NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2023), Exams of Nursing

Download NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2023) and more Exams Nursing in PDF only on Docsity! Option C. Grunting occurs when an infant attempts to maintain an adequate functional residual capacity in the face of poorly compliant lungs by partial glottic closure. As the infant prolongs the expiratory phase against this partially closed glottis, there is a prolonged and increased residual volume that maintains the airway opening and also an audible expiratory sound. Option E: Nasal flaring occurs when the nostrils widen while breathing and is a sign of troubled breathing or respiratory distress. Correct Answers: C, E, F, & G NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2023) 1.1. Question While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply. o A. Abdominal respirations o B. Irregular breathing rate o C. Inspiratory grunt o D. Increased heart rate with crying o E. Nasal flaring o F. Cyanosis o G. Asymmetric chest movement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Have the client empty the bladder. The first step in the process is to have the client void prior to administering the pre-operative medication. If the Correct order is shown above. • 2. Question A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications. View Answers: o Place the call bell within reach o Raise the side rails on the bed o Have the client empty bladder o Instruct the client to remain in bed NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option F: Cyanosis refers to the bluish discoloration of the skin and indicates a decrease in oxygen attached to the red blood cells in the bloodstream. o Option G: Asymmetric chest movement occurs when the abnormal side of the lungs expands less and lags behind the normal side. This indicates respiratory distress. o Option A: Abdominal respiration is normal among infants and young children. Since their intercostal muscles are not yet fully developed, they use their abdominal muscles much more to pull the diaphragm down for breathing. o Option B: Newborns can have irregular breathing patterns ranging from 30 to 60 breaths per minute with short periods of apnea (15 seconds). o Option D: An increase in heart rate is normal for an infant during activity (including crying). Option A: African-Americans develop high blood pressure at younger ages than other groups in the US. Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension. Option B: The incidence of hypertension in Asian- Americans does not appear to be significantly higher than the general population, according to limited US data. Option C: The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African-Americans with greater risks than Caucasians. Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity. Correct Answer: A: 45-year-old African American attorney o B. 60-year-old Asian-American shop owner o C. 40-year-old Caucasian nurse o D. 55-year-old Hispanic teacher • 5. Question A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first? o A. Gastric lavage o B. Administer acetylcysteine (Mucomyst) orally o C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. Have the patient drink activated charcoal mixed with water Correct Answer: A. Gastric lavage o Option A: Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life- threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion. o Option B: The oral formulation of acetylcysteine is the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetylcysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen to its nontoxic form. When given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally or intravenously. o Option C: Intermittent IV infusion with Dextrose 5% may be considered for late-presenting or chronic ingestion. o Option D: Oral activated charcoal (AC) avidly adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) since it can effectively adsorb it and neutralize the benefits. • 6. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: A. Go get a blood pressure check within the next 15 minutes The blood pressure reading is moderately high with the need to have it rechecked after a few minutes to verify. The client states it is ‘usually much lower.’ Thus a concern exists for complications such as stroke. o Options B & D: Waiting 2 months or a week for follow-up is too long. o Option C: Immediate check by the provider of care is not warranted. • 9. Question At a community health fair, the blood pressure of a 62-year- old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to: o A. Go get a blood pressure check within the next 15 minutes o B. Check blood pressure again in two (2) months o C. See the healthcare provider immediately o D. Visit the health care provider within one (1) week for a BP check • 10. Question The hospital has sounded the call for a disaster drill on the evening shif . Whic of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission? NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Decreasing amounts of body fat and muscle mass are common in toddlers. o Option B: A decrease in the change in body appearance occurs among young adults. Option B: The client with antibiotic-induced diarrhea still needs continuous strict monitoring as the blood sugar levels may become unstable and dehydration is still possible. Option C: Stevens-Johnson syndrome (SJS) is a rare, serious disorder of the skin and mucous membranes. It’s usually a reaction to medication that starts with flu-like symptoms, followed by a painful rash that spreads and blisters. Option D: Cellulitis is often an underestimated complication of HIV disease, but they are responsible for an appreciable morbidity. Correct Answer: A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and admitted with bacterial pneumonia five days ago. The best candidate for discharge is one who has had a chronic condition and is most familiar with their care. This client in option A is most likely stable and could continue medication therapy at home. o A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and admitted with bacterial pneumonia five days ago. o B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with antibiotic-induced diarrhea 24 hours ago. o C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and was admitted with Stevens-Johnson syndrome that morning. o D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48 hours ago. • 11. Question A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication: NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Notify the healthcare provider of the child’s status Option A: Levothyroxine (Synthroid) has a side effect of insomnia. Taking it in the morning could prevent interfering with the client’s sleeping pattern. Option B: Some of the side effects of Levothyroxine include hyperactivity and an increase in heart rate. Option C: Keep this drug in a cool, dark, and dry place. Option D: A decrease in the heart rate is the desired effect of Levothyroxine. Correct Answer: A. Should be taken in the morning o A. Should be taken in the morning o B. May decrease the client’s energy level o C. Must be stored in a dark container o D. Will decrease the client’s heart rate • 12. Question A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first? o A. Prepare the child for X-ray of upper airways o B. Examine the child’s throat o C. Collect a sputum specimen o D. Notify the healthcare provider of the child’s status NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Avoiding very heavy meals Eating large, heavy meals can pull blood away from the heart for digestion and is dangerous for the client with coronary artery disease. Too much plaque may accumulate in the arteries and block the delivery of blood and oxygen in major organs of the body. Option A: The client in option A might be experiencing an overdose. Option B: The client in option B is having withdrawal syndrome. Option D: The client in option D may experience a decrease in sensorium later on due to head trauma. Correct Answer: C. An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 10. Nurses who are floated to other units should be assigned to a client who has minimal anticipated immediate complications of their problem. This client exhibits opioid toxicity with the pinpoint pupils and has the least risk of complications to occur in the near future. o D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room. • 16. Question When teaching a client with coronary artery disease about nutrition, the nurse should emphasize: o A. Eating three (3) balanced meals a day o B. Adding complex carbohydrates o C. Avoiding very heavy meals o D. Limiting sodium to 7 gms per day NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Discomfort at the IV insertion site may indicate inflammation or infection of the site. Option B: Morphine is a strong painkiller indicated for severe pain. Option D: The pump is working correctly if there is only 50 ml left at noon. Correct Answer: C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon The minimal dose of 10 mL per hour which would be 40 mL given in a four (4) hour period. Only 60 mL should be left at noon. The pump is not functioning when more than expected medicine is left in the container. • 17. Question Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working? o A. The client complains of discomfort at the IV insertion site o B. The client states “I just can’t get relief from my pain.” o C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon o D. The level of the drug is 100 ml at 8 AM and is 50 ml at noon • 18. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Eating a balanced diet should be a part of the management of a client with coronary artery disease. o Option B: Complex carbohydrates decrease inflammation and help decrease the risk of plaque build-up in the arteries. o Option C: People with cardiovascular diseases should have a limit of less than 1.5 Correct Answer: A. Decrease in the level of Option A: Too much exposure to electrical energy can become a hazard to one’s health. Option C: Mind-body balance refers to yoga. Option D: Low-impact aerobic exercises are easier on the joints but are not part of chiropractic medicine. Correct Answer: B. Spinal column manipulation The theory underlying chiropractic is that interference with the transmission of mental impulses between the brain and body organs produces diseases. Such interference is caused by the misalignment of the vertebrae. Manipulation reduces subluxation. The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response? o A. Electrical energy fields o B. Spinal column manipulation o C. Mind-body balance o D. Exercise of joints • 19. Question The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention? o A. Decrease in the level of consciousness o B. Loss of bladder control o C. Altered sensation to stimuli o D. Emotional lability NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: There is no need to keep the client on NPO before the procedure. Option B: Enemas are not recommended for any type of radiograph test. Option C: Furosemide (Lasix) is unnecessary for this examination. Correct Answer: D. No special orders are necessary for this examination There are no special orders for this procedure, however, the client must be instructed of the general rule during radiography tests: remove any clothing, jewelry, or objects that may interfere with the test. • 22. Question Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test? o A. Client must be NPO before the examination o B. Enema to be administered prior to the examination o C. Medicate client with furosemide 20 mg IV 30 minutes prior to the examination o D. No special orders are necessary for this examination • 23. Question The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question? o A. “You need to regain your strength before attempting such exertion.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option D: The symptoms are indicative of an emergency situation so the patient must be brought to the emergency department Option A: The instruction in option A is vague and does not specifically tell the patient how to determine if the activity is already appropriate for him. Option C: Having a glass of wine is not recommended for a client who just had a myocardial infarction. Option D: Having an active walking program does not guarantee that the client has regained strength for strenuous activity. Correct Answer: B. “When you can climb 2 flights of stairs without problems, it is generally safe.” There is a risk of cardiac rupture at the point of the myocardial infarction for about six (6) weeks. Scar tissue should form about that time. Waiting until the client can tolerate climbing stairs is the usual advice given by healthcare providers. o B. “When you can climb 2 flights of stairs without problems, it is generally safe.” o C. “Have a glass of wine to relax you, then you can try to have sex.” • 24. Question A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first? o A. A 2-month-old infant with a history of rolling off the bed and has bulging fontanelle with crying o B. A teenager who got a singed beard while camping o C. An elderly client with complaints of frequent liquid brown colored stools o D. A middle-aged client with intermittent pain behind the right scapula NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: When an infant is crying, the fontanels may look like they are bulging. Option C: The client in Option C can wait to be seen within the first hour. Option D: The client in Option D does not have a life- threatening condition but will still require immediate pain relief. Correct Answer: B. A teenager who got a singed beard while camping This client is in the greatest danger with a potential of respiratory distress. Any client with singed facial hair has been exposed to heat or fire in close range that could have caused serious damage to the interior of the lungs. Note that the interior lining of the lungs has no nerve fibers so the client will not be aware of swelling. Option A: The statement in Option A is correct but pertains to the risks associated with a toddler. Option B: Setting limits on a toddler may cause frustration instead of independence. Correct Answer: C. “I understand the need to use those new skills.” Erikson describes the stage of the toddler as being the time when there is normally an increase in autonomy. The child needs to use motor skills to explore the environment and develop autonomy. • 25. Question While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs? o A. “I want to protect my child from any falls.” o B. “I will set limits on exploring the house.” o C. “I understand the need to use those new skills.” o D. “I intend to keep control over our child.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: The cerebellum is not affected in rhabdomyosarcoma. Option C: The kidneys are not directly affected by the disease. Option D: Bones are not directly affected by the disease. Rhabdomyosarcoma is the most common children’s soft tissue sarcoma. It originates in striated (skeletal) muscles and can be found anywhere in the body. Symptoms of rhabdomyosarcoma include if the cancer is in the head or neck area: sudden bulging or swelling of the eyes, conjunctival chemosis, and headache. It can also affect the urinary or reproductive system. Its common site of metastasis is the lung. Option A: Living in harmony with one’s natural environment with the aim of keeping all aspects of a person-mind, body, and spirit- in a state of harmony and balance so that disease never has a chance to develop. Option B: This balance and a healthy lifestyle are the focus of Chinese medicine which empowers the individual to participate in his own health. Correct Answer: D. Restore yin and yang For followers of Chinese medicine, health is maintained through the balance between the forces of yin and yang. Traditional Chinese medicine is a medical system that began being developed in China about 5000 years ago, which makes it the oldest continuous medical system on the planet. • 29. Question The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to: o A. Achieve harmony o B. Maintain a balance of energy o C. Respect life o D. Restore yin and yang NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Force fluids and reassess blood pressure Orthostatic hypotension, a decrease in systolic blood pressure of more than 15 mmHg, and an increase in heart rate of more than 15 percent usually accompanied by dizziness indicate volume depletion, inadequate vasoconstrictor mechanisms, and autonomic insufficiency. o Option A: Fluids may not be necessarily protein-rich. o Option B: Restricting fluids could aggravate the client’s dizziness. • 30. Question During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to: o A. Increase fluids that are high in protein o B. Restrict fluids o C. Force fluids and reassess blood pressure o D. Limit fluids to non-caffeine beverages • 31. Question The nurse prepares the client for the insertion of a pulm nary artery catheter (Swan-Ganz catheter). The nurse teac e the clien that the cath ter will be inserted to provide inf rmation about: NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option C: In Chinese medicine, the body, and indeed a human being, is not seen as a machine, living in isolation from the world around it. Human beings are seen as part of the whole of things, which includes our Correct Answer: B. Initiate high- quality chest compressions Option A: Stroke volume is calculated using measurements of ventricle volumes from an echocardiogram and subtracting the volume of the blood in the ventricle at the end of a beat (called end- systolic volume) from the volume of blood just prior to the beat (called end-diastolic volume). Option B: Cardiac output is calculated by multiplying the stroke volume by the heart rate. Option C: The CVP can be measured either manually using a manometer or electronically using a transducer. Correct Answer: D. Left ventricular functioning The catheter is placed in the pulmonary artery. Information regarding left ventricular function is obtained when the catheter balloon is inflated. o A. Stroke volume o B. Cardiac output o C. Venous pressure o D. Left ventricular functioning • 32. Question A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is: o A. Start a peripheral IV o B. Initiate high-quality chest compressions o C. Establish an airway o D. Obtain the crash cart NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” o C. “I have to use the bedpan to pass my water at least every 1 to 2 hours.” o D. “It seems that the pain medication is not working as well today.” Correct Answer: B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” The nurse would be concerned about all of these comments, however, the most life-threatening is option B. Clients who had hip or knee surgery are at higher risk for the development of postoperative pulmonary embolism. Sudden dyspnea and tachycardia are classic findings of pulmonary embolism. Without prophylaxis (e.g., anticoagulation medications), deep vein thrombosis can develop within 7 to 14 days following the surgery and can lead to pulmonary embolism. The nurse should be aware of the other signs of DVT which include: pain and tenderness at or below the area of the clot, skin discoloration, swelling, or tightness of the affected leg. Signs of pulmonary embolism include acute onset of dyspnea, tachycardia, confusion, and pleuritic chest pain. o Option A: Muscle spasms occur after total hip replacements and acute pain is expected after a surgical procedure. o Option C: May indicate urinary infection and needs further assessment by the nurse. o Option D: May require a reevaluation of pain and interventions to manage pain though does not need immediate action. • 36. Question A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) assessment cues below may indicate the client is experiencing a negative side effect from the medication? o A. Weight gain of 5 pounds NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Decreased appetite Furosemide is a loop diuretic that is used for pulmonary edema, edema in heart failure, nephrotic syndrome, and hypertension. Furosemide causes a loss of potassium unless a supplement or a potassium-rich diet is taken. A decrease in appetite is caused by hypokalemia. Signs and symptoms of hypokalemia include anorexia, fatigue, nausea, decreased GI motility, muscle weakness, dysrhythmias, reduced urine osmolality, altered level of consciousness. o