NCLEX Prep Exam 1 Practice Questions with Solutions, Exams of Nursing

Download NCLEX Prep Exam 1 Practice Questions with Solutions and more Exams Nursing in PDF only on Docsity! Practice Questions: NCLEX Prep Exam 1 with 145 Terms all Solutions 100% Verified & Passed 2023-2024. which of the following interventions are a priority during exacerbation of left sided HF - Verified Answer: high fowlers, O2, diuretics The nurse is preparing a pt to be discharged after a diagnosis of HF. which statement shows an appropriated understanding of nurses teaching - Verified Answer: -I will call doc if I gain more than 2 lbs in a few days an adult is admitted w an acute exacerbation of CHF. vitals are T 99, P 115, R 32, Bp 122/64. 0.5 mg of dig IV and 40 mg of furosemide IV are administered immediately. the nurse recognizes that the meds are having a therapeutic effect if -pulse rate decreases below 100 -pt has decreased crackles and edema -pt has an increased bp, decreased peripheral vascular resistance -the client expectorates frothy sputum - Verified Answer: -pt has decreased crackles and edema-nothing to do w HR because you aren't giving it for that reason. THINK AB THE REASON you're giving it (things like this will be on test) which would you see w right ventricular failure in a pt - Verified Answer: JVD a pts fam asks how to know if pt is improving while receiving furosemide for CHF. The nurse response should be based on understanding that improvement in the pts conditions is characterized by - Verified Answer: -diminishing O2 needs best indictors for cardiac output - Verified Answer: Bp and urine S3 - Verified Answer: indicative of hypertrophy of ventricles what would be the first nursing intervention for an asthma patient w severe anxiety - Verified Answer: stay with the patient which statment by a patient suggests a diagnosis of UTI is likely - Verified Answer: it burns when I pee A home care aide notified the agency that she found the pt lying on the floor when the home health nurse arrived, the newly diagnosed diabetic pt is semi-comatose, w a fast HR and a low bp. The pts skin is warm and dry. Which of the following conditions is suspected - Verified Answer: DKA The nurse administers the pts morning dose of regular insulin at 0730 am the nurse should anticipate observing the pt for a hypoglycemic reaction at which of the following times - Verified Answer: 1000 A pt w DM says "if i could just avoid what you call carbohydrates in my diet, I guess I would be okay.: the nurse should base the response to this comment on the knowledge that diabetes affects the metabolism of which of the following - Verified Answer: Proteins fats and carbohydrates A pt who is started on metformin and glyburide would have initially presented w which symptoms - Verified Answer: Polydipsia, polyuria, and weight gain A diabetic pt who is taking regular and NPH insulin ask why she must mix the two insulins. The nurse explains that regular and NPH insulins are mixed to ensure - Verified Answer: A total duration of action of 24 hrs A nurse is teaching an adult pt who has type 1 DM about ketoacidosis. The nurse explains that the one primary cause of the developmental Ketoacidosis is - Verified Answer: Not taking insulin regularly A 17 yr old is newly diagnosed w DM. she is hospitalized for insulin dose stabilization and is being taught insulin admin and self0monitoring of blood glucose levels. The nurse tells the pt that the major benefit of SMBG levels is - Verified Answer: Blood glucose is maintained close to normal levels A pt w type 1 DM is admitted to the ED. which respiratory patterns require immediate action? - Verified Answer: Deep, rapid respirations w long expirations (Kussmaul's) A 55 yr. old male recently diagnosed w type 2 DM and is prescribed teh sulfonylurea glipizide (Glucotrol). He is concerned ab the diagnosis and says he knows nothing about diabetes. The nurse determines that the pt needs teaching and support. The nurse explains that glipizide is believed to lower the blood glucose level be which of the following actions - Verified Answer: Stimulating insulin release from functioning beta cells in the pancreas. A nurse is attending the bridal shower and another guest starts to tremble and complains of dizziness. The nuse notices a medical alert bracelet for diabetes. The best action for the nurse to take is to - Verified Answer: Give the guest a glass of OJ A woman usually administers her NPH insulin at 0600 am but she plans to attend a banquet and fashion show next week, at which lunch will be served at 1400 rather than noon when she usually eats lunch. Which of the following statements demonstrates to the nurse an understanding of peak action of NPH and