NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS, Exams of Nursing

Download NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS and more Exams Nursing in PDF only on Docsity! NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 1 | 85 1. 1. Question After cardiac surgery, a client’s blood pressure measures 126/80 mm Hg. Nurse Katrina determines that mean arterial pressure (MAP) is which of the following? o A. 46 mm Hg o B. 80 mm Hg o C. 95 mm Hg o D. 90 mm Hg Correct Answer: C. 95 mm Hg Use the following formula to calculate MAP MAP = systolic + 2 (diastolic) MAP = 126 mm Hg + 2 (80 mm Hg) MAP = 286 mm Hg MAP = 95 mm Hg o Option A: 46 mmHg is according to the calculations. o Option B: 80 mmHg is inadequate according to the formula used in the computation. o Option D: 90 mmHg is according to the computation using the formula of mean arterial pressure. • 2. Question NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 2 | 85 A female client arrives at the emergency department with chest and stomach pain and a report of black tarry stool for several months. Which of the following orders should the nurse Oliver anticipate? o A. Cardiac monitor, oxygen, creatine kinase and lactate dehydrogenase levels o B. Prothrombin time, partial thromboplastin time, fibrinogen and fibrin split product values o C. Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel o D. Electroencephalogram, alkaline phosphatase, and aspartate aminotransferase levels, basic serum metabolic panel Correct Answer: C. Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel. An electrocardiogram evaluates the complaints of chest pain, laboratory tests determine anemia, and the stool test for occult blood determines blood in the stool. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 5 | 85 Corticosteroid therapy can decrease antibody production and phagocytosis of the antibody-coated platelets, retaining more functioning platelets. o Option A: ASA blocks prostaglandin synthesis. Inhibition of COX-1 results in the inhibition of platelet aggregation for about 7-10 days (average platelet lifespan). o Option C: Methotrexate inhibits enzymes responsible for nucleotide synthesis which prevents cell division and leads to anti-inflammatory actions. It causes thrombocytopenia. o Option D: Vitamin K is used to treat an excessive anticoagulate state from warfarin overload. • 5. Question A female client is scheduled to receive a heart valve replacement with a porcine valve. Which of the following types of transplant is this? o A. Allogeneic o B. Autologous o C. Syngeneic o D. Xenogeneic Correct Answer: D. Xenogeneic A xenogeneic transplant is between a human and another species. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 6 | 85 o Option A: Allogeneic transplant is between two humans, o Option B: Autologous is a transplant from the same individual. o Option C: A syngeneic transplant is between identical twins. • 6. Question Marco falls off his bicycle and injures his ankle. Which of the following actions shows the initial response to the injury in the extrinsic pathway? Correct Answer: B. Release of tissue thromboplastin Tissue thromboplastin is released when damaged tissue comes in contact with clotting factors. o Option A: Calcium is released to assist the conversion of factors X to Xa. o Option C: Conversion of factors XII to XIIa are part of the intrinsic pathway. o Option D: Conversion factors VIII to VIIIa are part of the intrinsic pathway. • 7. Question Instructions for a client with systemic lupus erythematosus (SLE) would include information about which of the following blood dyscrasias? o A. Release of Calcium o B. Release of tissue thromboplastin o C. Conversion of factors XII to factor XIIa o D. Conversion of factor VIII to factor VIIIa NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 7 | 85 o A. Dressler’s syndrome o B. Polycythemia o C. Essential thrombocytopenia o D. Von Willebrand’s disease Correct Answer: C. Essential thrombocytopenia Essential thrombocytopenia is linked to immunologic disorders, such as SLE and the human immunodeficiency virus. o Option A: Dressler’s syndrome is pericarditis that occurs after myocardial infarction and isn’t linked to SLE. o Option B: Moderate to severe anemia is associated with SLE, not polycythemia. It is found in about 50% of patients, with anemia of chronic disease being the most common form. o Option D: Von Willebrand disease is a blood disorder in which the blood doesn’t clot properly. Blood contains many proteins that help the body stop bleeding. One of these proteins is called von Willebrand factor. • 8. Question The nurse is aware that the following symptom is most commonly an early indication of stage 1 Hodgkin’s disease? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 10 | 85 o C. Renal dysfunction o D. Myocardial irritability Correct Answer: B. Muscle spasm Back pain or paresthesia in the lower extremities may indicate impending spinal cord compression from a spinal tumor. This should be recognized and treated promptly as the progression of the tumor may result in paraplegia. o Option A: The reasons underlying the relative paucity of CNS invasion by multiple myeloma in comparison with other tumors, whether solid or hematological, remain unknown, but this phenomenon might be the result of underlying biological characteristics, or lack thereof, of malignant plasma cells. o Option C: In some cases, renal impairment is caused by the accumulation and precipitation of light chains, which form casts in the distal tubules, resulting in renal obstruction. o Option D: Some of the treatments used in MM may also affect cardiovascular health, however, with careful risk assessment, monitoring, and prophylactic therapy, many of these cardiovascular complications can be managed or treated successfully. • 11. Question Nurse Patricia is aware that the average length of time from human immunodeficiency virus (HIV) infection to the development of acquired immunodeficiency syndrome (AIDS)? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 11 | 85 o A. Less than 5 years o B. 5 to 7 years o C. 10 years o D. More than 10 years Correct Answer: C. 10 years Epidemiologic studies show the average time from initial contact with HIV to the development of AIDS is 10 years. The interval from HIV infection to the diagnosis of AIDS ranges from about 9 months to 20 years or longer, with a median of 12 years. o Option A: Less than 5 years is too short a time for the development of AIDS. o Option B: 5 to 7 years is not the average time when an HIV infection develops into AIDS. o Option D: More than 10 years is more than the average time for HIV to develop into AIDS. • 12. Question An 18-year-old male client admitted with heat stroke begins to show signs of disseminated intravascular coagulation (DIC). Which of the following laboratory findings is most consistent with DIC? o A. Low platelet count NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 12 | 85 o B. Elevated fibrinogen levels o C. Low levels of fibrin degradation products o D. Reduced prothrombin time Correct Answer: A. Low platelet count In DIC, platelets and clotting factors are consumed, resulting in microthrombi and excessive bleeding. As clots form, fibrinogen levels decrease and the prothrombin time increases. o Option B: Severe, rapidly evolving DIC is diagnosed by demonstrating thrombocytopenia, an elevated partial thromboplastin time and prothrombin time, increased levels of plasma D-dimers, and a decreasing plasma fibrinogen level. o Option C: Fibrin degradation products increase as fibrinolysis takes place. o Option D: Both PT and aPTT seem prolonged in about 50% of DIC cases which is attributed to the consumption of coagulation factors but can also be prolonged in impaired synthesis of coagulation factors and in massive bleeding. • 13. Question Mario comes to the clinic complaining of fever, drenching night sweats, and unexplained weight loss over the past 3 months. Physical examination reveals a single enlarged supraclavicular lymph node. Which of the following is the most probable diagnosis? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 15 | 85 o A. “I should contact the physician if Stacy has difficulty in sleeping”. o B. “I will call my doctor if Stacy has persistent vomiting and diarrhea”. o C. “My physician should be called if Stacy is irritable and unhappy”. o D. “Should Stacy have continued hair loss, I need to call the doctor”. Correct Answer: B. “I will call my doctor if Stacy has persistent vomiting and diarrhea”. Persistent (more than 24 hours) vomiting, anorexia, and diarrhea are signs of toxicity and the patient should stop the medication and notify the healthcare provider. o Option A: Oftentimes, chemotherapy drugs cause patients to feel tired and sleepy throughout the day. Therefore, patients on chemotherapy can end up napping or sleeping during the day and that leads to difficulty sleeping at night or through the night. o Option C: Chemotherapy medications can directly impact the way people feel emotionally and physically. o Option D: Chemotherapy drugs are powerful medications that attack rapidly growing cancer cells. Unfortunately, these NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 16 | 85 drugs also attack other rapidly growing cells in the body, including those in the hair roots. • 16. Question Molly Sue is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Her mother states to the nurse that it is hard to see Molly Sue with no hair. The best response for the nurse is: o A. “Molly Sue looks very nice wearing a hat”. o B. “You should not worry about her hair, just be glad that she is alive”. o C. “Yes, it is upsetting. But try to cover up your feelings when you are with her or else she may be upset”. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 17 | 85 o D. “This is only temporary; Molly Sue will re-grow new hair in 3-6 months but may be different in texture”. Correct Answer: D. “This is only temporary; Stacy will re- grow new hair in 3-6 months but may be different in texture”. This is the appropriate response. The nurse should help the mother how to cope with her own feelings regarding the child’s disease so as not to affect the child negatively. When the hair grows back, it is still of the same color and texture. o Option A: It can be an option for the client to use a hat, but the nurse should be open about explanations regarding the side effects of chemotherapy. o Option B: Avoid reassuring the client. Statements of fact would be a good response. o Option C: The mother should be open and honest with the child, and providing an honest and true response would be a big help to both of them. • 17. Question Brittany who is undergoing chemotherapy for her throat cancer is experiencing stomatitis. To promote oral hygiene and comfort, the nurse-in-charge should: o Provide frequent mouthwash with normal saline. o A. Provide frequent mouthwash with normal saline. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 20 | 85 Correct Answer: C. Chronic obstructive bronchitis Clients with chronic obstructive bronchitis appear bloated; they have large barrel chest and peripheral edema, cyanotic nail beds, and at times, circumoral cyanosis. o Option A: Clients with ARDS are acutely short of breath and frequently need intubation for mechanical ventilation and large amounts of oxygen. o Option B: Clients with asthma don’t exhibit characteristics of chronic disease. o Option D: Clients with emphysema appear pink and cachectic. • 20. Question The term “pink puffer” refers to the female client with which ofthe following conditions? o A. Adult respiratory distress syndrome (ARDS) o B. Asthma o C. Chronic obstructive bronchitis o D. Emphysema NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 21 | 85 Correct Answer: D. Emphysema Because of the large amount of energy it takes to breathe, clients with emphysema are usually cachectic. They’re pink and usually breathe through pursed lips, hence the term “puffer.” o Option A: Clients with ARDS are usually acutely short of breath. o Option B: Clients with asthma don’t have any particular characteristics. o Option C: Clients with chronic obstructive bronchitis are bloated and cyanotic in appearance. • 21. Question Jose is in danger of respiratory arrest following the administration of a narcotic analgesic. An arterial blood gas value is obtained. Nurse Oliver would expect the paco2 to be which of the following values? o A. 15 mm Hg o B. 30 mm Hg o C. 40 mm Hg o D. 80 mm Hg Correct Answer: D. 80 mm Hg A client about to go into respiratory arrest will have inefficient ventilation and will be retaining carbon dioxide. The value expected would be around 80 mm Hg. All other values are lower than expected. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 22 | 85 o Option A: 15 mmHg is a low value for a client about to go into respiratory arrest. o Option B: 30 mmHg is lower than the expected value because of inefficient ventilation. o Option C: 40 mmHg is still less than the expected value for a client who is about to go into respiratory arrest. • 22. Question Timothy’s arterial blood gas (ABG) results are as follows; pH 7.16; Paco2 80 mm Hg; Pao2 46 mm Hg; HCO3- 24 mEq/L; Sao2 81%. This ABG result represents which of the following conditions? o A. Metabolic acidosis o B. Metabolic alkalosis o C. Respiratory acidosis o D. Respiratory alkalosis Correct Answer: C. Respiratory acidosis Because Paco2 is high at 80 mm Hg and the metabolic measure, HCO3- is normal, the client has respiratory acidosis. o Option A: If the HCO3- was below 22 mEq/L the client would have metabolic acidosis. o Option B: The result of the ABG is less than 7.35, which makes metabolic alkalosis . o Option D: The pH is less than 7.35, academic, which eliminates respiratory alkalosis as a possibility. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 25 | 85 o A. Impaired clotting mechanism o B. Varix formation o C. Inadequate nutrition o D. Trauma of invasive procedure Correct Answer: A. Impaired clotting mechanism Cirrhosis of the liver results in decreased Vitamin K absorption and formation of clotting factors resulting in impaired clotting mechanism. o Option B: Esophageal varices sometimes form when blood flow to the liver is blocked, most often by scar tissue in the liver caused by liver disease. o Option C: Inadequate nutrition alone cannot cause excessive bleeding in cirrhosis. o Option D: An invasive procedure may cause trauma that may result in bleeding, but the client has not yet undergone any invasive procedure. • 26. Question Mr. Jay develops hepatic encephalopathy. Which clinical manifestation is most common with this condition? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 26 | 85 o A. Increased urine output o B. Altered level of consciousness o C. Decreased tendon reflex o D. Hypotension Correct Answer: B. Altered level of consciousness Changes in behavior and level of consciousness are the first signs of hepatic encephalopathy. Hepatic encephalopathy is caused by liver failure and develops when the liver is unable to convert protein metabolic product ammonia to urea. This results in accumulation of ammonia and other toxic in the blood that damages the cells. o Option A: The main cause of renal dysfunction in inpatients with liver disease is prerenal failure; specifically, the cause is a reduction in perfusion of the kidneys. o Option C: It must be emphasized that the flapping tremor of the extremities is also observed in patients with uremia, pulmonary insufficiency, and barbiturate toxicity. o Option D: A diseased liver can cause portal hypertension, which is high blood pressure in the portal vein. The portal vein supplies the liver with blood. Over time, this pressure causes blood vessels to grow, called collateral blood vessels. These vessels act as channels to divert the blood under high pressure. • 27. Question Patrick who is diagnosed with liver cirrhosis is experiencing symptoms of hepatic encephalopathy. The physician ordered 50ml of Lactulose p.o. every 2 hours. Patrick suddenly develops diarrhea. The nurse best action would be: NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 27 | 85 o A. “I’ll see if your physician is in the hospital”. o B. “Maybe you’re reacting to the drug; I will withhold the next dose”. o C. “I’ll lower the dosage as ordered so the drug causes only 2 to 4 stools a day”. o D. “Frequently, bowel movements are needed to reduce sodium level”. Correct Answer: C. “I’ll lower the dosage as ordered so the drug causes only 2 to 4 stools a day”. Lactulose is given to a patient with hepatic encephalopathy to reduce absorption of ammonia in the intestines by binding with ammonia and promoting more frequent bowel movements. If the patient experiences diarrhea, it indicates overdosage and the nurse must reduce the amount of medication given to the patient. The stool will be mushy or soft. Lactulose is also very sweet and may cause cramping and bloating. o Option A: The nurse may inform the physician so that he may order a lower dosage. o Option B: Withholding the next dose is unnecessary; the nurse may lower the dosage as ordered. o Option D: Lactulose, in this case, is given to reduce absorption of ammonia in the intestines. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 30 | 85 o B. Obtain vital signs. o C. Ask the client to “lift up”. o D. Apply gloves and assess the groin site. Correct Answer: D. Apply gloves and assess the groin site. Observing standard precautions is the first priority when dealing with any blood fluid. Assessment of the groin site is the second priority. This establishes where the blood is coming from and determines how much blood has been lost. The goal in this situation is to stop the bleeding. o Option A: The nurse would call for help if it were warranted after the assessment of the situation. o Option B: After determining the extent of the bleeding, vital signs assessment is important. o Option C: The nurse should never move the client, in case a clot has formed. Moving can disturb the clot and cause rebleeding. • 30. Question Which of the following treatments is a suitable surgical intervention for a client with unstable angina? o A. Cardiac catheterization o B. Echocardiogram o C. Nitroglycerin NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 31 | 85 o D. Percutaneous transluminal coronary angioplasty (PTCA) Correct Answer: D. Percutaneous transluminal coronary angioplasty (PTCA) PTCA can alleviate the blockage and restore blood flow and oxygenation. o Option A: Cardiac catheterization is a diagnostic tool – not a treatment. It is a procedure used to diagnose and treat certain cardiovascular conditions. o Option B: An echocardiogram is a non-invasive diagnostic test. It is a graphic outline of the heart’s movement. o Option C: Nitroglycerin is an oral sublingual medication. It is a vasodilatory drug used primarily to provide relief from anginal chest pain. • 31. Question The nurse is aware that the following terms used to describe reduced cardiac output and perfusion impairment due to ineffective pumping of the heart is: o A. Anaphylactic shock o B. Cardiogenic shock o C. Distributive shock o D. Myocardial infarction (MI) NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 32 | 85 Correct Answer: B. Cardiogenic shock Cardiogenic shock is shock related to ineffective pumping of the heart. o Option A: Anaphylactic shock results from an allergic reaction. This severe reaction happens when an over- release of chemicals puts the person into shock. o Option C: Distributive shock results from changes in the intravascular volume distribution and is usually associated with increased cardiac output. o Option D: MI isn’t a shock state, though in most cases, a lack of oxygen to the heart, usually from a heart attack, damages its main pumping chamber. Without oxygen-rich blood circulating to that area of the heart, the heart muscle can weaken and go into cardiogenic shock. • 32. Question A client with hypertension asks the nurse which factors can causeblood pressure to drop to normal levels? o A. Kidneys’ excretion to sodium only. o B. Kidneys’ retention of sodium and water. o C. Kidneys’ excretion of sodium and water. o D. Kidneys’ retention of sodium and excretion of water. