NCLEX-RN EXAM PACK SET 7 QUESTIONS AND ANSWERS -2023, Exams of Health, psychology

Download NCLEX-RN EXAM PACK SET 7 QUESTIONS AND ANSWERS -2023 and more Exams Health, psychology in PDF only on Docsity! NCLEX-RN EXAM PACK SET 7 QUESTIONS AND ANSWERS UPDATED 2022\2023) 1. 1. Question The nurse is providing discharge teaching for the client withleukemia. The client should be told to avoid: o A. Using oil- orcream-based soaps o B. Flossing between the teeth o C. The intake of salt o D. Using an electric razor • 2. Question The nurse is changing the ties of the client with a tracheostomy.The safest method of changing the tracheostomy ties is to: o A. Apply the new tie before removing the old one. o B. Have a helper present. o C. Hold the tracheostomy with the nondominant handwhile removing the old tie. o D. Ask the doctor to suture the tracheostomy in place. • 3. Question The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse shouldgive priority to: o A. Turning the client to the left side o B. Milking the tube to ensure patency o C. Slowing the intravenous infusion o D. Notifying the physician • 7. Question The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to: o A. Determine lung maturity o B. Measure the fetal activity o C. Show the effect of contractions on fetal heart rate o D. Measure the wellbeing of the fetus • 8. Question The nurse is evaluating the client who was admitted 8 hours agofor induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse? Correct Answer: A. Tire easily The toddler with a ventricular septal defect will tire easily. The hole (defect) occurs in the wall (septum) that separates the heart’s lower chambers (ventricles) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder. o Options B and C: He will not grow normally but will not need more calories. o Option D: He will be susceptible to bacterial infection, but he will be no more susceptible to viral infections than other children. o A. Instruct the client to push o B. Perform a vaginal exam o C. Turn off the Pitocin infusion o D. Place the client in a semi-Fowler’s position • 9. Question The nurse notes the following on the ECG monitor. The nursewould evaluate the cardiac arrhythmia as: o A. Atrial flutter o B. A sinus rhythm o C. Ventricular tachycardia o D. Atrial fibrillation • 10. Question A client with clotting disorder has an order to continue lovenox (Enoxaparin) injections after discharge. The nurse should teach the client that lovenox injections should: o A. Be injected into the deltoid muscle o B. Be injected into the abdomen o C. Aspirate after the injection o D. Clear the air from the syringe before injections Correct Answer: C. Ventricular tachycardia The graph indicates ventricular tachycardia. o Options A, B, D: The answers in A, B, and D are not noted on the ECG strip. Correct Answer: B. Be injected into the abdomen o B. A padded tongue blade o C. An endotracheal tube o D. An airway • 15. Question The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by: o A. Cats o B. Dogs o C. Turtles o D. Birds • 16. Question What’s the first intervention for a patient experiencing chestpain and a p02 of 89%? o A. Administer morphine o B. Administer oxygen o C. Administer sublingual nitroglycerin o D. Obtain an electrocardiogram (ECC) • 17. Question Which of the following signs and symptoms usually signifies rapidexpansion and impending rupture of an abdominal aortic aneurysm? o A. Abdominal pain o B. Absent pedal pulses o C. Chest pain o D. Lower back pain • 18. Question In which of the following types of cardiomyopathy does cardiacoutput remain normal? o A. Obliterative o B. Restrictive o C. Dilated o D. Hypertrophic Correct Answer: D. Hypertrophic Hypertrophic cardiomyopathy (HCM) is a condition in which there is a severe ventricular hypertrophy and poor diastolic filling. It is an autosomal dominant condition wherein the heart muscles asymmetrically increases in size and mass along the septum. Theincrease in the thickness of heart muscles reduces the size of thecavities of the ventricles causing them to take a longer time to relax after systole. Cardiac output isn’t affected by hypertrophic cardiomyopathy because the size of the ventricle remains relatively unchanged. o Options A and B: Restrictive cardiomyopathy (RCM)is wherein the walls of the heart are rigid causing arestrictive stretching and filling of blood properly. Restrictive and obliterative cardiomyopathy are the same. o Option C: Dilated cardiomyopathy (DCM) is a condition in which the left ventricle is enlarged and weakened causing a decrease in the ability to pump blood (decreased cardiac output). It is the most common type of cardiomyopathy and commonly leadsto progressive heart failure. The cause of DCM canbe idiopathic or it can result from inflammatory processeslike myocarditis, or from cytotoxic agents like alcohol and certain neoplastic drugs. • 19. Question Which of the following interventions should be your first prioritywhen treating a patient experiencing chest pain while walking? o A. Have the patient sit down. o B. Get the patient back to bed. o C. Obtain an ECG. • 23. Question Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress? o A. Cushing syndrome o B. Pain receptors o C. Immune response o D. Neural transmission • 24. Question A patient infected with human immunodeficiency virus (HIV)begins zidovudine