risk for hypoglycemia - Verified Answer: I will take the insulin at 0800 am that day A 35 yr old diabetic is displaying signs of irritability and irrational behaviour during an office visit. The nurse observes visible tremors in the pts hands and the pt is a diaphoretic. Based on the pts history and the nurses understanding of DM, the nurse interprets these findings to be a sign of - Verified Answer: hypoglycemia this regimen is not preferred as maintaiing good blood glucose control may be inhibited when treating an unconscious pt w hypoglycemia. which treatmetn is most effective - Verified Answer: D50 IV a pt is diagnosed w type 2 diabetes that must be controlled w 70/30 combination insulin. which intervention should be included in the plan of care - Verified Answer: assess the pts ability to read small print a pt is experiencing DKA who presents w kussmauls respirations. what action takes priority - Verified Answer: -administration of IV insulin a nurse teaches a pt w type 1 DM. which statement would the nurse include in this pts teaching to decrease the pts insulin needs - Verified Answer: -walk at a moderate pace for 1 mile daily which is the mechanism of action of an ACE inhibitor - Verified Answer: blocks angiotensin II and aldosterone which of the following medications can cause a cough that is non- productive - Verified Answer: ACE inhibitor which of the following medications would require checking a pulse before administration - Verified Answer: beta blocker a side effect of both ACE inhibitors and angiotensin receptor blockers is - Verified Answer: angioedema this medication requires the RN to check the potassium prior to administration - Verified Answer: aldosterone antagonists (spironolactone) the provider states that your pt is having problems with increased preload, which med would help decrease pre load - Verified Answer: loop diuretic (furosemide) if something works on arteries it affects ______ and if something works on veins it alters ______ - Verified Answer: -afterload, preload which lab test should be checked before administering diuretics - Verified Answer: potassium as you are administering a beta-blocker, what should the nurse assess before administering this med - Verified Answer: Heart rate which of the following meds could be used in the treatment of heart failure - Verified Answer: diuretics what does it mean when a med has a positive inotropic effect - Verified Answer: increases the contractile force of the myocardium what does it mean when a med has a negative chronotropic effects - Verified Answer: decrease the heart rate or AV conduction which of the following meds is an Angiotension II receptor blocker - Verified Answer: losartan the med digoxin is used for the following condition - Verified Answer: congestive heart failure which of the following meds can decrease the mortality rate for pts experiencing congestive heart failure - Verified Answer: ACE inhibitors -increased T3 -decreased TSH -increaed T4 -increased TSH - Verified Answer: increased TSH what is not included w the s/sx of hashimotos thyroiditis -hyperpyrexia -fatigue and decreased BMR -intolerance to cold -increased cholesterol - Verified Answer: hyperpyrexia s/sx of hypoparathyrodism -chvosteks and trousseau's -anorexia -muscle weakness -depression - Verified Answer: chvostek's and trousseus what disease is hyperfunction of anterior pituitary or adrenal cortex to produce ACTH -addison's -hashimotos -graves -cushings - Verified Answer: cushings which lab value for cushings would you expect -hyperkalemia -hyponatremia -hypokalemia -hypoglycemia - Verified Answer: hypokalemia which lab finding would you expect w addisons -hyperglycemia -hypernatremia -hypokalemia -hyperkalemia - Verified Answer: -hyperkalemia which lab finding would you expect for DIabetes insipidus -specific grac >1.035 -decreased BUN -specivif grac <1.005 - Verified Answer: -specific grac <1.005 a pt is diagnosed w hyperthyroidism and surgery is scheduled because the pt refuses ablation therapy while awaiting the surgical date. the nurse should plan to instruct the pt to - Verified Answer: eliminate coffee, tea, and cola from diet which of the following meds should be available in emergency treatment if a pt develops tetany following a subtotal thyroidectomy -sodium phosphate -calcium gluconate -calcitonin -sodium bicarbonate - Verified Answer: calcium gluconate -tetany is s/sx of hypoparathyroidism nurse ask pt to state name as soon as she regains conscioness post op after subtotal thyroidectomy and at each assessment. the nurse does thsi to monitor for s/ssx fo which -internal hemmorage -decreasing LOC -laryngeal nerve damage -upper - Verified Answer: laryngeal nerve damage a