NCLEX-RN Exam Pack Set 6 (75 Questions & Answers Updated 2022-2024) GRADED A+, Exams of Nursing

Download NCLEX-RN Exam Pack Set 6 (75 Questions & Answers Updated 2022-2024) GRADED A+ and more Exams Nursing in PDF only on Docsity! NCLEX-RN Exam Pack Set 6 (75 Questions & Answers Updated 2022-2024) GRADED A+. 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 • 2. Question 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 • 3. Question Olivia had coronary artery bypass graft (CABG) surgery 3 days ago. Which of the following conditions is suspected by the nurse when a decrease in platelet count from 230,000 ul to 5,000 ul is noted? o A. Pancytopenia o B. Idiopathic thrombocytopenic purpura (ITP) o C. Disseminated intravascular coagulation (DIC) • 7. Question Instructions for a client with systemic lupus erythematosus (SLE) would include information about which of the following blood dyscrasias? o A. Dressler’s syndrome o B. Polycythemia o C. Essential thrombocytopenia o D. Von Willebrand’s disease • 8. Question The nurse is aware that the following symptom is most commonly an early indication of stage 1 Hodgkin’s disease? o A. Pericarditis o B. Night sweat o C. Splenomegaly o D. Persistent hypothermia • 9. Question Francis with leukemia has neutropenia. Which of the following functions must be frequently assessed? o A. Blood pressure o B. Bowel sounds o C. Heart sounds o D. Breath sounds • 10. Question The nurse knows that neurologic complications of multiple myeloma (MM) usually involve which of the following body systems? o A. Brain o B. Muscle spasm o C. Renal dysfunction o D. Myocardial irritability • 14. Question A male client with a gunshot wound requires an emergency blood transfusion. His blood type is AB negative. Which blood type would be the safest for him to receive? o A. AB Rh-positive o B. A Rh-positive o C. A Rh-negative o D. O Rh-positive o Option A: The incubation period ranges from 1 to 4 days. Peak virus shedding usually occurs from 1 day before the onset of symptoms to 3 days after. o Option B: Clients with sickle cell anemia manifest signs and symptoms of chronic anemia with pallor of the mucous membrane, fatigue, and decreased tolerance for exercise; they don’t show fever, night sweats, weight loss or lymph node enlargement. o Option C: In some cases, the signs of leukemia may include noticeable swelling of the neck, armpit, or groin. This occurs when leukemia has spread to the lymph nodes. • 15. Question Stacy was diagnosed with acute lymphoid leukemia (ALL). She was discharged from the hospital following her chemotherapy treatments. Which statement of Stacy’s mother indicated that she understands when she will contact the physician? 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”. • 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”. o D. “This is only temporary; Molly Sue will re-grow new hair in 3-6 months but may be different in texture”. • 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. o B. Apply viscous Lidocaine to oral ulcers as needed. o C. Use lemon glycerine swabs every 2 hours. o D. Rinse mouth with Hydrogen Peroxide. • 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 • 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 • 23. Question Norma has started a new drug for hypertension. Thirty minutes after she takes the drug, she develops chest tightness and becomes short of breath and tachypnea. She has a decreased level of consciousness. These signs indicate which of the following conditions? o A. Asthma attack o B. Pulmonary embolism o C. Respiratory failure o D. Rheumatoid arthritis • 24. Question Mr. Gonzales was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver which laboratory test indicates liver cirrhosis? o A. Decreased red blood cell count o B. Decreased serum acid phosphatase level o C. Elevated white blood cell count o D. Elevated serum aminotransferase • 25. Question The biopsy of Mr. Gonzales confirms the diagnosis of cirrhosis. Mr. Gonzales is at increased risk for excessive bleeding primarily because of: o A. Impaired clotting mechanism o Option D: Rheumatoid arthritis is an autoimmune and inflammatory disease, which means that the immune system attacks healthy cells in the body by mistake, causing inflammation in the affected parts of the body. • 28. Question Which of the following groups of symptoms indicates a ruptured abdominal aortic aneurysm? o A. Lower back pain, increased blood pressure, decreased red blood cell (RBC) count, increased white blood (WBC) count. o B. Severe lower back pain, decreased blood pressure, decreased RBC count, increased WBC count. o C. Severe lower back pain, decreased blood pressure, decreased RBC count, decreased RBC count, decreased WBC count. o D. Intermittent lower back pain, decreased blood pressure, decreased RBC count, increased WBC count. 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. Correct Answer: B. Severe lower back pain, decreased blood pressure, decreased RBC count, increased WBC count. Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can’t be alleviated until the aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn’t increase. For the same reason, the RBC count has decreased – not increased. The WBC count increases as cells migrate to the site of injury. o Option A: The pain is severe due to the ruptured aneurysm; the blood pressure is decreased due to blood loss. o Option C: The increase in WBC count is due to the cells migrating to the site of the injury. • 29. Question After undergoing a cardiac catheterization, Tracy has a large puddle of blood under his buttocks. Which of the following steps should the nurse take first? o A. Call for help. o B. Obtain vital signs. o C. Ask the client to “lift up”. o D. Apply gloves and assess the groin site. • 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 o Option D: The pain in a ruptured aneurysm is constant and can only be alleviated if the aneurysm is repaired. o D. Percutaneous transluminal coronary angioplasty (PTCA) • 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) • 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? o A. “Your son had a mild concussion, acetaminophen is strong 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, which increases the intracranial pressure (ICP).” 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. • 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. • 37. Question When prioritizing care, which of the following clients should the nurse Olivia assess first? o A. A 17-year-old client 24-hours post appendectomy. o B. A 33-year-old client with a recent diagnosis of Guillain-Barre syndrome. o C. A 50-year-old client 3 days post myocardial infarction. o D. A 50-year-old client with diverticulitis. Correct Answer: B. A 33-year-old client with a recent diagnosis of Guillain-Barre syndrome Guillain-Barre syndrome is characterized by ascending paralysis and potential respiratory failure. The order of client assessment should follow client priorities, with disorder of airways, breathing, and then circulation. o Option A: The client who is post appendectomy has no signs of hemorrhage or unstable vital signs. Possible complications of appendectomy are bleeding, wound infection, peritonitis, blocked bowels, and injury to nearby organs. o Option C: There’s no information to suggest the postmyocardial infarction client has an arrhythmia or other complication. About 90% of patients who have an acute MI develop some form of cardiac arrhythmia during or immediately after the event. o Option D: There’s no evidence to suggest perforation for the client with diverticulitis as a priority of care. Diverticula are small, bulging pouches that can form in the lining of the digestive system.when one or more of the pouches become inflamed, and in some cases infected, that condition is known as diverticulitis. • 38. Question 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 for gout? o A. Replaces estrogen. o B. Decreases infection. o C. Decreases inflammation. o D. Decreases bone demineralization. Correct Answer: C. Decreases inflammation. o A. Pitting edema of the legs o B. An irregular apical pulse o C. Dry mucous membranes o D. Frequent urination • 42. Question Cyrill with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty-six hours later, the client’s urine output suddenly rises above 200 ml/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse’s suspicion of diabetes insipidus? o A. Above-normal urine and serum osmolality levels. o B. Below-normal urine and serum osmolality levels. o C. Above-normal urine osmolality level, below-normal serum osmolality level. o D. Below-normal urine osmolality level, above- normal serum osmolality level. • 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? 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.” • 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 • 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. • 49. Question The physician orders laboratory tests to confirm hyperthyroidism in a female client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis? o Option C: Temperature regulation may be affected by excess cortisol and isn’t an accurate indicator of infection. 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. o C. An increase in the TSH level after 30 minutes during the TSH stimulation test. o D. Below-normal levels of serum triiodothyronine (T3) and serum thyroxine (T4) as detected by radioimmunoassay. • 50. Question Rico with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U-100 regular insulin and 35 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? o A. “Inject insulin into healthy tissue with large blood vessels and nerves.” o B. “Rotate injection sites within the same anatomic region, not among different regions.” o C. “Administer insulin into areas of scar tissue or hypertrophy whenever possible.” o D. “Administer insulin into sites above muscles that you plan to exercise heavily later that day.” • 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. 