therapy. Which of the following statements best describes this drug’s action? o A. It stimulates the immune system. o B. It destroys the outer wall of the virus and kills it. o C. It interferes with viral replication o D. It promotes excretion of viral antibodies. Correct Answer: C. Immune response Corticosteroids suppress eosinophils, lymphocytes, and natural killer cells, inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation, stabilizes lysosomal membranes, decreases capillary permeability, and depresses phagocytosis of tissues by white blood cells, thus blocking the release of more inflammatory materials. o Option A: Excessive corticosteroid therapy can lead to Cushing’s syndrome. o Option B: Analgesics suppress pain receptors. o Option D: Opioids and heroin may suppress neural transmission if taken in unregulated amounts. Correct Answer: C. It interferes with viral replication. • 25. Question A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. Whatcould you tell him to help him reduce his discomfort? o A. "Hold your cough as much as possible." o B. "Place the head of your bed flat to help withcoughing." o C. "Restrict fluids to help decrease the amount ofsputum." o D. "Splint your chest wall with a pillow forcomfort." • 26. Question A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions shouldyou take first? o A. Take a full medical history. Zidovudine inhibits DNA synthesis in HIV, thus interfering with viral replication. The drug doesn’t destroy the viral wall, stimulate the immune system, or promote HIV antibody excretion. o Options A, B, D: These options are not functions of Zidovudine. o B. Give a bronchodilator by nebulizer. o C. Apply a cardiac monitor to the patient. o D. Provide emotional support for the patient. • 27. Question A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He developed severe hypoxia48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed? o A. Atelectasis o B. Pneumonia o C. Bronchitis o D. Acute respiratory distress syndrome (ARDS) Correct Answer: D. Acute respiratory distress syndrome (ARDS). Severe hypoxia after smoke inhalation typically is related to ARDS. The other choices aren’t typically associated with smoke inhalation. o Option A: Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid. • 31. Question When giving intravenous (I.V.) phenytoin, which of the followingmethods should you use? o A. Use an in-line filter. o B. Withhold other anticonvulsants. o C. Mix the drug with saline solution only. o D. Flush the I.V. catheter with dextrose solution. • 32. Question After surgical repair of a hip, which of the following positions isbest for the patient’s legs and hips? o A. Abduction o B. Adduction o C. Prone o D. Subluxated • 33. Question Which of the following factors should be the primary focus ofnursing management in a patient with acute pancreatitis? o A. Nutrition management o B. Fluid and electrolyte balance o C. Management of hypoglycemia o D. Pain control • 34. Question After a liver biopsy, place the patient in which of the followingpositions? o A. Left side-lying, with the bed flat o B. Right side-lying, with the bed flat o C. Left side-lying, with the bed in semi-Fowler’s position o D. Right side-lying, with the bed in semi-Fowler’sposition o Option D: A subluxation is a partial dislocation of a joint. It’s often the result of acute injury or repetitive motions, but it can also occur because of medical conditions where the ligaments are loose. Correct Answer: B. Fluid and electrolyte balance Acute pancreatitis is commonly associated with fluid isolation and accumulation in the bowel secondary to ileus or peripancreatic edema. Fluid and electrolyte loss from vomiting is a major concern. Therefore, your priority is to manage hypovolemia and restore electrolyte balance. o Options A and D: Pain control and nutrition also are important, but not priority. o Option C: Patients are at risk for hyperglycemia, not hypoglycemia. • 35. Question Which of the following potentially serious complications couldoccur with therapy for hypothyroidism? o A. Acute hemolytic reaction o B. Angina or cardiac arrhythmia o C. Retinopathy o D. Thrombocytopenia • 36. Question Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? o A. Diabetes mellitus o B. Diabetes insipidus o C. Diabetic ketoacidosis Correct Answer: B. Right side-lying, with the bed flat. Positioning the patient on his right side with the bed flat will splint the biopsy site and minimize bleeding. o Options A, C, D: The other positions won’t do this and may cause more bleeding at the site or internally. • 40. Question Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site? o A. Thoroughly irrigate the wound before collecting the specimen. o B. Use a sterile swab and wipe the crusty area around the outside of the wound. o C. Gently roll a sterile swab from the center of the wound outward to collect drainage. o D. Use a sterile swab to collect drainage from the dressing. o Option A: Albumin is used as an adjunct therapy, not a primary fluid replacement. o Option B: Dextrose isn’t given to burn patients during the first 24 hours because it can cause pseudodiabetes. o Option D: The patient is hyperkalemic from the potassium shift from the intracellular space to the plasma, so potassium would be detrimental. • 41. Question A nurse is administering IV furosemide to a patient admitted