pt w malignant hot nodules of the thyroid gland has a thyroidectomy the nurses priority action should be to -elevate HOB to limit edema of neck -emphasize pt will take steroids whenever her life involves physical or emotional stress - Verified Answer: -emphasizing pt will need steroid replacement for rest of life nurse caring for pt who had a transsphenoidal surgery for a pituitay adenoma. in post op period, the nurse teachs the pt to -remove nasal packing after 48 hours -cough and deep breath hourly -take acetaminophen for severe HA -report frequent swallowing or postnasal drip - Verified Answer: -report frequent swallowing or postnasal drip which of the following should nurse expect w a pt wi addisons -acne -hyperpigmentation -low blood sugar -low K -increased appetite - Verified Answer: hyperpigmentation, low blood sugar, which of the following statements is a concern regarding home care of a pt w addison's disease -if i misss a dose of my steroid meds i should double up on my next dose -i will only need to take the steroids during stressful events -i may need to taper my steroid dose -i will need to monitor myself for weight gain -i should consume a commercial sports beverage when exerising - Verified Answer: -if i misss a dose of my steroid meds i should double up on my next dose -i will only need to take the steroids during stressful events -i should consume a commercial sports beverage when exerising what is NOT a clinical manifestation of Hypoparathyroidism -chovestek's -tetany -muscle weakness, fatigue, and lethargy -trouseau's - Verified Answer: -muscle weakness, fatigue, lethargy what is not included in the medical management with Myxedema Coma -cooling measures, ice packs, cooling blankets, acetaminophen -thyroid replacement therapy -corticosteroids IV -manage airway and be prepared for intubation - Verified Answer: - cooling measures what is the most common cause of cushing's syndrome -pneumonia -autoimmune disease -pituitary adenoma -hirsutism - Verified Answer: pituitary adenoma what is not included for post-op care of a pt post hypophysectomy -monitor neuro status hourly for first 24 hours -monitor nasal drainage -encourage coughing post op to prevent pneumonia -monitor fluid balances, especially for output greater than intake - Verified Answer: -encourage coughing post op to prevent pna what cardiac changes would you expect to have w a pt diagnosed w cushing's disease -hypotension and weak thready pulse -hypovolemia and shock -hypertension, bounding pulse, hypervolemia, and edema formation -hyperkalemia - Verified Answer: -HTN, bounding pulse, hypervolemia, and edema formation -increased DTR -increased bp and decreased pulse -hypotension and tachy -hypothermia and increased pulserate - Verified Answer: ? which would you include in the plan of care for hyperthyroidism? -provide 3 small meals -extra blankets -high fiber diet -restful environment for sleep - Verified Answer: restful environment for sleep Grave's disease. what would you expct to find a history of -diaphoresis -menorreah -dry brittle hair -sensitivity to cold - Verified Answer: -DIAPHORESIS -decreased TSH -increased T3 and when assessing pt w graves, which would you expect to find -constipation, dry skin, weight gain -lethargy, weight gian, forgetfulness -wieght loss, expothalmus, restlessness -lethargy, weight loss, protruding eyeballs - Verified Answer: weight loss, exopthalmus, restlessness pt w subtotal thyroidectomy (due to anatomical location, alwasy think of parathyroid as well) for a tumor resection. pt complains fo feeling funny and jittery. what is nurses best action based on this complaint? -explain that is is expected after thyroid surgery -take vitals and put in highfowlers -stat serum Ca and phos level and document results -test for chovestek's and trousseus and notify provider - Verified Answer: -test for chovestek's and trousseus and notify provider! ---looking for hypocalcemia and this is best choice because you can check it immediately and don't need an order or have to wait for results -subtotal means they won't need lifelong TH replacement therapy planning care for the first 24 hours after thyroidectomy. which is best nursing intervention -check back and sides of dressing for bleeding -support head duirng ROM -encourage feelings of surgery -advise that regular activiites can be resumed immediately - Verified Answer: check back and sides of dressing for bleeding pt complaining of tingling fingers and numbness of mouth. the nurse should check everything EXCEPT -look at medical history -test for trouseus -DTR's -check urine output - Verified Answer: -check urine output ---history would be good to see what meds they are on when discussing depression