breast is highly suspicious for carcinoma of the breast. Dark pink genitalia, watery cervical mucus, and triangular pubic hair distribution are all normal female NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. STIs are easily cured, so prevention is not important. C. Abstinence and then condoms are the best prevention. Correct D. Douches for women and cleaning the penis will prevent STIs. 1. What is an abnormal finding the nurse should identify during physical assessment of the female reproductive system? A. Dimpling of breast Correct B. Dark pink genitalia C. Watery cervical mucus D. Triangular hair distribution 2. Which male patient is most susceptible to experiencing erectile dysfunction as a consequence of his drug regimen? A. A patient who has been prescribed a βadrenergic blocker for hypertension Correct Antihypertensives are commonly implicated in cases of erectile dysfunction. Antibiotics, PPIs, and SSRIs are less likely to negatively impact men's sexual function. An absence of pubic hair is an unexpected finding in the older male patient. It is common for the left testicle to hang lower than the right, and the intestines are often not palpable through the inguinal rings. The foreskin should be easily retractable. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 B. A patient who uses a proton pump inhibitor (PPI) to control his acid reflux C. A patient who is taking a cephalosporin antibiotic in order to treat cellulitis D. A patient who takes a selective serotonin reuptake inhibitor (SSRI) to treat his depression Incorrect 3. The nurse is performing an admission assessment of a 70yearold male patient prior to bladder resection surgery. What assessment finding of the patient's genitourinary system constitutes an unexpected finding? A. The patient's left testicle hangs lower than his right. B. Pubic hair is absent from the patient's genital region. Correct C. The patient's intestines are not palpable through the inguinal rings. D. The patient's foreskin can be manually retracted to expose the meatus. Incorrect 4. A 48yearold woman has sought care because of urinary incontinence. The woman states that running or jumping often precipitates leakage of urine, an event that has been occurring with increasing regularity in recent months. Which assessment question is most relevant to try to determine the cause of the patient's problem? Trauma to the pelvic musculature during birth is often the cause of urge and stress incontinence in female patients. UTIs, family history, and exercise are less likely to contribute Stroke is a common cause of erectile dysfunction. A stroke and underlying cardiovascular disease is unlikely to be related to an inguinal hernia, testosterone deficiency, or BPH. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 A. "Do you find that you are prone to frequent urinary tract infections (UTIs)?" B. "Do you know if your mother or sisters have experienced similar problems?" C. "Did you experience any muscle damage when giving birth to your children?" Correct D. "Do you participate in a regular program of physical exercise and stretching?" 5. A 58yearold male patient with a history of transient ischemic attacks (TIAs) is undergoing rehabilitation following an ischemic stroke. The patient's medical history is likely to be related to what health problems? A. Inguinal hernia B. Erectile dysfunction Correct C. Testosterone deficiency D. Benign prostatic hyperplasia (BPH) Incorrect 6. A 78yearold female is complaining about hair growing on her chin. How should the nurse explain this occurrence to this patient? A technician usually administers a calculated dose of a radioisotope 2 hours before a bone scan. If the patient was injected at 9:00 AM, the procedure should be done at 11:00 AM. 10:00 AM would be too early; 1:00 PM and 9:30 PM would be too late. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 A prolactin assay will detect pituitary dysfunction that can cause amenorrhea. Human chorionic gonadotropin (hCG) is used to detect pregnancy. The biologic tumor markers, α- fetoprotein, hCG, and CA 125 may be used to assess for reproductive malignancies and to monitor therapy. Venereal disease research laboratory (VDRL) is a nonspecific antibody test used to screen for syphilis, a sexually transmitted infection. 1. A 54yearold patient admitted with cellulitis and probable osteomyelitis received an injection of radioisotope at 9:00 AM before a bone scan. The nurse should plan to send the patient for the bone scan at what time? A. 9:30 PM Incorrect B. 10:00 AM C. 11:00 AM Correct D. 1:00 PM 2. A 54yearold patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information? A. Two additional followup scans will be required. B. There will be only mild pain associated with the procedure. Incorrect C. The procedure takes approximately 15 to 30 minutes to complete. Patients are asked to drink increased fluids after a bone scan to aid in excretion of the radioisotope, if not contraindicated by another condition. No followup scans and no pain are associated with bone scans that take 1 hour of lying supine. Corticosteroids are associated with avascular necrosis and decreased bone and muscle mass. βblockers, calciumchannel blockers, and antiplatelet aggregators are not commonly associated with damage to the musculoskeletal system. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 D. The patient will be asked to drink increased fluids after the procedure. Correct 3. Musculoskeletal assessment is an important component of care for patients on what type of long term therapy? A. Corticosteroids Correct B. βAdrenergic blockers C. Antiplatelet aggregators D. Calciumchannel blockers Incorrect 4. A female patient with a longstanding history of rheumatoid arthritis has sought care because of increasing stiffness in her right knee that has culminated in complete fixation of the joint. The nurse would document the presence of which problem? A. Atrophy B. Ankylosis Correct C. Crepitation Ankylosis is stiffness or fixation of a joint, whereas contracture is reduced movement as a consequence of fibrosis of soft tissue (muscles, ligaments, or tendons). Atrophy is a flabby appearance of muscle leading to decreased function and tone. Crepitation is a grating or Passive ROM should be performed with extreme caution and may be best avoided when assessing older patients. Observing the patient's active ROM is more accurate and safe than asking the patient to lift weights with her legs. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 D. Contracture 5. The nurse is performing a musculoskeletal assessment of an 81yearold female patient whose mobility has been progressively decreasing in recent months. How should the nurse best assess the patient's range of motion (ROM) in the affected leg? A. Observe the patient's unassisted ROM in the affected leg. Correct B. Perform passive ROM, asking the patient to report any pain. Incorrect C. Ask the patient to lift progressive weights with the affected leg. D. Move both of the patient's legs from a supine position to full flexion. 6. In reviewing bone remodeling, what should the nurse know about the involvement of bone cells? A. Osteoclasts add canaliculi. B. Osteoblasts deposit new bone. Correct C. Osteocytes are mature bone cells. A technician usually administers a calculated dose of a radioisotope 2 hours before a bone scan. If the patient was injected at 9:00 AM, the procedure should be done at 11:00 AM. 10:00 AM would be too early; 1:00 PM and 9:30 PM would be too late. Patients are asked to drink increased fluids after a bone scan to aid in excretion of the radioisotope, if not contraindicated by another condition. No followup scans and no pain are associated with bone scans that take 1 hour of lying supine. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 A. 9:30 PM Incorrect B. 10:00 AM C. 11:00 AM Correct D. 1:00 PM 2. A 54yearold patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information? A. Two additional followup scans will be required. B. There will be only mild pain associated with the procedure. Incorrect C. The procedure takes approximately 15 to 30 minutes to complete. D. The patient will be asked to drink increased fluids after the procedure. Correct 3. Musculoskeletal assessment is an important component of care for patients on what type of long term therapy? Corticosteroids are associated with avascular necrosis and decreased bone and muscle mass. βblockers, calciumchannel blockers, and antiplatelet aggregators are not commonly associated with damage to the musculoskeletal system. Ankylosis is stiffness or fixation of a joint, whereas contracture is reduced movement as a consequence of fibrosis of soft tissue (muscles, ligaments, or tendons). Atrophy is a flabby appearance of muscle leading to decreased function and tone. Crepitation is a grating or NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 A. Corticosteroids Correct B. βAdrenergic blockers C. Antiplatelet aggregators D. Calciumchannel blockers Incorrect 4. A female patient with a longstanding history of rheumatoid arthritis has sought care because of increasing stiffness in her right knee that has culminated in complete fixation of the joint. The nurse would document the presence of which problem? A. Atrophy B. Ankylosis Correct C. Crepitation D. Contracture Passive ROM should be performed with extreme caution and may be best avoided when assessing older patients. Observing the patient's active ROM is more accurate and safe than asking the patient to lift weights with her legs. Bone remodeling is achieved when osteoclasts remove old bone and osteoblasts deposit new bone. Osteocytes are mature bone cells, and osteons or Haversian systems create a dense bone structure, but these are not involved with bone remodeling. NR NCLEX EXAM BEST QUESTIONS WITH CORRECT ANSWERS ASSURED SUCCESS 2023 5. The nurse is performing a musculoskeletal assessment of an 81yearold female patient whose mobility has been progressively decreasing in recent months. How should the nurse best assess the patient's range of motion (ROM) in the affected leg? A. Observe the patient's unassisted ROM in the affected leg. Correct B. Perform passive ROM, asking the patient to report any pain. Incorrect C. Ask the patient to lift progressive weights with the affected leg. D. Move both of the patient's legs from a supine position to full flexion. 6. In reviewing bone remodeling, what should the nurse know about the involvement of bone cells? A. Osteoclasts add canaliculi. B. Osteoblasts deposit new bone. Correct C. Osteocytes are mature bone cells. D. Osteons create a dense bone structure.