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 35 | 85 Correct Answer: C. Pancytopenia, elevated antinuclear antibody (ANA) titer Laboratory findings for clients with SLE usually show pancytopenia, elevated ANA titer, and decreased serum complement levels. o Option A: Decreased levels of serum complement is usually associated with SLE. The cause of complement activation in SLE is the formation of immune complexes, which in turn activate complement, predominantly by means of the classical pathway. o Option B: Thrombocytopenia is one of the components of pancytopenia. It is a condition in which the platelet count is decreased. o Option D: Clients may have elevated BUN and creatinine levels from nephritis, but the increase does not indicate SLE. The part of the kidney most frequently troubled by SLE is part of the nephron called the glomerulus, a tuft of capillaries that functions to filter substances from the blood. For this reason, the type of kidney inflammation most commonly experienced in lupus is glomerulonephritis. • 35. Question Arnold, a 19-year-old client with a mild concussion is discharged from the emergency department. Before discharge, he complains of a headache. When offered acetaminophen, his mother tells the nurse the headache is severe and she would like her son to have something stronger. Which of the following responses by the nurse is appropriate? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 36 | 85 o A. “Your son had a mild concussion, acetaminophen isstrong enough.” o B. “Aspirin is avoided because of the danger of Reye’s syndrome in children or young adults.” o C. “Narcotics are avoided after a head injury because they may hide a worsening condition.” o D. Stronger medications may lead to vomiting, whichincreases the intracranial pressure (ICP).” Correct Answer: C. Narcotics are avoided after a head injury because they may hide a worsening condition. Narcotics may mask changes in the level of consciousness that indicate increased ICP. o Option A: Acetaminophen is strong enough ignores the mother’s question and therefore isn’t appropriate. o Option B: Aspirin is contraindicated in conditions that may have bleeding, such as trauma, and for children or young adults with viral illnesses due to the danger of Reye’s syndrome. o Option D: Stronger medications may not NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 37 | 85 necessarily lead to vomiting but will sedate the client, thereby masking changes in his level of consciousness. • 36. Question When evaluating an arterial blood gas from a male client with a subdural hematoma, the nurse notes the Paco2 is 30 mm Hg. Which of the following responses best describes the result? o A. Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP). o B. Emergent; the client is poorly oxygenated. o C. Normal. o D. Significant; the client has alveolar hypoventilation. Correct Answer: A. Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP) NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 40 | 85 JP has been diagnosed with gout and wants to know why colchicine is used in the treatment of gout. Which of the following actions of colchicines explains why it’s effective f or gout? o A. Replaces estrogen. o B. Decreases infection. o C. Decreases inflammation. o D. Decreases bone demineralization. Correct Answer: C. Decreases inflammation. The action of colchicines is to decrease inflammation by reducing the migration of leukocytes to synovial fluid. o Option A: Colchicine does not replace estrogen. Colchicine works by reducing the inflammation caused by crystals of uric acid in the joints. o Option B: Decreasing infection is not a mechanism of action of colchicine. The primary mechanism of action of colchicine is tubulin disruption. This leads to subsequent downregulation of multiple inflammatory pathways and modulation of innate immunity. o Option D: Colchicine doesn’t decrease bone demineralization. The toxic effects of colchicine are related to NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 41 | 85 this anti-mitotic activity within proliferating tissue such as skin, hair, and bone marrow. • 39. Question Norma asks for information about osteoarthritis. Which of the following statements about osteoarthritis is correct? o A. Osteoarthritis is rarely debilitating. o B. Osteoarthritis is a rare form of arthritis. o C. Osteoarthritis is the most common form of arthritis. o D. Osteoarthritis affects people over 60. Correct Answer: C. Osteoarthritis is the most common form of arthritis Osteoarthritis is the most common form of arthritis and can be extremely debilitating. It can afflict people of any age, although most are elderly. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 42 | 85 o Option A: Osteoarthritis is an extremely debilitating disease. The cartilage within a joint begins to break down and the underlying bone begins to change. o Option B: It is the most common form of arthritis. It affects over 32.5 million US adults. o Option D: Osteoarthritis can affect people of any age, but are most common among the elderly. Women are more likely to develop QA than men, especially after the age of 50. • 40. Question Ruby is receiving thyroid replacement therapy, develops the flu, and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication will put the client at risk for developing which of the following life- threatening complications? o A. Exophthalmos o B. Thyroid storm o C. Myxedema coma o D. Tibial myxedema Correct Answer: C. Myxedema coma Myxedema coma, severe hypothyroidism, is a life-threatening condition that may develop if thyroid replacement medication isn’t taken. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 45 | 85 o D. Below-normal urine osmolality level, above- normal serum osmolality level. Correct Answer: D. Below-normal urine osmolality level, above-normal serum osmolality level In diabetes insipidus, excessive polyuria causes dilute urine, resulting in a below-normal urine osmolality level. At the same time, polyuria depletes the body of water, causing dehydration that leads to an above-normal serum osmolality level. o Option A: Urine osmolality level should be below normal because of excessive polyuria. o Option B: Serum osmolality levels should be above normal because of dehydration. o Option C: For the same reasons, diabetes insipidus doesn’t cause above-normal urine osmolality or below- normal serum osmolality levels. • 43. Question Jomari is diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which of the following statements indicates that the client understands her condition and how to control it? NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 46 | 85 o A. “I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual.” o B. “If I experience trembling, weakness, and headache, I should drink a glass of soda that contains sugar.” o C. “I will have to monitor my blood glucose level closely and notify the physician if it’s constantly elevated.” o D. “If I begin to feel especially hungry and thirsty, I’ll eat a snack high in carbohydrates.” Correct Answer: A. “I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual.” Inadequate fluid intake during hyperglycemic episodes often leads to HHNS. By recognizing the signs of hyperglycemia (polyuria, polydipsia, and polyphagia) and increasing fluid intake, the client may prevent HHNS. o Option B: Drinking a glass of non-diet soda would be appropriate for hypoglycemia. o Option C: A client whose diabetes is controlled with oral antidiabetic agents usually doesn’t need to monitor blood glucose levels. o Option D: A high carbohydrate diet would exacerbate the client’s condition, particularly if fluid intake is low. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 47 | 85 • 44. Question A 66-year-old client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders? o A. Diabetes mellitus o B. Diabetes insipidus o C. Hypoparathyroidism o D. Hyperparathyroidism Correct Answer: D. Hyperparathyroidism Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercalciuria- causing polyuria. o Option A: Common symptoms of diabetes mellitus include polyuria, polydipsia, and polyphagia o Option B: While clients with diabetes insipidus also have polyuria, they don’t have bone pain and increased sleeping. o Option C: Hypoparathyroidism is characterized by urinary frequency rather than polyuria. • 45. Question NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 50 | 85 o Option D: A low corticotropin level with a low cortisol level would be associated with hypocortisolism. • 47. Question A male client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor. Preoperatively, the nurse should assess for potential complications by doing which of the following? o A. Testing for ketones in the urine. o B. Testing urine specific gravity. o C. Checking temperature every 4 hours. o D. Performing capillary glucose testing every 4 hours. Correct Answer: D. Performing capillary glucose testing every 4 hours. The nurse should perform capillary glucose testing every 4 hours because excess cortisol may cause insulin resistance, placing the client at risk for hyperglycemia. o Option A: Urine ketone testing isn’t indicated because the client does secrete insulin and, therefore, isn’t at risk for ketosis. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 51 | 85 o Option B: Urine specific gravity isn’t indicated because although fluid balance can be compromised, it usually isn’t dangerously imbalanced. o Option C: Temperature regulation may be affected by excess cortisol and isn’t an accurate indicator of infection. • 48. Question Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Mariner should expect the dose’s: o A. Onset to be at 2 p.m. and its peak to be at 3 p.m. o B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m. o C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m. o D. Onset to be at 4 p.m. and its peak to be at 6 p.m. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 52 | 85 Correct Answer: C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m. Regular insulin, which is a short-acting insulin, has an onset of 15 to 30 minutes and a peak of 2 to 4 hours. Because the nurse gave the insulin at 2 p.m., the expected onset would be from 2:15 p.m. to 2:30 p.m. and the peak from 4 p.m. to 6 p.m. o Option A: 2 p.m. is when the insulin was given; onset does not occur at the same time as the medication was given o Option B: The peak starts 2 to 4 hours after the insulin was given, which will be at 4 p.m. o Option D: Onset of 4 p.m. is very late; 15 to 30 minutes is the expected onset of insulin. Peak shoud start at 4 p.m. • 49. Question The physician orders laboratory tests to confirm hyperthyroidismin a female client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis? o A. No increase in the thyroid-stimulating hormone (TSH) level after 30 minutes during the TSH stimulation test. o B. A decreased TSH level. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 55 | 85 o Option A: Insulin should be injected only into healthy tissue lacking large blood vessels, nerves, or scar tissue, or other deviations. o Option C: Injecting insulin into areas of hypertrophy may delay absorption. The client shouldn’t inject insulin into areas of lipodystrophy (such as hypertrophy or atrophy); to prevent lipodystrophy, the client should rotate injection sites systematically. o Option D: Exercise speeds drug absorption, so the client shouldn’t inject insulin into sites above muscles that will be exercised heavily. • 51. Question Nurse Sarah expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate? o A. Elevated serum acetone level. o B. Serum ketone bodies. o C. Serum alkalosis. o D. Below-normal serum potassium level. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 56 | 85 Correct Answer: D. Below-normal serum potassium level. A client with HHNS has an overall body deficit of potassium resulting from diuresis, which occurs secondary to the hyperosmolar, hyperglycemic state caused by the relative insulin deficiency. o Option A: An elevated serum acetone level is a symptom of diabetic ketoacidosis. Hepatic metabolism of free fatty acids as an alternative energy source results in accumulation of acidic intermediate and end metabolites (ie, ketones). Ketone bodies have generally included acetone, a true ketone. o Option B: Serum ketone bodies are characteristic of diabetic ketoacidosis. Ketone bodies are produced from acetyl coenzyme A mainly in the mitochondria within hepatocytes when carbohydrate utilization is impaired because of relative or absolute insulin deficiency, such that energy must be obtained from fatty acid metabolism. o Option C: Metabolic acidosis, not serum alkalosis, may occur in HHNS. A wide anion gap can be observed in patients with HHNS. The mild acidosis in HHNS is often multifactorial and results, in part, from the accumulation of minimal ketoacids in the absence of effective insulin activity. • 52. Question For a client with Graves’ disease, which nursing intervention promotes comfort? o A. Restricting intake of oral fluids. o B. Placing extra blankets on the client’s bed. o C. Limiting intake of high-carbohydrate foods. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 57 | 85 o D. Maintaining room temperature in the low- normal range. Correct Answer: D. Maintaining room temperature in the low-normal range. Graves’ disease causes signs and symptoms of hypermetabolism, such as heat intolerance, diaphoresis, excessive thirst and appetite, and weight loss. To reduce heat intolerance and diaphoresis, the nurse should keep the client’s room temperature in the low-normal range. o Option A: To replace fluids lost via diaphoresis, the nurse should encourage, not restrict, intake of oral fluids. o Option B: Placing extra blankets on the bed of a client with heat intolerance would cause discomfort. o Option C: To provide needed energy and calories, the nurse should encourage the client to eat high- carbohydrate foods. • 53. Question Patrick is treated in the emergency department for a Colles’ fracture sustained during a fall. What is a Colles’ fracture? o A. Fracture of the distal radius. o B. Fracture of the olecranon. o C. Fracture of the humerus. o D. Fracture of the carpal scaphoid. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 60 | 85 Correct Answer: A. Adult respiratory distress syndrome (ARDS) Severe hypoxia after smoke inhalation is typically related to ARDS. o Option B: Atelectasis is not associated with smoke inhalation. Inhaling harmful smoke can inflame the lungs and airway, causing them to swell and block oxygen. This can lead to acute respiratory distress syndrome and failure. o Option C: Bronchitis does not develop due to smoke inhalation. However, if the client already has bronchitis, inhalational injuries can worsen its condition. o Option D: Pneumonia isn’t typically associated with smoke inhalation and severe hypoxia. • 56. Question A 67-year-old client develops acute shortness of breath and progressive hypoxia requiring right femur. The hypoxia was probably caused by which of the following conditions? o A. Asthma attack o B. Atelectasis o C. Bronchitis o D. Fat embolism o A. Adult respiratory distress syndrome ( ARDS ) o B. Atelectasis o C. Bronchitis o D. Pneumonia NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 61 | 85 Correct Answer: D. Fat embolism Long bone fractures are correlated with fat emboli, which cause shortness of breath and hypoxia. o Option A: Asthma attacks do not develop following a femoral fracture. o Option B: He could develop atelectasis but it typically doesn’t produce progressive hypoxia. o Option C: It’s unlikely the client has developed bronchitis without a previous history. • 57. Question A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this? o A. Acute asthma o B. Chronic bronchitis o C. Pneumonia o D. Spontaneous pneumothorax Correct Answer: D. Spontaneous pneumothorax A spontaneous pneumothorax occurs when the client’s lung collapses, causing an acute decrease in the amount of functional lung used in NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 62 | 85 oxygenation. The sudden collapse was the cause of his chest pain and shortness of breath. o Option A: An asthma attack would show wheezing breath sounds. o Option B: Bronchitis would have rhonchi. o Option C: Pneumonia would have bronchial breath sounds over the area of consolidation. • 58. Question A 62-year-old male client was in a motor vehicle accident as an unrestrained driver. He’s now in the emergency department complaining of difficulty of breathing and chest pain. On auscultation of his lung field, no breath sounds are present in the upper lobe. This client may have which of the following conditions? o A. Bronchitis o B. Pneumonia o C. Pneumothorax o D. Tuberculosis (TB) Correct Answer: C. Pneumothorax Pneumothorax is defined as the presence of air or gas in the pleural cavity, which can impair oxygenation and/or ventilation. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 65 | 85 o Option B: Clot formation usually occurs in the legs. This is called deep vein thrombosis, which occurs in one or more of the deep veins in the legs. o Option C: Loss of lung parenchyma is not found with hemoptysis in pulmonary embolism. The lung parenchyma comprises a large number of thin-walled alveoli, forming an enormous surface area, which serves to maintain proper gas exchange. o Option D: A regional loss of surfactant is one of the consequences in pulmonary embolism. • 61. Question Alvin with a massive pulmonary embolism will have an arterial blood gas analysis performed to determine the extent of hypoxia. The acid-base disorder that may be present is? o A. Metabolic acidosis o B. Metabolic alkalosis o C. Respiratory acidosis o D. Respiratory alkalosis Correct Answer: D. Respiratory alkalosis A client with massive pulmonary embolism will have a large region and blow off large amounts of carbon dioxide, which crosses the unaffected alveolar-capillary membrane more readily than does oxygen and results in respiratory alkalosis. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 66 | 85 o Option A: Large amounts of carbon dioxide are blown off, removing the option of metabolic acidosis. o Option B: Respiratory, not metabolic, alkalosis is the result of a massive pulmonary embolism. o Option C: Acidosis does not occur with pulmonary embolism. Hypocapnia usually is present with an embolism. • 62. Question After a motor vehicle accident, Armand, a 22-year-old client, is admitted with a pneumothorax. The surgeon inserts a chest tube and attaches it to a chest drainage system. Bubbling soon appears in the water seal chamber. Which of the following is the most likely cause of the bubbling? o A. Air leak o B. Adequate suction o C. Inadequate suction o D. Kinked chest tube Correct Answer: A. Air leak Bubbling in the water seal chamber of a chest drainage system stems from an air leak. In pneumothorax, an air leak can occur as air is pulled from the pleural space. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 67 | 85 o Option B: Inadequate suction does not cause bubbling. o Option C: Bubbling doesn’t normally occur with adequate suction or any preexisting bubbling in the water seal chamber. o Option D: A kinked chest tube does not cause bubbling in the water seal chamber. • 63. Question Nurse Michelle calculates the IV flow rate for a postoperative client. The client receives 3,000 ml of Ringer’s lactate solution IV to run over 24 hours. The IV infusion set has a drop factor of 10 drops per milliliter. The nurse should regulate the client’s IV to deliver how many drops per minute? o A. 18 o B. 21 o C. 35 o D. 40 Correct Answer: B. 21 3000 x 10 divided by 24 x 60. o Option A: 18 is according to the formula used. o Option C: 35 is more than the prescribed gtts/minute as calculated. o Option D: 40 is more than the correct gtts/minute as calculated. • 64. Question NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 70 | 85 o B. Prevent the formation of blisters o C. Promote movement o D. Prevent pain and discomfort Correct Answer: A. Lessen the amount of cellular damage Rapid continuous rewarming of frostbite primarily lessens cellular damage. Rapid rewarming is the single most effective therapy for frostbite. Heat conduction and radiation from deeper tissue circulation prevent freezing and ice crystallization until the skin temperature drops below 0°C. o Option B: Blisters contain high amounts of thromboxane and prostaglandins. They contract and dry within 2-3 weeks, forming a dark eschar that sloughs off in 4 weeks. o Option C: Before movement can be improved, the cell injury should be resolved first. o Option D: It does not prevent the formation of blisters. It does promote movement, but this is not the primary reason for rapid rewarming. It might increase pain for a short period of time as the feeling comes back into the extremity. • 67. Question A client recently started on hemodialysis wants to know how the dialysis will take the place of his kidneys. The nurse’s response is based on the knowledge that hemodialysis works by: NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 71 | 85 o A. Passing water through a dialyzing membrane o B. Eliminating plasma proteins from the blood o C. Lowering the pH by removing nonvolatile acids o D. Filtering waste through a dialyzing membrane Correct Answer: D. Filtering waste through a dialyzing membrane Hemodialysis works by using a dialyzing membrane to filter waste that has accumulated in the blood. Dialysis largely replicates the functions of the kidneys in patients with chronic kidney failure. Hemodialysis takes over the key tasks of the o D. Tell the client that he should remain in isolation for 2 weeks Correct Answer: B. Contact the physician for an order for immune globulin The client who is immunosuppressed and is exposed to measles should be treated with medications to boost his immunity to the virus. If the patient knows that he has been exposed to measles and his CD4 count is less than 200, he should talk to his doctor about whether post-exposure prophylaxis (PEP) with immunoglobulin may be an option. PEP may provide some protection or lessen the severity of infection if it occurs. If the CD4 count is 200 or greater, PEP can also include getting the MMR vaccine. Ideally, PEP should be administered within 72 hours of exposure to measles. o Option A: Antibiotics may not be an effective treatment. One important characteristic of measles infection is that it produces more serious illness and increased mortality among immunocompromised individuals, primarily those with defects in T-cell immunity. Because >90% of the human immunodeficiency virus (HIV)–infected children live in regions where measles is still endemic, achieving high rates of NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 72 | 85 kidneys, removing waste materials, toxins, excess salt and fluids from the body. o Option A: In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from the blood. To get the blood into the artificial kidney, the doctor needs to make an access (entrance) into the blood vessels. This is done by minor surgery to the arm or leg. o Option B: The transfer of metabolic toxins through the membrane into the dialysis fluid is based on natural processes. This process is known as diffusion. When blood and dialysis fluid with different concentrations of molecules are separated by a semipermeable membrane, the molecules move through the membrane to the lower concentration. However, large proteins and blood cells are too big to pass through the small membrane- pores, so they remain in the blood. o Option C: A dialyzer is an artificial filter containing fine fibers. The fibers are hollow with microscopic pores in the wall, also known as semi-permeable dialysis membrane. To remove toxins during hemodialysis, a special dialysis-fluid flows through the filter, and bathes the fibers from the outside, while the blood flows through the hollow fiber. Due to the semi- permeable dialysis membrane, toxins, urea and other small particles can pass through the membrane. • 68. Question During a h ome visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most ap propriate? o A. Administer an antibiotic o o B. Contact the physician for an order for immune globulin C. Administer an antiviral NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 75 | 85 o Option A: The door should remain closed, but a negative- pressure room is not necessary. Whenever possible, patients with MRSA will have a single room or will share a room only with someone else who also has MRSA. o Option B: MRSA is spread by contact with blood or body fluid or by touching the skin of the client. Patients are asked to stay in their hospital rooms as much as possible. They should not go to common areas, such as the gift shop or cafeteria. They may go to other areas of the hospital for treatments and tests. o Option C: It is cultured from the nasal passages of the client, so