for pt w hypothyroidism. what is the nurses best response -normal effects of Thyroid hormone replacement therapy and will diminish overtime -most likely related to increase TH levels and will improve w treatment -normal part of having a chronic illness -most likely related to low thyroid hormone levels and will improve w treatment - Verified Answer: -most likley related to low thyroid hormone levels and will improve w treatment which of the following would be priority for a pt w mxedema coma -prevent fluid volume deficit - Verified Answer: maintain electrolyte balances (monitor and replace) SIADH specific grav and treatment - Verified Answer: high -volume overload -treatment is diuretics! and monitor electrolytes pt w SIADH. which manifestation would you report to provider -Sodium of 112 and HA -K of 5 -Ca of 10 and -Mg of 1.2 and large UO - Verified Answer: -Sodium of 112 and HA this is a critical level and can cause seizure nurse admitting pt w addison's. which s/sx would you expect -hypoglycemia brady cardia -high fever, irritable -bronze pigmentation, hypotension, and anorexia -tachy cardia and hypotension - Verified Answer: -bronze pigmentation, hypotension, and anorexia Pt needs to monitor diet for Addison's, which is priority -increase Cals -increase sodium -restrict K -increase protein - Verified Answer: restrict K -make sure they are staying well hydrated which s/sx would indicate a pt w Addison's is receiving too much glucocorticoid treatment -anorexia -dizzienss -weight gain -poor skin turger - Verified Answer: weight gain -need to monitor hydration, diet, intake of K rich foods, notify for addisonina crisis pt w adrenal/addisonian crisis. which changes would indicate pt is responding good to medical and nursing care -UO increased -pts BP is increased -pt loses weight -peripheral edema decreased - Verified Answer: pts bp is increased which diagnosis would be most appropriate for a pt w Cushing's disease -fluid volume deficit: hypernatremia -body image disturbances d/t hirsutism and fat deposits -alterations in nutrition; hypoglycemia -risk for injury d/t increased clotting - Verified Answer: -body image disrubances d/t hirtusim and fat deposits which assessment would be most important w pt w pituitary tumor that secretes ACTH -height -bp -UO -pulse rate - Verified Answer: bp pt experiencing an acute gout attack has received several doses of hourly oral colchicine. As the nurse prepares to administer the next dose, the pt begins vomiting. What action should the nurse take - Verified Answer: Discontinue the med and call the provider when planning the care of a pt w RA, the nurse considers that this disease - Verified Answer: is a systemic inflammatory disorder important pain control education for OA - Verified Answer: -alternate walking briskly and jogging when exercising although they are similar in many ways RA differs from OA in that it is - Verified Answer: systemic after surgery for a fractured hip the pt complains of pain. the nurse should - Verified Answer: perform a complete pain assessment a pt is temporarily placed in Buck's extension traction while awaiting surger for a fractured hip. the nurse would reconnize a complication of the treatment if the following was noted - Verified Answer: -dusky color of the toes of the affected leg to prevent the most common complication following an open reducation and internal fixation of a fractured hip, the nurse should expec to - Verified Answer: apply sequenial compression stockings a pt gets out of bed and becomes anxious and has a feeling if impending doom. the nurse thinks the pt may be experiencing a pulmonary embolus. which action should the nurse implement first - Verified Answer: -place pt in high fowlers position select the true statment regarding compartment syndrome - Verified Answer: s/sx include severe pain on passive stretching, pallar, numbness, and tingling the joints that would most likely be affected in a pt w OA are the - Verified Answer: hips and knees when a pt who has had hip replacement surgery is lying on her side, the nurse should place a pillow between the legs to prevent - Verified Answer: adduction of the hip joint left lower leg is pale and cool in a total knee antroplasty pt. what action is best - Verified Answer: assess the neuromuscular status of the leg a nurse is concerned when assessing a pt w a fracture being treated by traction when - Verified Answer: traction weights are resting on the floor a nurse delegates care of pt in traction to the UAP. which statement is best by the nurse - Verified Answer: -ensure the weights remain freely hanging at all times which pt is highest risk at developing a fat embolus - Verified Answer: - pt w fractured femur