Option A: Weight gain is not a negative side effect of furosemide. o Option B: Edema of the ankles are indications for the administration of furosemide. o Option C: Gastric irritability is not a side Correct Answer: B. Imp ove the client’s nutrition status Venous stasis occurs when venous blood collects and stagnates in the lower leg due to incompetent venous valves. Eventually, little oxygen and nutrients are supplied o B. Edema of the ankles o C. Gastric irritability o D. Decreased appetite • 37. Question The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing in ervention would be most effective in promoting healing? o A. Apply dressing using sterile technique o B. Improve the client’s nutrition status o C. Initiate limb compression therapy o D. Begin proteolytic debridement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Positive feedback is most useful when given immediately. Option C: Negative statements are never helpful in any given situation. Option D: Every goal should always be attainable. Correct Answer: A. Specific feedback is given as close to the event as possible Feedback is most useful when given immediately. Positive behavior is strengthened through immediate feedback, and it is easier to modify problem behaviors if the standards are clearly understood. Option B: Patients with multiple sclerosis should not exercise to the point of fatigue as strenuous physical exercise raises body temperature and may aggravate symptoms. Option E: Continuous exercise with no rest periods is contraindicated for patients with multiple sclerosis Correct answers: B & E. o D. Performance goals should be higher than what is attainable • 39. Question The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply. o A. “I can lift weights and do resistance training.” o B. “I should exercise to the point of exhaustion.” o C. “I can include aerobic exercises in my routine.” o D. “Proper stretching should be done before starting my routine.” o E. “I should exercise continuously without rest.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. We have safety bars installed in the bathroom and have 24-hour alarms on the doors. Note all options are correct statements. However, safety is most important to reinforce. o Option C: Ensuring safety of the client with increasing memory loss is a priority of home • 40. Question During the evaluation of the quality of home care for a client with Alzheimer’s disease, the priority for the nurse is to reinforce which statement by a family member? o A. “At least two (2) full meals a day are eaten.” o B. “We go to a group discussion every week at our community center.” o C. “We have safety bars installed in the bathroom and have 24-hour alarms on the doors.” o D. “The medication is not a problem to have it taken three (3) times a day.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) who wants to exercise. The patient should be advised to take short rest periods, preferably lying down. Again, extreme fatigue may contribute to the exacerbation of symptoms. o Option A: Exercises should include activities that would strengthen weak muscles because diminishing muscle strength is often a primary concern in multiple sclerosis. These activities include lifting weights and resistance exercises. o Option C: Aerobic exercises help promote muscle efficiency, increase flexibility, improves mood, and helps eliminate stress. o Option D: Muscle stretching should be included prior to exercise as this helps minimize muscle spasticity and contractures o Option A: Warfarin (Coumadin). Has a pregnancy category X and associated with central nervous system defects, spontaneous abortion, stillbirth, Correct Answer: A. Warfarin (Coumadin); B. Finasteride (Propecia, Proscar) • 41. Question A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply. o A. Warfarin (Coumadin) o B. Finasteride (Propecia, Proscar) o C. Celecoxib (Celebrex) o D. Clonidine (Catapres) o E. Transdermal nicotine (Habitrol) o F. Clofazimine(Lamprene) NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) be removed in order to prevent falls and other injuries. A hazard-free home environment allows the patient maximum independence and a sense of autonomy. o Option A: In addition to proper nutrition, mealtimes should be kept pleasant, simple, calm, and without confrontations. Patients with AD prefer foods that are familiar, appetizing, and tastes good. Food should be cut into smaller pieces when possible to prevent choking. Hot food and beverages should be served warm or have their temperature checked to prevent burns. o Option B: Socialization is encouraged for patients with dementia. Participation in simple activities, visits from friends, doing hobbies, or caring for pets helps improve the quality of life. so your body reacts to it in a similar way that it does to vitamin A. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Sulfasalazine may discolor the urine or skin to orange-yellow color. Sulfasalazine is used to treat ulcerative colitis (UC), and to decrease the frequency of UC attacks. Sulfasalazine will not cure ulcerative colitis, but it can reduce the number of attacks you have. Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. Correct Answer: D. Aspirin Aspirin is not known to cause discoloration of the urine. Side effects and complications of taking aspirin include stroke caused by a burst blood vessel. The Food and Drug Administration doesn’t recommend aspirin therapy for the prevention of heart attacks in people who haven’t already had a heart attack, stroke or another cardiovascular condition. • 43. Question A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration? o A. Sulfasalazine o B. Levodopa o C. Phenolphthalein o D. Aspirin NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option F: Nitro-Dur patch is used to prevent chest pain or angina. Its side effects are headache, lightheadedness, nausea, and • 44. Question You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drugs, if found inside the fridge, should be removed? o A. Nadolol (Corgard) o B. Opened (in-use) Humulin N injection o C. Urokinase (Kinlytic) o D. Epoetin alfa IV (Epogen) Correct Answer: A. Corgard Nadolol (Corgard) is stored at room temperature between 59 to 86 ºF (15 and 30 ºC) away from heat, moisture, and light. Do not store in the bathroom and keep the bottle tightly closed. o Option B: Humulin N injection if unopened (not in use) is stored in the fridge and can be used until the expiration date, or stored at room temperature and used within 31 days. If opened (in-use), store the vial in a refrigerator or at room temperature and use within 31 days. Store the injection pen at room temperature (do not refrigerate) and use within 14 days. Keep it in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen. o Option C: Urokinase (Kinlytic) is refrigerated at 2– 8°C. Lyophilized Urokinase although stable at room temperature for 3 weeks, should be stored NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option C: Phenolphthalein can discolor the urine to a red color. Phenolphthalein is often used as an indicator in acid-base titrations. For this application, it turns colorless in acidic immune complexes. o Option B: IgD antibodies are found in small amounts in the tissues that line the belly or chest. Secreted IgD appears to enhance mucosal homeostasis and NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Before reporting to a social worker, it is imperative to start a prophylaxis to reduce viral replication. Option C: Pentamidine is an antimicrobial medication given to prevent and treat pneumocystis pneumonia. Option D: It is natural to have strong emotions after an exposure to HIV in the workplace. The healthcare Correct Answer: B. Start prophylactic AZT treatment Azidothymidine (AZT) treatment is the most critical intervention. It is an antiretroviral medication used to prevent and treat HIV/AIDS by reducing the replication of the virus. Post-exposure prophylaxis (PEP) for HIV is a treatment to suppress the virus and prevent infection after exposure. PEP should be taken within 72 hours of possible exposure to HIV, so it is important to seek treatment quickly. • 46. Question A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take? o A. Immediately see a social worker o B. Start prophylactic AZT treatment o C. Start prophylactic Pentamidine treatment o D. Seek counseling NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) immune surveillance by “arming” myeloid effector cells such as basophils and mast cells with IgD antibodies reactive against mucosal antigens, including commensal and pathogenic microbes. o Option C: IgE antibodies cause the body to react against foreign substances such as pollen, spores, animal dander. IgE antibodies are found in the lungs, skin, and mucous membranes. They are involved in allergic • 47. Question A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? o A. Atherosclerosis o B. Diabetic nephropathy o C. Autonomic neuropathy o D. Somatic neuropathy Correct Answer: C. Autonomic neuropathy Autonomic neuropathy (also known as Diabetic Autonomic Neuropathy) affects the autonomic nerves, which control the bladder, intestinal tract, and genitals, among other organs. Paralysis of the bladder is a common symptom of this type of neuropathy, as manifested by bladder urgency and inability to start urination. o Option A: Atherosclerosis, or hardening of the arteries, is a condition in which plaque builds up inside the arteries. Plaque is made of cholesterol, fatty substances, cellular waste products, calcium, and fibrin (a clotting material in the blood). o Option B: Diabetic nephropathy (DN) is typically defined by macro albuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24- hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) worker might feel anger, fear, blame, or depression. During the difficult time of prevention treatment and waiting, they may want to seek support. Try an employee- assistance program or local mental health Option A: Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the large intestine; most people don’t have symptoms. Option C: Hypocalcemia is low calcium levels in the blood; it is asymptomatic in mild forms but can cause paresthesia, tetany, muscle cramps, and carpopedal spasms in severe hypocalcemia. Option