with congestive heart failure. After the infusion, which of the followingsymptoms is not expected? o A. Increased urinary output o B. Decreased edema o C. Decreased pain o D. Decreased blood pressure • 42. Question There are a number of risk factors associated with coronary artery disease. Which of the following is a modifiable risk factor? o A. Gender o B. Age o C. Obesity o D. Heredity • 43. Question Tissue plasminogen activator (t-PA) is considered for the treatment of a patient who arrives in the emergency departmentfollowing the onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA? o A. Worsening chest pain that began earlier in theevening o B. History of cerebral hemorrhage o C. History of prior myocardial infarction o D. Hypertension • 44. Question Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the followingchoices reflects the purpose of exercise for this patient? o A. Increases fitness and prevents future heart attacks o B. Prevents bedsores o C. Prevents DVT (deep vein thrombosis) o D. Prevent constipations o C. "Headaches are a frequent side effect of nitroglycerine because it causes vasodilation." o D. "The headaches are unlikely to be related to the nitroglycerin, so you should see your doctor for furtherinvestigation." • 48. Question A patient received surgery and chemotherapy for colon cancer, completing therapy three (3) months previously, and she is now in remission. At a follow-up appointment, she complains of fatigue following activity and difficulty with concentration at herweekly bridge games. Which of the following explanations wouldaccount for her symptoms? o A. The symptoms may be the result of anemiacaused by chemotherapy. o B. The patient may be immunosuppressed. o C. The patient may be depressed. o D. The patient may be dehydrated. Correct Answer: C. “Headaches are a frequent side effect of nitroglycerine because it causes vasodilation.” Nitroglycerin is a potent vasodilator and often produces unwanted effects such as headache, dizziness, and hypotension. Patients should be counseled, and the dose titrated, to minimize these effects. In spite of the side effects, nitroglycerin is effective at reducing myocardial oxygen consumption and increasing blood flow. o Option A: The patient should not stop the medication. o Option B: Nitroglycerine does not cause bleeding in the brain. o Option D: Headaches are one of the side effects of nitroglycerin. Correct Answer: A. The symptoms may be the result of anemia caused by chemotherapy. • 49. Question A clinic patient has a hemoglobin concentration of 10.8 g/dL and reports sticking to a strict vegetarian diet. Which of the followingnutritional advice is appropriate? o A. The diet is providing adequate sources of iron andrequires no changes. o B. The patient should add meat to her diet; a vegetariandiet is not advised. o C. The patient should use iron cookware to prepare foods, such as dark- green, leafy vegetables, and legumes, which are high in iron. o D. Acup of coffee or tea should be added to every meal • 50. Question A hospitalized patient is receiving packed red blood cells (PRBCs)for treatment of severe anemia. Which of the following is the most accurate statement? A. Transfusion reaction is most likely immediately afterthe infusion is completed. o B. PRBCs are best infused slowly through a 20g. IV catheter. o C. PRBCs should be flushed with a 5% dextrose solution. o D. A nurse should remain in the room during the first 15 minutes of infusion. • 51. Question A patient who has received chemotherapy for cancer treatment isgiven an injection of Epoetin. Which of the following should reflectthe findings in a complete blood count (CBC) drawn several days later? o A. An increase inneutrophil count o B. An increase inhematocrit o C. Hyponatremia o D. Low serum albumin o E. Mood swings • 55. Question A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for aneutropenic patient? o A. Change the disposable mask immediately after use. o B. Change gloves immediately after use. o C. Minimize patient contact. o D. Minimize conversation with the patient. Correct Answer: A, B, D, and E. Side effects of corticosteroids include weight gain, fluid retention with hypertension, Cushingoid features, low serum albumin, suppressed inflammatory response, and mood swings. Patients are encouraged to eat a diet high in protein, vitamins, and minerals and low in sodium. o Option C: Corticosteroids cause hypernatremia and not hyponatremia. • 56. Question A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectiousprecautions. Which of the following statements by family members indicates that the family needs more education? o A. We will bring in books and magazines forentertainment. o B. We will bring in personal care items for comfort. o C. We will bring in fresh flowers to brighten the room. o D. We will bring in family pictures and get-well cards. • 57. Question A nurse is caring for a patient with acute lymphoblastic leukemia(ALL). Which of the following is the most likely age range of the patient? o A. 3-10 years o B. 25-35 years o C. 45-55 years o D. over 60 years Correct Answer: C. We will bring in fresh flowers to brighten the room. During induction chemotherapy, the leukemia patient is severely immunocompromised and at risk of serious infection. Fresh flowers, fruit, and plants can carry microbes and should be avoided. o