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 o B. Calcium and phosphorous o C. Phosphorus and potassium o D. Potassium and sodium • 55. Question Johnny, a firefighter, was involved in extinguishing a house fire and is being treated for smoke inhalation. He developed severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. He most likely has developed which of the following conditions? o A. Adult respiratory distress syndrome (ARDS) o B. Atelectasis o C. Bronchitis o D. Pneumonia • 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 • 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 • 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 • 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 • 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 • 64. Question Mickey, a 6-year-old child with a congenital heart disorder is admitted with congestive heart failure. Digoxin (lanoxin) 0.12 mg is ordered for the child. The bottle of Lanoxin contains .05 mg of Lanoxin in 1 ml of solution. What amount should the nurse administer to the child? o A. 1.2 ml o B. 2.4 ml o C. 3.5 ml o D. 4.2 ml • 65. Question Nurse Alexandra teaches a client about elastic stockings. Which of the following statements, if made by the client, indicates to the nurse that the teaching was successful? o A. “I will wear the stockings until the physician tells me to remove them.” o B. “I should wear the stockings even when I am asleep.” o C. “Every four hours I should remove the stockings for a half hour.” o D. “I should put on the stockings before getting out of bed in the morning.” • 66. Question The primary reason for rapid continuous rewarming of the area affected by frostbite is to: o A. Lessen the amount of cellular damage o B. Prevent the formation of blisters o Option D: 4.2 ml is an dosage according to the formula used. 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 measles vaccine coverage is especially important among these populations to suppress excess measles-associated morbidity and mortality. o Option C: Antivirals would not be as effective as immunoglobulins for the client with AIDS. Early identification and antiretroviral treatment of HIV- infected infants and children are critical to maximizing measles vaccine immunogenicity and providing protection against other HIV-related complications. o Option D: The patient should remain in isolation, but the administration of immunoglobulin is a priority. The impact of HIV-related immunocompromise and subsequent effects of antiretroviral therapy (ART) on immune reconstitution and, ultimately, on vaccine immunogenicity is unclear. • 69. Question A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact? o A. The client should be placed in a room with negative pressure. o B. Infection requires close contact; therefore, the door may remain open. o C. Transmission is highly likely, so the client should wear a mask at all times. o D. Infection requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown. • 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." 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. 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 • 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 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. • 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 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., church, shopping), try going at off-peak times, when they are not as crowded. • 75. Question A client has an order for streptokinase. Before administering the medication, the nurse should assess the client for: o A. A history of streptococcal infections o B. Allergies to pineapples and bananas o C. Prior therapy with phenytoin o D. A history of alcohol abuse occlusive dressing over the site after removal, and a period of post-procedure monitoring. o Option C: The patient is asked to take a deep breath, hold it, and bear down during the removal to avoid introduction of an air embolism. Breath-holding or Valsalva maneuver will increase intracardiac pressures. Immediate occlusion is required to prevent air embolism. Option D: The patient’s head should be placed in a supine position with the head of the bed flat to reduce the risk of air embolism. Risk for air embolism increases when the catheter insertion site is above heart level (e.g., in a sitting position), if the patient is hypovolemic or during spontaneous inspiration. Correct Answer: A history of streptococcal infections Clients with a history of streptococcal infections could have antibodies that render the streptokinase ineffective. Due to streptokinase’s thrombolytic mechanisms of action, patients need monitoring for bleeding. The patient’s thrombin time, prothrombin time, partial thromboplastin time, complete blood count, and any signs of bleeding demand careful surveillance. Patients also need monitoring for signs and symptoms of reinfarction or vessel occlusion. o Option B: There is no reason to assess the client for allergies to pineapples or bananas. Streptokinase can precipitate an allergic reaction. Symptoms include fever, shivering, and rash. Patients in rare instances have developed nonfatal anaphylactic reactions. In cases of anaphylaxis, patients should be administered