D: Irritable bowel syndrome is a widespread condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety, or previous intestinal infection. Correct Answer: B. Hypercalcemia Hypercalcemia can cause polyuria, severe abdominal pain, and confusion. A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect? o A. Diverticulosis o B. Hypercalcemia o C. Hypocalcemia o D. Irritable bowel syndrome • 50. Question Rhogam is most often used to treat mothers that have a infant. o A. RH positive, RH positive o B. RH positive, RH negative o C. RH negative, RH positive NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option C. Grunting occurs when an infant attempts to maintain an adequate functional residual capacity in the face of poorly compliant lungs by partial glottic closure. As the infant prolongs the expiratory phase against this partially closed glottis, there is a prolonged and increased residual volume that maintains the airway opening and also an audible expiratory sound. Option E: Nasal flaring occurs when the nostrils widen while breathing and is a sign of troubled breathing or respiratory distress. Correct Answers: C, E, F, & G NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2023) 1.1. Question While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply. o A. Abdominal respirations o B. Irregular breathing rate o C. Inspiratory grunt o D. Increased heart rate with crying o E. Nasal flaring o F. Cyanosis o G. Asymmetric chest movement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Have the client empty the bladder. The first step in the process is to have the client void prior to administering the pre-operative medication. If the Correct order is shown above. • 2. Question A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications. View Answers: o Place the call bell within reach o Raise the side rails on the bed o Have the client empty bladder o Instruct the client to remain in bed NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option F: Cyanosis refers to the bluish discoloration of the skin and indicates a decrease in oxygen attached to the red blood cells in the bloodstream. o Option G: Asymmetric chest movement occurs when the abnormal side of the lungs expands less and lags behind the normal side. This indicates respiratory distress. o Option A: Abdominal respiration is normal among infants and young children. Since their intercostal muscles are not yet fully developed, they use their abdominal muscles much more to pull the diaphragm down for breathing. o Option B: Newborns can have irregular breathing patterns ranging from 30 to 60 breaths per minute with short periods of apnea (15 seconds). o Option D: An increase in heart rate is normal for an infant during activity (including crying). Option A: African-Americans develop high blood pressure at younger ages than other groups in the US. Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension. Option B: The incidence of hypertension in Asian- Americans does not appear to be significantly higher than the general population, according to limited US data. Option C: The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African-Americans with greater risks than Caucasians. Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity. Correct Answer: A: 45-year-old African American attorney o B. 60-year-old Asian-American shop owner o C. 40-year-old Caucasian nurse o D. 55-year-old Hispanic teacher • 5. Question A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first? o A. Gastric lavage o B. Administer acetylcysteine (Mucomyst) orally o C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. Have the patient drink activated charcoal mixed with water Correct Answer: A. Gastric lavage o Option A: Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life- threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion. o Option B: The oral formulation of acetylcysteine is the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetylcysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen to its nontoxic form. When given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally or intravenously. o Option C: Intermittent IV infusion with Dextrose 5% may be considered for late-presenting or chronic ingestion. o Option D: Oral activated charcoal (AC) avidly adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) since it can effectively adsorb it and neutralize the benefits. • 6. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: A. Go get a blood pressure check within the next 15 minutes The blood pressure reading is moderately high with the need to have it rechecked after a few minutes to verify. The client states it is ‘usually much lower.’ Thus a concern exists for complications such as stroke. o Options B & D: Waiting 2 months or a week for follow-up is too long. o Option C: Immediate check by the provider of care is not warranted. • 9. Question At a community health fair, the blood pressure of a 62-year- old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to: o A. Go get a blood pressure check within the next 15 minutes o B. Check blood pressure again in two (2) months o C. See the healthcare provider immediately o D. Visit the health care provider within one (1) week for a BP check • 10. Question The hospital has sounded the call for a disaster drill on the evening shif . Whic of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission? NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Decreasing amounts of body fat and muscle mass are common in toddlers. o Option B: A decrease in the change in body appearance occurs among young adults. Option B: The client with antibiotic-induced diarrhea still needs continuous strict monitoring as the blood sugar levels may become unstable and dehydration is still possible. Option C: Stevens-Johnson syndrome (SJS) is a rare, serious disorder of the skin and mucous membranes. It’s usually a reaction to medication that starts with flu-like symptoms, followed by a painful rash that spreads and blisters. Option D: Cellulitis is often an underestimated complication of HIV disease, but they are responsible for an appreciable morbidity. Correct Answer: A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and admitted with bacterial pneumonia five days ago. The best candidate for discharge is one who has had a chronic condition and is most familiar with their care. This client in option A is most likely stable and could continue medication therapy at home. o A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and admitted with bacterial pneumonia five days ago. o B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with antibiotic-induced diarrhea 24 hours ago. o C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and was admitted with Stevens-Johnson syndrome that morning. o D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48 hours ago. • 11. Question A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication: NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Notify the healthcare provider of the child’s status Option A: Levothyroxine (Synthroid) has a side effect of insomnia. Taking it in the morning could prevent interfering with the client’s sleeping pattern. Option B: Some of the side effects of Levothyroxine include hyperactivity and an increase in heart rate. Option C: Keep this drug in a cool, dark, and dry place. Option D: A decrease in the heart rate is the desired effect of Levothyroxine. Correct Answer: A. Should be taken in the morning o A. Should be taken in the morning o B. May decrease the client’s energy level o C. Must be stored in a dark container o D. Will decrease the client’s heart rate • 12. Question A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first? o A. Prepare the child for X-ray of upper airways o B. Examine the child’s throat o C. Collect a sputum specimen o D. Notify the healthcare provider of the child’s status NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Avoiding very heavy meals Eating large, heavy meals can pull blood away from the heart for digestion and is dangerous for the client with coronary artery disease. Too much plaque may accumulate in the arteries and block the delivery of blood and oxygen in major organs of the body. Option A: The client in option A might be experiencing an overdose. Option B: The client in option B is having withdrawal syndrome. Option D: The client in option D may experience a decrease in sensorium later on due to head trauma. Correct Answer: C. An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 10. Nurses who are floated to other units should be assigned to a client who has minimal anticipated immediate complications of their problem. This client exhibits opioid toxicity with the pinpoint pupils and has the least risk of complications to occur in the near future. o D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room. • 16. Question When teaching a client with coronary artery disease about nutrition, the nurse should emphasize: o A. Eating three (3) balanced meals a day o B. Adding complex carbohydrates o C. Avoiding very heavy meals o D. Limiting sodium to 7 gms per day NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Discomfort at the IV insertion site may indicate inflammation or infection of the site. Option B: Morphine is a strong painkiller indicated for severe pain. Option D: The pump is working correctly if there is only 50 ml left at noon. Correct Answer: C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon The minimal dose of 10 mL per hour which would be 40 mL given in a four (4) hour period. Only 60 mL should be left at noon. The pump is not functioning when more than expected medicine is left in the container. • 17. Question Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working? o A. The client complains of discomfort at the IV insertion site o B. The client states “I just can’t get relief from my pain.” o C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon o D. The level of the drug is 100 ml at 8 AM and is 50 ml at noon • 18. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Eating a balanced diet should be a part of the management of a client with coronary artery disease. o Option B: Complex carbohydrates decrease inflammation and help decrease the risk of plaque build-up in the arteries. o Option C: People with cardiovascular diseases should have a limit of less than 1.5 Correct Answer: A. Decrease in the level of Option A: Too much exposure to electrical energy can become a hazard to one’s health. Option C: Mind-body balance refers to yoga. Option D: Low-impact aerobic exercises are easier on the joints but are not part of chiropractic medicine. Correct Answer: B. Spinal column manipulation The theory underlying chiropractic is that interference with the transmission of mental impulses between the brain and body organs produces diseases. Such interference is caused by the misalignment of the vertebrae. Manipulation reduces subluxation. The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response? o A. Electrical energy fields o B. Spinal column manipulation o C. Mind-body balance o D. Exercise of joints • 19. Question The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention? o A. Decrease in the level of consciousness o B. Loss of bladder control o C. Altered sensation to stimuli o D. Emotional lability NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: There is no need to keep the client on NPO before the procedure. Option B: Enemas are not recommended for any type of radiograph test. Option C: Furosemide (Lasix) is unnecessary for this examination. Correct Answer: D. No special orders are necessary for this examination There are no special orders for this procedure, however, the client must be instructed of the general rule during radiography tests: remove any clothing, jewelry, or objects that may interfere with the test. • 22. Question Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test? o A. Client must be NPO before the examination o B. Enema to be administered prior to the examination o C. Medicate client with furosemide 20 mg IV 30 minutes prior to the examination o D. No special orders are necessary for this examination • 23. Question The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question? o A. “You need to regain your strength before attempting such exertion.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option D: The symptoms are indicative of an emergency situation so the patient must be brought to the emergency department Option A: The instruction in option A is vague and does not specifically tell the patient how to determine if the activity is already appropriate for him. Option C: Having a glass of wine is not recommended for a client who just had a myocardial infarction. Option D: Having an active walking program does not guarantee that the client has regained strength for strenuous activity. Correct Answer: B. “When you can climb 2 flights of stairs without problems, it is generally safe.” There is a risk of cardiac rupture at the point of the myocardial infarction for about six (6) weeks. Scar tissue should form about that time. Waiting until the client can tolerate climbing stairs is the usual advice given by healthcare providers. o B. “When you can climb 2 flights of stairs without problems, it is generally safe.” o C. “Have a glass of wine to relax you, then you can try to have sex.” • 24. Question A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first? o A. A 2-month-old infant with a history of rolling off the bed and has bulging fontanelle with crying o B. A teenager who got a singed beard while camping o C. An elderly client with complaints of frequent liquid brown colored stools o D. A middle-aged client with intermittent pain behind the right scapula NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: When an infant is crying, the fontanels may look like they are bulging. Option C: The client in Option C can wait to be seen within the first hour. Option D: The client in Option D does not have a life- threatening condition but will still require immediate pain relief. Correct Answer: B. A teenager who got a singed beard while camping This client is in the greatest danger with a potential of respiratory distress. Any client with singed facial hair has been exposed to heat or fire in close range that could have caused serious damage to the interior of the lungs. Note that the interior lining of the lungs has no nerve fibers so the client will not be aware of swelling. Option A: The statement in Option A is correct but pertains to the risks associated with a toddler. Option B: Setting limits on a toddler may cause frustration instead of independence. Correct Answer: C. “I understand the need to use those new skills.” Erikson describes the stage of the toddler as being the time when there is normally an increase in autonomy. The child needs to use motor skills to explore the environment and develop autonomy. • 25. Question While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs? o A. “I want to protect my child from any falls.” o B. “I will set limits on exploring the house.” o C. “I understand the need to use those new skills.” o D. “I intend to keep control over our child.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: The cerebellum is not affected in rhabdomyosarcoma. Option C: The kidneys are not directly affected by the disease. Option D: Bones are not directly affected by the disease. Rhabdomyosarcoma is the most common children’s soft tissue sarcoma. It originates in striated (skeletal) muscles and can be found anywhere in the body. Symptoms of rhabdomyosarcoma include if the cancer is in the head or neck area: sudden bulging or swelling of the eyes, conjunctival chemosis, and headache. It can also affect the urinary or reproductive system. Its common site of metastasis is the lung. Option A: Living in harmony with one’s natural environment with the aim of keeping all aspects of a person-mind, body, and spirit- in a state of harmony and balance so that disease never has a chance to develop. Option B: This balance and a healthy lifestyle are the focus of Chinese medicine which empowers the individual to participate in his own health. Correct Answer: D. Restore yin and yang For followers of Chinese medicine, health is maintained through the balance between the forces of yin and yang. Traditional Chinese medicine is a medical system that began being developed in China about 5000 years ago, which makes it the oldest continuous medical system on the planet. • 29. Question The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to: o A. Achieve harmony o B. Maintain a balance of energy o C. Respect life o D. Restore yin and yang NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Force fluids and reassess blood pressure Orthostatic hypotension, a decrease in systolic blood pressure of more than 15 mmHg, and an increase in heart rate of more than 15 percent usually accompanied by dizziness indicate volume depletion, inadequate vasoconstrictor mechanisms, and autonomic insufficiency. o Option A: Fluids may not be necessarily protein-rich. o Option B: Restricting fluids could aggravate the client’s dizziness. • 30. Question During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to: o A. Increase fluids that are high in protein o B. Restrict fluids o C. Force fluids and reassess blood pressure o D. Limit fluids to non-caffeine beverages • 31. Question The nurse prepares the client for the insertion of a pulm nary artery catheter (Swan-Ganz catheter). The nurse teac e the clien that the cath ter will be inserted to provide inf rmation about: NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option C: In Chinese medicine, the body, and indeed a human being, is not seen as a machine, living in isolation from the world around it. Human beings are seen as part of the whole of things, which includes our Correct Answer: B. Initiate high- quality chest compressions Option A: Stroke volume is calculated using measurements of ventricle volumes from an echocardiogram and subtracting the volume of the blood in the ventricle at the end of a beat (called end- systolic volume) from the volume of blood just prior to the beat (called end-diastolic volume). Option B: Cardiac output is calculated by multiplying the stroke volume by the heart rate. Option C: The CVP can be measured either manually using a manometer or electronically using a transducer. Correct Answer: D. Left ventricular functioning The catheter is placed in the pulmonary artery. Information regarding left ventricular function is obtained when the catheter balloon is inflated. o A. Stroke volume o B. Cardiac output o C. Venous pressure o D. Left ventricular functioning • 32. Question A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is: o A. Start a peripheral IV o B. Initiate high-quality chest compressions o C. Establish an airway o D. Obtain the crash cart NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” o C. “I have to use the bedpan to pass my water at least every 1 to 2 hours.” o D. “It seems that the pain medication is not working as well today.” Correct Answer: B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” The nurse would be concerned about all of these comments, however, the most life-threatening is option B. Clients who had hip or knee surgery are at higher risk for the development of postoperative pulmonary embolism. Sudden dyspnea and tachycardia are classic findings of pulmonary embolism. Without prophylaxis (e.g., anticoagulation medications), deep vein thrombosis can develop within 7 to 14 days following the surgery and can lead to pulmonary embolism. The nurse should be aware of the other signs of DVT which include: pain and tenderness at or below the area of the clot, skin discoloration, swelling, or tightness of the affected leg. Signs of pulmonary embolism include acute onset of dyspnea, tachycardia, confusion, and pleuritic chest pain. o Option A: Muscle spasms occur after total hip replacements and acute pain is expected after a surgical procedure. o Option C: May indicate urinary infection and needs further assessment by the nurse. o Option D: May require a reevaluation of pain and interventions to manage pain though does not need immediate action. • 36. Question A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) assessment cues below may indicate the client is experiencing a negative side effect from the medication? o A. Weight gain of 5 pounds NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Decreased appetite Furosemide is a loop diuretic