Options A, B, and D: Books, pictures, and other personal items can be cleaned with antimicrobials before being brought into the room to minimize the risk of contamination. Correct Answer: A. 3-10 years The peak incidence of ALL is at 4 years (range 3-10). • 58. Question A patient is admitted to the oncology unit for diagnosis of suspected Hodgkin’s disease. Which of the following symptoms istypical of Hodgkin’s disease? o A. Painful cervical lymph nodes o B. Night sweats and fatigue o C. Nausea and vomiting o D. Weight gain • 59. Question The Hodgkin’s disease patient described in the question aboveundergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin’s disease were correct, which of the following cells would the pathologist expect to find? o A. Lymphoblastic cells o B. Reed-Sternberg cells o Option B: It is uncommon after the mid-teen years. o Option C: The peak incidence of chronic myelogenous leukemia (CML) is 45-55 years. o Option D: The peak incidence of acute myelogenous leukemia (AML) occurs at 60 years. Two-thirds of cases of chronic lymphocytic leukemia (CLL) occur after 60 years. • 63. Question A 25-year-old male is admitted in sickle cell crisis. Which of thefollowing interventions would be of the highest priority for this client? o A. Taking hourly blood pressures with mechanical cuff o B. Encouraging fluid intake of at least 200mL perhour o C. Position in high Fowler’s with knee gatch raised o D. Administering Tylenol as ordered • 64. Question Which of the following foods would the nurse encourage theclient in sickle cell crisis to eat? o A. Peaches o B. Cottage cheese o C. Popsicle o D. Lima beans • 65. Question A newly admitted client has a sickle cell crisis. The nurse is planning care based on the assessment of the client. The client iscomplaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. o A. Adjust the room temperature o B. Give a bolus of IV fluids o C. Start O2 o D. Administer meperidine (Demerol) 75 mg IV push Correct Answer: C. Popsicle Hydration is important in the client with sickle cell disease to prevent thrombus formation. Popsicles, gelatin, juice, and pudding have high fluid content. o Options A, B, D: These food items do not aid in hydration and are, therefore, . • 66. Question The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select? o A. Roast beef, gelatin salad, green beans, and peach pie o B. Chicken salad sandwich, coleslaw, French fries, icecream o C. Egg salad on wheat bread, carrot sticks, lettucesalad, raisin pie o D. Pork chop, creamed potatoes, corn, and coconut cake • 67. Question Clients with sickle cell anemia are taught to avoid activities thatcause hypoxia and hypoxemia. Which of the following activities would the nurse recommend? o A. A family vacation in the Rocky Mountains o B. Chaperoning the local boys club on asnow-skiing trip o C. Traveling by airplane for business trips o D. A bus trip to the Museum of Natural History Correct Answer: C. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie Egg yolks, wheat bread, carrots, raisins, and green, leafy vegetables are all high in iron, which is an important mineral for this client. o Options A, B, and D: Roast beef, cabbage, and pork chops are also high in iron, but the side dishes accompanying these choices are not. Correct Answer: D. A bus trip to the Museum of Natural History Taking a trip to the museum is the only answer that does not pose a threat. • 72. Question A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment? o A. The client collects stamps as a hobby. o B. The client recently lost his job as a postal worker. o C. The client had radiation for treatment ofHodgkin’s disease as a teenager. o D. The client’s brother had leukemia as a child. • 73. Question An African American client is admitted with acute leukemia. Thenurse is assessing for signs and symptoms of bleeding. Where isthe best site for examining for the presence of petechiae? o A. The abdomen o B. The thorax o C. The earlobes o D. The soles of the feet • 74. Question A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse toinquire? o A. "Have you noticed a change in sleeping habitsrecently?" o B. "Have you had a respiratory infection in the last 6 months?" o C. "Have you lost weight recently?" o D. "Have younoticed changes in your alertness?" Correct Answer: B. “Have you had a respiratory infection in the last 6 months?” The client with leukemia is at risk for infection and has often had recurrent respiratory infections during the previous 6 months. Correct Answer: D. The soles of the feet Petechiae are not usually visualized on dark skin. The soles of the feet and palms of the hand provide a lighter surface for assessing the client for petechiae. o Options A, B, and C: The skin in the abdomen, thorax, and earlobes might be too dark to make an assessment. • 75. Question Which of the following would be the priority nursing diagnosisfor the adult client with acute leukemia? o A. Oral mucousmembrane, altered related to chemotherapy o B. Risk for injuryrelated to thrombocytopenia o C. Fatigue related to the disease process o D. Interrupted family processes related to life-threatening illness of a family member o Options A, C, and D: Insomnolence, weight loss, and a decrease in alertness also occur in leukemia, but bleeding tendencies and infections are the primary clinical manifestations.