the client should be instructed to cover his nose and mouth when he sneezes or coughs. It is not necessary for the client to wear the mask at all times; the nurse should wear the mask. • 70. Question A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates an understanding of phantom limb pain? o A. "The pain will go away in a few days." NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 76 | 85 o B. "The pain is due to peripheral nervous system interruptions. I will get you some pain medication." o C. "The pain is psychological because your foot is no longer there." o D. "The pain and itching are due to the infection you had before the surgery." Correct Answer: B. “The pain is due to peripheral nervous system interruptions. I will get you some pain medication.” Pain-related to phantom limb syndrome is due to a peripheral nervous system interruption. A recent study estimated that there were about 1.6 million people with limb loss in the USA in 2005 and this number was projected to increase by more than double to 3.6 million by the year 2050. Vascular problems, trauma, cancer, and congenital limb deficiency are among the common causes of limb loss. o Option A: Phantom limb pain can last several months or indefinitely. The phantom pain and sensation may have its onset immediately or years after the amputation. There are reports of two peak periods of onset, the first within a month and the second a year after amputation. The prevalence is reported to decrease over time after amputation. NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 77 | 85 o Option C: The explanation of phantom limb pain is not psychologically related. PLP was once thought to be primarily a psychiatric illness. With the accumulation of evidence from research over the past decades, the paradigm has shifted more towards changes at several levels of the neural axis, especially the cortex. Peripheral mechanisms and central neural mechanisms are among the hypotheses that have gained consensus as proposed mechanisms over the recent years. o Option D: Pain and itching are not symptoms of an infection due to surgery. During amputation, peripheral nerves are severed. This results in massive tissue and neuronal injury-causing disruption of the normal pattern of afferent nerve input to the spinal cord. This is followed by a process called deafferentation and the proximal portion of the severed nerve sprouts to form neuromas. There is an increased accumulation of molecules enhancing the expression of sodium channels in these neuromas that results in hype-excitability and spontaneous discharges. This abnormal peripheral activity is thought to be a potential source of stump pain, including phantom pain. • 71. Question A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple procedure, the doctor will remove the: NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 80 | 85 o Option A: Canned fruits are allowed since they are processed and pasteurized. Fresh fruits and vegetables are fine as long as they are washed first or cooked thoroughly. Meat, fish, and eggs should also be fully cooked. Commercially prepared and packaged foods are acceptable but avoid buying foods indented and swollen cans or damaged packaging. o Option B: Salt is allowed. The keys to a low-bacteria diet are choosing foods that are less likely to carry bacteria while avoiding the foods that do. Frequent hand washing and paying particular attention to food safety practices are also essential. o Option D: Ketchup is also allowed. Bread, ready-to- eat cereals, pancakes, waffles, and crackers are safe to eat. Bottled beverages, hot beverages, and pasteurized fruit and vegetable juices are good as well. Cream cheese, sour cream, mayonnaise, margarine, commercial peanut butter, and chocolate are okay, too. • 73. Question A client is discharged home with a prescription for Coumadin (sodium warfarin). The client should be instructed to: o A. Have a Protime done monthly o B. Eat more fruits and vegetables o C. Drink more liquids o D. Avoid crowds NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 81 | 85 Correct Answer: A. Have a Protime done monthly Coumadin is an anticoagulant. One of the tests for bleeding time is a Protime. This test should be done monthly. The client will need to have his blood tested to tell how well the medication is working. The blood test, called prothrombin time (PT or protime), is used to calculate the International Normalized Ratio (INR). INR helps the healthcare provider determine how well warfarin is working to prevent blood clots and if the dose needs to be adjusted. o Option B: Eating more fruits and vegetables is not necessary, and dark-green vegetables contain vitamin K, which increases clotting. Vitamin K is needed for normal blood clotting. However, large changes in the amount of vitamin K in the diet can change the way warfarin works. If the client eats foods high in vitamin K, it’s important to keep a weekly intake of vitamin K- containing foods consistent. o Option C: Drinking more liquids could boost the platelet count and increase the body’s immunity. Do not start consuming the following herbal teas and supplements because they may affect the INR, causing it to be too high or too low. If the client drinks tea, black tea (such as orange pekoe tea) is acceptable because it is not high in Vitamin K. o Option D: Avoiding crowds is important for patients with decreased WBC. Stay away from people who are ill. Avoid contact with anyone who has recently been vaccinated, including infants and children. Avoid crowds as much as possible. When going to places where there are often a lot of people (i.e., NCLEX-RN EXAM PACK SET 6 (75 QUESTIONS & ANSWERS LATEST UPDATED 2024) TOP RANKED ANSWERS P a g e 82 | 85 church, shopping), try going at off-peak times, when they are not as crowded. • 74. Question The nurse is assisting the physician with the removal of a central venous catheter. To facilitate removal, the nurse should instruct the client to: o A. Perform the Valsalva maneuver as the catheter is advanced o B. Turn his head to the left side and hyperextend the neck o C. Take slow, deep breaths as the catheter is removed o D. Turn his head to the right while maintaining a sniffing position Correct Answer: A. Perform the Valsalva maneuver as the catheter is advanced The client who is having a central venous catheter removed should be told to hold his breath and bear down. This prevents air from entering the line.