that is used for pulmonary edema, edema in heart failure, nephrotic syndrome, and hypertension. Furosemide causes a loss of potassium unless a supplement or a potassium-rich diet is taken. A decrease in appetite is caused by hypokalemia. Signs and symptoms of hypokalemia include anorexia, fatigue, nausea, decreased GI motility, muscle weakness, dysrhythmias, reduced urine osmolality, altered level of consciousness. o Option A: Weight gain is not a negative side effect of furosemide. o Option B: Edema of the ankles are indications for the administration of furosemide. o Option C: Gastric irritability is not a side Correct Answer: B. Imp ove the client’s nutrition status Venous stasis occurs when venous blood collects and stagnates in the lower leg due to incompetent venous valves. Eventually, little oxygen and nutrients are supplied o B. Edema of the ankles o C. Gastric irritability o D. Decreased appetite • 37. Question The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing in ervention would be most effective in promoting healing? o A. Apply dressing using sterile technique o B. Improve the client’s nutrition status o C. Initiate limb compression therapy o D. Begin proteolytic debridement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Positive feedback is most useful when given immediately. Option C: Negative statements are never helpful in any given situation. Option D: Every goal should always be attainable. Correct Answer: A. Specific feedback is given as close to the event as possible Feedback is most useful when given immediately. Positive behavior is strengthened through immediate feedback, and it is easier to modify problem behaviors if the standards are clearly understood. Option B: Patients with multiple sclerosis should not exercise to the point of fatigue as strenuous physical exercise raises body temperature and may aggravate symptoms. Option E: Continuous exercise with no rest periods is contraindicated for patients with multiple sclerosis Correct answers: B & E. o D. Performance goals should be higher than what is attainable • 39. Question The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply. o A. “I can lift weights and do resistance training.” o B. “I should exercise to the point of exhaustion.” o C. “I can include aerobic exercises in my routine.” o D. “Proper stretching should be done before starting my routine.” o E. “I should exercise continuously without rest.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. We have safety bars installed in the bathroom and have 24-hour alarms on the doors. Note all options are correct statements. However, safety is most important to reinforce. o Option C: Ensuring safety of the client with increasing memory loss is a priority of home • 40. Question During the evaluation of the quality of home care for a client with Alzheimer’s disease, the priority for the nurse is to reinforce which statement by a family member? o A. “At least two (2) full meals a day are eaten.” o B. “We go to a group discussion every week at our community center.” o C. “We have safety bars installed in the bathroom and have 24-hour alarms on the doors.” o D. “The medication is not a problem to have it taken three (3) times a day.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) who wants to exercise. The patient should be advised to take short rest periods, preferably lying down. Again, extreme fatigue may contribute to the exacerbation of symptoms. o Option A: Exercises should include activities that would strengthen weak muscles because diminishing muscle strength is often a primary concern in multiple sclerosis. These activities include lifting weights and resistance exercises. o Option C: Aerobic exercises help promote muscle efficiency, increase flexibility, improves mood, and helps eliminate stress. o Option D: Muscle stretching should be included prior to exercise as this helps minimize muscle spasticity and contractures o Option A: Warfarin (Coumadin). Has a pregnancy category X and associated with central nervous system defects, spontaneous abortion, stillbirth, Correct Answer: A. Warfarin (Coumadin); B. Finasteride (Propecia, Proscar) • 41. Question A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply. o A. Warfarin (Coumadin) o B. Finasteride (Propecia, Proscar) o C. Celecoxib (Celebrex) o D. Clonidine (Catapres) o E. Transdermal nicotine (Habitrol) o F. Clofazimine(Lamprene) NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) be removed in order to prevent falls and other injuries. A hazard-free home environment allows the patient maximum independence and a sense of autonomy. o Option A: In addition to proper nutrition, mealtimes should be kept pleasant, simple, calm, and without confrontations. Patients with AD prefer foods that are familiar, appetizing, and tastes good. Food should be cut into smaller pieces when possible to prevent choking. Hot food and beverages should be served warm or have their temperature checked to prevent burns. o Option B: Socialization is encouraged for patients with dementia. Participation in simple activities, visits from friends, doing hobbies, or caring for pets helps improve the quality of life. so your body reacts to it in a similar way that it does to vitamin A. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Sulfasalazine may discolor the urine or skin to orange-yellow color. Sulfasalazine is used to treat ulcerative colitis (UC), and to decrease the frequency of UC attacks. Sulfasalazine will not cure ulcerative colitis, but it can reduce the number of attacks you have. Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. Correct Answer: D. Aspirin Aspirin is not known to cause discoloration of the urine. Side effects and complications of taking aspirin include stroke caused by a burst blood vessel. The Food and Drug Administration doesn’t recommend aspirin therapy for the prevention of heart attacks in people who haven’t already had a heart attack, stroke or another cardiovascular condition. • 43. Question A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration? o A. Sulfasalazine o B. Levodopa o C. Phenolphthalein o D. Aspirin NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option F: Nitro-Dur patch is used to prevent chest pain or angina. Its side effects are headache, lightheadedness, nausea, and • 44. Question You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drugs, if found inside the fridge, should be removed? o A. Nadolol (Corgard) o B. Opened (in-use) Humulin N injection o C. Urokinase (Kinlytic) o D. Epoetin alfa IV (Epogen) Correct Answer: A. Corgard Nadolol (Corgard) is stored at room temperature between 59 to 86 ºF (15 and 30 ºC) away from heat, moisture, and light. Do not store in the bathroom and keep the bottle tightly closed. o Option B: Humulin N injection if unopened (not in use) is stored in the fridge and can be used until the expiration date, or stored at room temperature and used within 31 days. If opened (in-use), store the vial in a refrigerator or at room temperature and use within 31 days. Store the injection pen at room temperature (do not refrigerate) and use within 14 days. Keep it in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen. o Option C: Urokinase (Kinlytic) is refrigerated at 2– 8°C. Lyophilized Urokinase although stable at room temperature for 3 weeks, should be stored NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option C: Phenolphthalein can discolor the urine to a red color. Phenolphthalein is often used as an indicator in acid-base titrations. For this application, it turns colorless in acidic immune complexes. o Option B: IgD antibodies are found in small amounts in the tissues that line the belly or chest. Secreted IgD appears to enhance mucosal homeostasis and NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Before reporting to a social worker, it is imperative to start a prophylaxis to reduce viral replication. Option C: Pentamidine is an antimicrobial medication given to prevent and treat pneumocystis pneumonia. Option D: It is natural to have strong emotions after an exposure to HIV in the workplace. The healthcare Correct Answer: B. Start prophylactic AZT treatment Azidothymidine (AZT) treatment is the most critical intervention. It is an antiretroviral medication used to prevent and treat HIV/AIDS by reducing the replication of the virus. Post-exposure prophylaxis (PEP) for HIV is a treatment to suppress the virus and prevent infection after exposure. PEP should be taken within 72 hours of possible exposure to HIV, so it is important to seek treatment quickly. • 46. Question A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take? o A. Immediately see a social worker o B. Start prophylactic AZT treatment o C. Start prophylactic Pentamidine treatment o D. Seek counseling NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) immune surveillance by “arming” myeloid effector cells such as basophils and mast cells with IgD antibodies reactive against mucosal antigens, including commensal and pathogenic microbes. o Option C: IgE antibodies cause the body to react against foreign substances such as pollen, spores, animal dander. IgE antibodies are found in the lungs, skin, and mucous membranes. They are involved in allergic • 47. Question A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? o A. Atherosclerosis o B. Diabetic nephropathy o C. Autonomic neuropathy o D. Somatic neuropathy Correct Answer: C. Autonomic neuropathy Autonomic neuropathy (also known as Diabetic Autonomic Neuropathy) affects the autonomic nerves, which control the bladder, intestinal tract, and genitals, among other organs. Paralysis of the bladder is a common symptom of this type of neuropathy, as manifested by bladder urgency and inability to start urination. o Option A: Atherosclerosis, or hardening of the arteries, is a condition in which plaque builds up inside the arteries. Plaque is made of cholesterol, fatty substances, cellular waste products, calcium, and fibrin (a clotting material in the blood). o Option B: Diabetic nephropathy (DN) is typically defined by macro albuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24- hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) worker might feel anger, fear, blame, or depression. During the difficult time of prevention treatment and waiting, they may want to seek support. Try an employee- assistance program or local mental health Option A: Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the large intestine; most people don’t have symptoms. Option C: Hypocalcemia is low calcium levels in the blood; it is asymptomatic in mild forms but can cause paresthesia, tetany, muscle cramps, and carpopedal spasms in severe hypocalcemia. Option D: Irritable bowel syndrome is a widespread condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety, or previous intestinal infection. Correct Answer: B. Hypercalcemia Hypercalcemia can cause polyuria, severe abdominal pain, and confusion. A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect? o A. Diverticulosis o B. Hypercalcemia o C. Hypocalcemia o D. Irritable bowel syndrome • 50. Question Rhogam is most often used to treat mothers that have a infant. o A. RH positive, RH positive o B. RH positive, RH negative o C. RH negative, RH positive NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. RH negative, RH negative Correct Answer: C. RH negative, RH positive Rhogam prevents the production of anti-RH antibodies in the mother that has an Rh-positive fetus. o Option A: RhoGAM is a prescription medicine that is used to prevent Rh immunization, a condition in which an individual with Rh-negative blood develops antibodies after exposure to Rh-positive blood. o Option B: If the father or baby is not conclusively shown to be Rh-negative, RhoGAM should be given to an Rh-negative mother in the following clinical situations to prevent Rh immunization: after delivery of an Rh-positive baby; routine prevention of Rh immunization at 26 to 28 weeks of pregnancy; maternal or fetal bleeding during pregnancy from certain conditions; or an actual or threatened pregnancy loss at any stage. o Option D: It isn’t until second and subsequent pregnancies when antibodies are already built up, that Rh incompatibility can cause problems. Indeed, these antibodies can cross the placenta and attack the baby’s red blood cells. This can cause the baby to develop anemia, and in severe cases, result in miscarriage. • 51. Question A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU? o A. A Guthrie test can check the necessary lab values o B. The urine has a high concentration of phenyl pyruvic acid o C. Mental deficits are often present with PKU NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. The effects of PKU are reversible NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) • 52. Question A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient? o A. Onset of pulmonary edema o B. Metabolic alkalosis o C. Respiratory alkalosis o D. Parkinson’s disease type symptoms Correct Answer: A. Onset of pulmonary edema Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development. Early symptoms of aspirin poisoning also include tinnitus, hyperventilation, vomiting, dehydration, and fever. Late signs include drowsiness, bizarre behavior, unsteady walking, and coma. Abnormal breathing caused by aspirin poisoning is usually rapid and deep. Pulmonary edema may be related to an increase in permeability within the capillaries of the lung leading to “protein leakage” and transudation of fluid in both renal and pulmonary tissues. The alteration in renal tubule permeability may lead to a change in colloid osmotic pressure and thus facilitate pulmonary edema (via Medscape). o Option B: Aspirin overdose causes metabolic acidosis, not alkalosis. Metabolic alkalosis is a primary increase in serum bicarbonate (HCO3 -) concentration. o Option C: Respiratory alkalosis is a disturbance in acid and base balance due to alveolar hyperventilation. o Option D: Parkinson’s type symptoms include NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) hair than unaffected family members and are also likely to have skin disorders such as tremors, bradykinesia, rigid muscles, impaired posture and balance, speech changes, and loss of automatic movements. • 53. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Letting others know is correct, so that the other staff may become aware of the patient’s condition. However, this is not a priority. Option B: Before communication with the supervisor, the charge nurse must secure the environmental safety of the client first. Option C: Continuously updating the patient on the social environment is also correct, but this can come after securing the client’s safety. Correct Answer: D. Provide a secure environment for the patient. This patient’s safety is your primary concern. Patient safety protocols can help reduce medical mistakes and prevent adverse patient outcomes. When the goal is to help people, it seems obvious that it’s important to work to protect them from unintended or unexpected harm. A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is? o A. Let others know about the patient’s deficits. o B. Communicate with your supervisor your patient safety concerns. o C. Continuously update the patient on the social environment. o D. Provide a secure environment for the patient. • 54. Question A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient? o A. Deep breathing techniques to increase oxygen levels. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Observe for signs of bleeding Bleeding is the priority concern for a client taking thrombolytic medication. The primary mechanism of all thrombolytics is the conversion of plasminogen to the active form, plasmin, which then degrades fibrin. This proteolysis can occur with fibrin-bound plasminogen on the surface of thrombi and the unbound form within the plasma. The unbound plasmin generated degrades fibrin but also fibrinogen, factor V, and factor VIII. o Option A: During therapy, perform a neurologic assessment every 15 minutes during the 1-hour infusion. After therapy, check every 15 minutes • 57. Question A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following? o A. Observe for neurological changes o B. Monitor for any signs of renal failure o C. Check the food diary o D. Observe for signs of bleeding NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Simian crease refers to a single crease across the palm of the hand and is prominent among those with Down’s syndrome. o Option B: Brachycephaly is described as a shortening of the occipitofrontal diameter (front to the back of the head) of the fetal head. Postnatally, it is well established that babies with Down syndrome often had signs of brachycephaly in utero. o Option D: Patients with Down syndrome have low muscle tone or hypotonia, and Option B: Yellow vegetables are great sources of vitamins, such as vitamins A, B6, C, folate, magnesium, fiber, riboflavin, phosphorus, and potassium. Red meat is rich in protein, saturated fat, iron, zinc, and vitamin B. Option C: Carrots are a rich source of vitamin A from beta carotene, K1 (phylloquinone), and vitamin B6. Option D: Milk is a rich source of calcium. Milk is an excellent source of many vitamins and minerals, including vitamin B12, calcium, riboflavin, and phosphorus. It’s often fortified with other vitamins, especially vitamin D. Correct Answer: A. Green vegetables and liver Green vegetables and liver are a great source of folic acid. • 58. Question A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?” o A. Green vegetables and liver o B. Yellow vegetables and red meat o C. Carrots o D. Milk • 59. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option B: Although current guidelines do not include renal dysfunction as a contraindication to tPA therapy, some clinicians hesitate to administer tPA because of a tendency of bleeding in these patients. o Option C: Having a food diary is not related to the use of medication. Thrombolytic therapy is indicated in patients with evidence of ST- segment elevation MI (STEMI) or presumably new left bundle-branch block (LBBB) presenting within 12 hours of the onset of symptoms if Option A: Pneumococcal meningitis is caused by Streptococcus pneumoniae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae, which must avoid mucosal entrapment and evade the host immune system after local activation. Option B: H influenzae meningitis is caused by Haemophilus influenzae type B bacteria. It is the leading cause of bacterial meningitis in children under age 5. Haemophilus species are small oxidase-positive pleomorphic gram-negative aerobic or facultative anaerobic coccobacilli. Humans are the only known host for Haemophilus influenza. Option C: Bacteria called Neisseria meningitidis cause meningococcal disease. About 1 in 10 people have these bacteria in the back of their nose and throat without being ill. Correct Answer: D. Cl. difficile Cl. difficile has not been linked to meningitis. Clostridium difficile (C. diff ) is a germ (bacteria) that causes life-threatening diarrhea. It is usually a side-effect of taking antibiotics. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans? o A. S. pneumoniae o B. H. influenzae o C. N. meningitidis o D. Cl. difficile • 60. Question A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long do red blood cells live in my body? The correct response is: o A. The life span of RBC is 45 days NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: B. Initiative vs. guilt It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial Option A: Preoperative instructions are important for discharge planning, so it must start not only after the surgery. Option C: Creating a discharge plan within 48 hours of discharge could cause the plan to be incomplete, as it would lack the preparations made before the surgery. Option D: Including the preoperative discussion in the discharge plan is correct, but this should also extend towards the admission and the data taken upon admission for comprehensive planning of the client’s discharge. Correct Answer: B. Upon admission Discharge education begins upon admission. Ideally, it involves the client and the family, as well as the hospital staff. Effective discharge planning can decrease the chances of the client being readmitted to the hospital, and also can help in recovery, ensure medications are prescribed and given correctly, and adequately prepare folks to take over the client’s care. o D. Preoperative discussion • 62. Question A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson’s psychosocial development stages, the child is in which stage? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame and doubt o D. Intimacy vs. isolation NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Autonomy vs. shame and doubt Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control. o Option A: Trust vs Mistrust is the first stage Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them. Option C: Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control. Option D: Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, loving relationships with other people. on initiative versus guilt. It is important for the kids of this age to learn that they can exert power over themselves and the world. • 63. Question A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame and doubt o D. Intimacy vs. isolation NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them. Option B: It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial development centered on initiative Correct Answer: D. Intimacy vs. isolation Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, loving relationships with other people. • 64. Question A young adult is 20 years old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame o D. Intimacy vs. isolation NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them. o Option B: It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial development centered on initiative versus guilt. It is important for the kids to learn that they can exert power over themselves and the world. o Option D: Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart and slows electrical activity in the heart to control the heart rate. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Campylobacter infection, or campylobacteriosis, is caused by Campylobacter bacteria. It is the most common bacterial cause of diarrheal illness in the United States. Some people with, or at risk for, severe illness might need antibiotic treatment. Option B: Legionella bacteria can cause a serious type of pneumonia (lung infection) called Legionnaires’ disease. Legionnaires’ disease requires treatment with antibiotics. Option C: Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. Antibiotics are used to treat bacterial pneumonia. Correct Answer: D. Multiple Sclerosis Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). It cannot be treated by antibiotics. • 67. Question Which of the following conditions would a nurse not administer erythromycin? o A. Campylobacteriosis infection o B. Legionnaires disease o C. Pneumonia o D. Multiple Sclerosis • 68. Question A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute? o A. Decreased HR NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Weight gain Rapid weight loss occurs in patients newly diagnosed with type 1 diabetes. In people with diabetes, insufficient insulin prevents the body from getting glucose from the Option A: Occasionally, a cardiac examination may reveal extrasystoles, pauses, or bradycardia resulting from heart block or tachypnea resulting from respiratory muscle weakness. Option B: Paresthesias refers to a burning or prickling sensation that is usually felt in the hands, arms, legs, or feet, and is common in hyperkalemia. Option C: Skeletal muscle weakness and flaccid paralysis may be present, along with depressed or absent deep tendon reflexes. Correct Answer: D. Migraines Migraines are not a symptom of hyperkalemia. Symptoms of hyperkalemia, when present, are nonspecific and predominantly related to muscular or cardiac function. o B. Paresthesias o C. Muscle weakness of the extremities o D. Migraines • 69. Question A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute? o A. Vomiting o B. Extreme Thirst o C. Weight gain o D. Acetone breath smell NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Loss of appetite would be expected. Most cases of meningitis are caused by an infectious agent that has colonized or established a localized infection elsewhere in the host. Potential sites of colonization or infection include the skin, the nasopharynx, the respiratory tract, the gastrointestinal (GI) tract, and the genitourinary tract. The organism invades the submucosa at these sites by circumventing host defenses (eg, physical barriers, local immunity, and phagocytes or macrophages). o Option B: Vomiting occurs in 35% of patients with meningitis. The brain is naturally protected from the body’s immune system by the barrier that the meninges create between the bloodstream and the brain. Normally, this protection is an advantage because the barrier prevents the immune system from attacking the brain. However, in meningitis, the blood- brain barrier can become disrupted; once bacteria or other organisms have found their way to the brain, they are somewhat isolated from the immune system and can spread. o Option C: The classic triad of meningitis consists of fever, nuchal rigidity, and altered mental status. When the body tries to fight the infection, the problem can worsen; blood vessels become leaky and allow fluid, WBCs, and other infection-fighting particles to enter the meninges and brain. This process, in turn, causes brain swelling and can eventually result in decreasing blood flow to parts of the brain, worsening the symptoms of infection. o Option D: Other symptoms include photalgia (photophobia): discomfort when the patient looks into bright lights. Depending on the severity of bacterial meningitis, the inflammatory process may remain confined to the subarachnoid space. In less severe forms, the pial barrier is not penetrated, and the underlying parenchyma remains intact. However, in more severe forms of bacterial meningitis, the pial barrier is breached, and the underlying parenchyma is invaded by the NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) inflammatory process. Thus, bacterial meningitis may lead to widespread cortical destruction, particularly when left untreated. • 71. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition? o A. Yersinia pestis o B. Helicobacter pylori o C. Vibrio cholerae o D. Haemophilus aegyptius Correct Answer: D. Haemophilus aegyptius Haemophilus influenzae biogroup aegyptius (Hae) is a causative agent of acute and often purulent conjunctivitis, more commonly known as pink eye. o Option A: Plague is a disease that affects humans and other mammals. It is caused by the bacterium, Yersinia pestis. Y. pestis is primarily a disease of rodents or other wild mammals that usually is transmitted by fleas and often is fatal. Human disease is now rare and usually is associated with contact with rodents and their fleas. o Option B: Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect the stomach. Helicobacter pylori is a ubiquitous organism that is present in about 50% of the global population. Chronic infection with H pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. The most common route of H pylori infection is either oral-to- oral or fecal-to-oral contact. o Option C: Cholera, caused by the bacteria Vibrio cholerae, is rare in the United States and other industrialized nations. Cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. An estimated 2.9 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. ECG (electrocardiogram) o C. Thyroid function tests o D. CT scan Correct Answer: D. CT scan A CT scan would be performed for further investigation of the hemiparesis. Noncontrast CT scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke. o Option A: A complete blood count (CBC) and a basic chemistry panel can be useful baseline studies. A CBC serves as a baseline study and may reveal a cause for the stroke (eg, polycythemia, thrombocytosis, thrombocytopenia, leukemia), identify evidence of concurrent illness (eg, anemia), or issues that may affect reperfusion strategies (thrombocytopenia). o Option B: Electrocardiogram may serve as baseline data upon entry into the ED. An electrocardiogram (ECG or EKG) records the electrical signal from the heart to check for different heart conditions. Electrodes are placed on the chest to record the heart’s electrical signals, which cause the heart to beat. The signals are shown as waves on an attached computer monitor or printer. o Option C: Testing can often be limited to blood glucose, plus coagulation studies if the patient is on warfarin, heparin, or one of the newer antithrombotic agents (eg, dabigatran, rivaroxaban), not including thyroid studies. • 74. Question An 85-year-old male has been losing mobility and gaining weight over the last two (2) months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) performed? o A. CBC (complete blood count) NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. ECG (electrocardiogram) o C. Thyroid function tests o D. CT scan Correct Answer: C. Thyroid function tests Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function. Thyroid function tests are designed to distinguish hyperthyroidism and hypothyroidism from the euthyroid state. To accomplish this task, direct measurements of the serum concentration of the two thyroid hormones—triiodothyronine (T3) and tetraiodothyronine (T4)— more commonly known as thyroxine, are extensively employed. o Option A: The complete blood count and metabolic profile may show abnormalities in patients with hypothyroidism. Thyroid dysfunction induces different effects on blood cells such as anemia, erythrocytosis, leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. o Option B: Signs of hypothyroidism on ECG include sinus bradycardia, T-wave inversions (TWIs), QTc prolongation, and ventricular arrhythmias. Hypothyroidism can affect the cardiovascular system physiology and structure. These changes are often reflected on ECG. o Option D: Ultrasonography of the neck and thyroid can be used to detect nodules and infiltrative disease. High-resolution ultrasonography (USG) is the most sensitive imaging modality available for examination of the thyroid gland and associated abnormalities. Ultrasound scanning is non-invasive, widely available, less expensive, and does not use any ionizing radiation. Further, real- time ultrasound imaging helps to guide diagnostic and therapeutic interventional procedures in cases of thyroid disease. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022)