Nursing NCLEX-RN Exam Pack Set 1 75 Questions and Answers Updated 2024 Best Rated Solution, Exams of Nursing

Download Nursing NCLEX-RN Exam Pack Set 1 75 Questions and Answers Updated 2024 Best Rated Solution and more Exams Nursing in PDF only on Docsity! Nursing NCLEX-RN Exam Pack Set 1 75 Questions and Answers Updated 2024 Best Rated Solutions 1. 1. Question While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply. O A. Abdominal respirations O B. Irregular breathing rate O C. Inspiratory grunt O D. Increased heart rate with crying O E. Nasal flaring O F. Cyanosis O G. Asymmetric chest movement • 2. Question A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications. View Answers: o Place the call bell within reach o Raise the side rails on the bed o Have the client empty bladder o Instruct the client to remain in bed 2. 3. Question A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks with fluids and then aspirating the fluid back out. This procedure is done in life-threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion. o Option B: The oral formulation of acetyl cysteine is the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetyl cysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen to its nontoxic form. When given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally or intravenously. o Option C: Intermittent IV infusion with Dextrose 5% may be considered for late-presenting or chronic ingestion. o Option D: Oral activated charcoal (AC) avidly adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes since it can effectively adsorb it and neutralize the benefits. • 6. Question Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure? o A. Angina at rest o B. Thrombus formation o C. Dizziness o D. Falling blood pressure • 7. Question A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is: o A. Maintain fluid and electrolyte balance o B. Control nausea o C. Manage pain o D. Prevent urinary tract infection • 8. Question What would the nurse expect to see while assessing the growth of children during their school-age years? o A. Decreasing amounts of body fat and muscle mass o B. Little change in body appearance from year to year o C. Progressive height increase of 4 inches each year o D. Yearly weight gain of about 5.5 pounds per year • 9. Question At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to: o A. Go get a blood pressure check within the next 15 minutes o B. Examine the child’s throat o C. Collect a sputum specimen o D. Notify the healthcare provider of the child’s status • 13. Question In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation? o A. Polyphagia o B. Dehydration o C. Bedwetting o D. Weight loss • 14. Question A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection? o A. Trichomoniasis o B. Chlamydia o C. Staphylococcus o D. Streptococcus • 15. Question A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN? o A. A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing out of my chest.” o B. A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking two (2) days ago for my family. Why are my arms and legs jerking?” o C. An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 11, o D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room. • 16. Question When teaching a client with coronary artery disease about nutrition, the nurse should emphasize: o A. Eating three (3) balanced meals a day o B. Adding complex carbohydrates o C. Avoiding very heavy meals o D. Limiting sodium to 7 gms per day • 20. Question A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time? o A. Positive sweat test o B. Bulky greasy stools o C. Moist, productive cough o D. Meconium ileus • 21. Question The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs two (2) hours ago. The nurse should o A. Place a call to the client’s health care provider for instructions o B. Send him to the emergency room for evaluation o C. Reassure the client’s wife that the symptoms are transient o D. Instruct the client’s wife to call the doctor if his symptoms become worse • 22. Question Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test? o A. Client must be NPO before the examination o B. Enema to be administered prior to the examination o C. Medicate client with furosemide 20 mg IV 30 minutes prior to the examination o D. No special orders are necessary for this examination • 23. Question The nurse is giving discharge teaching to a client seven (7) days post- myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question? o A. “You need to regain your strength before attempting such exertion.” o B. “When you can climb 2 flights of stairs without problems, it is generally safe.” o C. “Have a glass of wine to relax you, then you can try to have sex.” • 24. Question A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first? o A. A 2-month-old infant with a history of rolling off the bed and has bulging fontanelle with crying o A. Narrowed QRS complex o B. Shortened “PR” interval o C. Tall peaked "T" waves o D. Prominent “U” waves • 28. Question A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body? o A. All striated muscles o B. The cerebellum o C. The kidneys o D. The leg bones • 29. Question The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to: o A. Achieve harmony o B. Maintain a balance of energy o C. Respect life o D. Restore yin and yang • 30. Question During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to: o A. Increase fluids that are high in protein o B. Restrict fluids o C. Force fluids and reassess blood pressure o D. Limit fluids to non-caffeine beverages • 31. Question The nurse prepares the client for the insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about: o A. Stroke volume o B. Cardiac output o C. Venous pressure o D. Left ventricular functioning • 32. Question A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is: o B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” o C. “I have to use the bedpan to pass my water at least every 1 to 2 hours.” o D. “It seems that the pain medication is not working as well today.” Correct Answer: B. “I just can’t ‘catch my breath’ over the past few minutes and I think I am in grave danger.” The nurse would be concerned about all of these comments, however, the most life-threatening is option B. Clients who had hip or knee surgery are at higher risk for the development of postoperative pulmonary embolism. Sudden dyspnea and tachycardia are classic findings of pulmonary embolism. Without prophylaxis (e.g., anticoagulation medications), deep vein thrombosis can develop within 7 to 14 days following the surgery and can lead to pulmonary embolism. The nurse should be aware of the other signs of DVT which include: pain and tenderness at or below the area of the clot, skin discoloration, swelling, or tightness of the affected leg. Signs of pulmonary embolism include acute onset of dyspnea, tachycardia, confusion, and pleuritic chest pain. o Option A: Muscle spasms occur after total hip replacements and acute pain is expected after a surgical procedure. o Option C: May indicate urinary infection and needs further assessment by the nurse. o Option D: May require a reevaluation of pain and interventions to manage pain though does not need immediate action. • 36. Question A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following assessment cues below may indicate the client is experiencing a negative side effect from the medication? o A. Weight gain of 5 pounds o B. Edema of the ankles o C. Gastric irritability o D. Decreased appetite • 37. Question The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing intervention would be most effective in promoting healing? o A. Apply dressing using sterile technique o B. Improve the client’s nutrition status o C. Initiate limb compression therapy o D. Begin proteolytic debridement extremities causing the cells to die or necrose. This ultimately leads to the formation of venous stasis ulcers characterized by shallow but large brown wounds with irregular margins that typically develop on the lower leg or ankle. The goal of clinical management in a client with venous stasis ulcers is to promote healing. This only can be accomplished with proper nutrition. Nutritional deficiencies are common causes of venous ulcers. Alterations in the diet to include foods high in protein, iron, zinc, and vitamins C and A are encouraged to promote wound healing. o Option A: Dressings are often used under compression bandages to promote faster healing and prevent adherence of the bandage to the ulcer. A wide range of dressings are available, including hydrocolloids (e.g., Duoderm), foams, hydrogels, pastes, and simple non-adherent dressings. o A. “At least two (2) full meals a day are eaten.” o B. “We go to a group discussion every week at our community center.” o C. “We have safety bars installed in the bathroom and have 24-hour alarms on the doors.” o D. “The medication is not a problem to have it taken three (3) times a day.” • 41. Question A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply. o A. Warfarin (Coumadin) o B. Finasteride (Propecia, Pros car) o C. Celecoxib (Celebrex) o D. Clonidine (Catapres) o E. Transdermal nicotine (Habitrol) o F. Clofazimine(Lamprene) • 42. Question A nurse is reviewing a patient’s past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply. o A. Ciprofloxacin (Cipro) o B. Sulfonamide o C. Norfloxacin (Noroxin) o D. Sulfamethoxazole and Trimethoprim (Bactrim) o E. Isotretinoin (Accutane) o F. Nitro-Dur patch body interact with UV rays from the sun. Anti-infectives are the most common cause of this type of reaction. o Option A: Ciprofloxacin is used to treat a variety of bacterial infections. Ciprofloxacin belongs to a class of drugs called quinolone antibiotics. It works by stopping the growth of bacteria. This antibiotic treats only bacterial infections. It will not work for virus infections (such as common cold, flu). Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness. o Option B: Sulfonamides are synthetic bacteriostatic antibiotics that competitively inhibit conversion of p- aminobenzoic acid to dihydropteroate, which bacteria need for folate synthesis and ultimately purine and DNA synthesis. Humans do not synthesize folate but acquire it in their diet, so their DNA synthesis is less affected. o Option C: Norfloxacin is an antibiotic in a group of drugs called fluoroquinolones. Norfloxacin fights bacteria in the body. Norfloxacin is used to treat different bacterial infections of the prostate or urinary tract (bladder and kidneys). Norfloxacin is also used to treat gonorrhea. o Option B: Humulin N injection if unopened (not in use) is stored in the fridge and can be used until the expiration date, or stored at room temperature and used within 31 days. If opened (in-use), store the vial in a refrigerator or at room temperature and use within 31 days. Store the injection pen at room temperature (do not refrigerate) and use within 14 days. Keep it in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen. o Option C: Urokinase (Kinlytic) is refrigerated at 2–8°C. Lyophilized Urokinase although stable at room temperature for 3 weeks, should be stored desiccated below -18°C. Upon reconstitution Urokinase should be stored at 4°C between 2-7 days and for future use below -18°C. • 45. Question A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb? o A. IgA o B. IgD o C. IgE o D. IgG Correct Answer: D. IgG IgG is the only immunoglobulin that can cross the placental barrier. About 70-80% of the immunoglobulins in the blood are IgG. Specific IgG antibodies are produced during an initial infection or other antigen exposure, rising a few weeks after it begins, then decreasing and stabilizing. The body retains a catalog of IgG antibodies that can be rapidly reproduced whenever exposed to the same antigen. IgG antibodies form the basis of long-term protection against microorganisms. o Option A: IgA antibodies protect body surfaces that are exposed to outside foreign substances. Immunoglobulin A (IgA) is the first line of defence in the resistance against infection, via inhibiting bacterial and viral adhesion to epithelial cells and by neutralisation of bacterial toxins and virus, both extra- and intracellularly. IgA also eliminates pathogens or antigens via an IgA-mediated excretory pathway where binding to IgA is followed by poly immunoglobulin receptor-mediated transport of immune complexes. o Option B: IgD antibodies are found in small amounts in the tissues that line the belly or chest. Secreted IgD appears to enhance mucosal homeostasis and • 46. Question A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take? o A. Immediately see a social worker o B. Start prophylactic AZT treatment o C. Start prophylactic Pentamidine treatment o D. Seek counseling • 47. Question A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? o A. Atherosclerosis o A. Diverticulosis o B. Hypercalcemia o C. Hypocalcemia o D. Irritable bowel syndrome • 50. Question Rhogam is most often used to treat mothers that have a infant. o A. RH positive, RH positive o B. RH positive, RH negative o C. RH negative, RH positive o D. RH negative, RH negative Correct Answer: C. RH negative, RH positive Rhogam prevents the production of anti-RH antibodies in the mother that has an Rh-positive fetus. o Option A: RhoGAM is a prescription medicine that is used to prevent Rh immunization, a condition in which an individual with Rh- negative blood develops antibodies after exposure to Rh-positive blood. o Option B: If the father or baby is not conclusively shown to be Rh- negative, RhoGAM should be given to an Rh-negative mother in the following clinical situations to prevent Rh immunization: after delivery of an Rh-positive baby; routine prevention of Rh immunization at 26 to 28 weeks of pregnancy; maternal or fetal bleeding during pregnancy from certain conditions; or an actual or threatened pregnancy loss at any stage. o Option D: It isn’t until second and subsequent pregnancies when antibodies are already built up, that Rh incompatibility can cause problems. Indeed, these antibodies can cross the placenta and attack the baby’s red blood cells. This can cause the baby to develop anemia, and in severe cases, result in miscarriage. • 51. Question A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU? o A. A Guthrie test can check the necessary lab values o B. The urine has a high concentration of phenyl pyruvic acid o C. Mental deficits are often present with PKU o D. The effects of PKU are reversible Correct Answer: D. The effects of PKU are reversible. Phenylketonuria (PKU) is an inherited disorder that increases the levels of phenylalanine (a building block of proteins) in the blood. If PKU is not treated, phenylalanine can build up to harmful levels in the body, causing intellectual disability and other serious health problems. The signs and symptoms of PKU vary from mild to severe. The most severe form of this disorder is known as classic PKU. Infants with classic PKU appear normal until they are a few months old. Without treatment, these children develop a permanent intellectual disability. Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. Untreated individuals may have a musty or mouse-like odor as a side effect of excess phenylalanine in the body. Children with classic PKU tend to have lighter skin and hair than unaffected family members and are also likely to have skin disorders such as eczema. The effects of PKU stay with the infant throughout their life (via Genetic Home Reference). o Option A: The Guthrie test as a bacterial inhibition assay was formerly used, but now being replaced by tandem mass spectrometry. o Option D: Parkinson’s type symptoms include tremors, bradykinesia, rigid muscles, impaired posture and balance, speech changes, and loss of automatic movements. • 53. Question A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is? o A. Let others know about the patient’s deficits. o B. Communicate with your supervisor your patient safety concerns. o C. Continuously update the patient on the social environment. o D. Provide a secure environment for the patient. • 54. Question A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient? o A. Deep breathing techniques to increase oxygen levels. o B. Cough regularly and deeply to clear airway passages. o C. Cough following bronchodilator utilization. o D. Decrease CO2 levels by increased oxygen take output during meals. • 55. Question A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present? o A. Slow pulse rate o B. Weight gain o C. Decreased systolic pressure o D. Irregular WBC lab values Correct Answer: B. Weight gain Weight gain due to fluid accumulation is associated with heart failure and congenital heart defects. When the heart does not circulate blood normally, the kidneys receive less blood and filter less fluid out of the circulation into the urine. The extra fluid in the circulation builds up in the lungs, the liver, around the eyes, and sometimes in the legs. o Option A: One of the symptoms of congenital heart defect is a rapid heartbeat. The heart must work harder to pump blood and supply enough for all the body systems. o Option C: There is an increase in the systolic blood pressure to compensate for the decrease of sufficient oxygen. o Option D: Irregular WBC is not a symptom of a congenital heart defect. An elevated WBC count is directly associated with an increased incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African- American and White men and women. An elevated total white blood cell (WBC) count is a risk factor for atherosclerotic vascular disease. • 56. Question A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome? o B. H. influenzae o C. N. meningitidis o D. Cl. difficile • 60. Question A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long do red blood cells live in my body? The correct response is: o A. The life span of RBC is 45 days o B. The life span of RBC is 60 days o C. The life span of RBC is 90 days o D. The life span of RBC is 120 days Correct Answer: D. The life span of RBC is 120 days Red blood cells have a lifespan of 120 in the body. Today, RBC population studies are performed with a label that is placed on the RBC ex vivo, making it possible to study both donor and autologous RBC. o Option A: Human red blood cells (RBC), after differentiating from erythroblasts in the bone marrow, are released into the blood and survive in the circulation for approximately 115 days. In humans and some other species, RBC normally survives in a nonrandom manner. This means that all of the RBC in an age cohort are removed by the reticuloendothelial system at about the same time. o Option B: Accurate measurement of long-term survival requires determination of the amount of remaining labeled RBC for all or most of the RBC lifespan. Optimal determination of long-term survival also requires a steady-state situation, with the important variable depending on the label used. o Option C: Only recently with the introduction of the biotin label has a method become available that allows the detection, analysis, and isolation of aging RBC and thus detailed studies of their properties. • 61. Question A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When should the discharge training and planning begin for this patient? o A. Following surgery o B. Upon admission o C. Within 48 hours of discharge o D. Preoperative discussion • 62. Question A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson’s psychosocial development stages, the child is in which stage? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame and doubt o D. Intimacy vs. isolation • 63. Question o A. Amitriptyline (Elavil) o B. Calcitonin o C. Peroxide desolate (Premix) o D. Verapamil (Clan) Correct Answer: A. Amitriptyline (Elavil) Amitriptyline (Elavil) is a tricyclic antidepressant and used to treat symptoms of depression. o Option B: Calcitonin is used to treat osteoporosis in women who have been in menopause. Calcitonin is a hormone that is produced in humans by the Para follicular cells (commonly known as C-cells) of the thyroid gland. Calcitonin is involved in helping to regulate levels of calcium and phosphate in the blood, opposing the action of the parathyroid hormone. o Option C: Premix (peroxide desolate) is indicated as adjunctive treatment to levodopa/carbidopa in the management of the signs and symptoms of Parkinson†s disease. o Option D: Verapamil is used to treat high blood pressure and to control angina (chest pain). The immediate-release tablets are also used alone or with other medications to prevent and treat irregular heartbeats. Verapamil is in a class of medications called calcium- channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart and slows electrical activity in the heart to control the heart rate. • 67. Question Which of the following conditions would a nurse not administer erythromycin? o A. Campylobacteriosis infection o B. Legionnaires disease o C. Pneumonia o D. Multiple Sclerosis • 68. Question A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute? o A. Decreased HR o B. Paresthesia o C. Muscle weakness of the extremities o D. Migraines • 69. Question A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute? o A. Vomiting o B. Extreme Thirst o C. Weight gain o D. Acetone breath smell o Option C: The classic triad of meningitis consists of fever, nuchal rigidity, and altered mental status. When the body tries to fight the infection, the problem can worsen; blood vessels become leaky and allow fluid, WBCs, and other infection-fighting particles to enter the meninges and brain. This process, in turn, causes brain swelling and can eventually result in decreasing blood flow to parts of the brain, worsening the symptoms of infection. o Option D: Other symptoms include photalgia (photophobia): discomfort when the patient looks into bright lights. Depending on the severity of bacterial meningitis, the inflammatory process may remain confined to the subarachnoid space. In less severe forms, the pial barrier is not penetrated, and the underlying parenchyma remains intact. However, in more severe forms of bacterial meningitis, the pial barrier is breached, and the underlying parenchyma is invaded by the inflammatory process. Thus, bacterial meningitis may lead to widespread cortical destruction, particularly when left untreated. • 71. Question A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition? o A. Yersinia pestis o B. Helicobacter pylori o C. Vibrio cholerae o D. Haemophilus aegyptius Correct Answer: D. Haemophilus aegyptius Haemophilus influenzae biogroup aegyptius (Hae) is a causative agent of acute and often purulent conjunctivitis, more commonly known as pink eye. o Option A: Plague is a disease that affects humans and other mammals. It is caused by the bacterium, Yersinia pestis. Y. pestis is primarily a disease of rodents or other wild mammals that usually is transmitted by fleas and often is fatal. Human disease is now rare and usually is associated with contact with rodents and their fleas. o Option B: Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect the stomach. Helicobacter pylori is a ubiquitous organism that is present in about 50% of the global population. Chronic infection with H pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. The most common route of H pylori infection is either oral-to- oral or fecal-to-oral contact. o Option C: Cholera, caused by the bacteria Vibrio cholerae, is rare in the United States and other industrialized nations. Cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. An estimated 2.9 million cases and 95,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can be severe. • 72. Question A nurse is reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition? o A. Borelli burgdorferi o B. Streptococcus pyogenes o C. Bacillus anthracis o D. Enterococcus faecalis • 73. Question A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two (2) weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed? to distinguish hyperthyroidism and hypothyroidism from the euthyroid state. To accomplish this task, direct measurements of the serum concentration of the two thyroid hormones—triiodothyronine (T3) and tetraiodothyronine (T4)— more commonly known as thyroxine, are extensively employed. o Option A: The complete blood count and metabolic profile may show abnormalities in patients with hypothyroidism. Thyroid dysfunction induces different effects on blood cells such as anemia, erythrocytosis, leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. o Option B: Signs of hypothyroidism on ECG include sinus bradycardia, T-wave inversions (TWIs), QTc prolongation, and ventricular arrhythmias. Hypothyroidism can affect the cardiovascular system physiology and structure. These changes are often reflected on ECG. o Option D: Ultrasonography of the neck and thyroid can be used to detect nodules and infiltrative disease. High-resolution ultrasonography (USG) is the most sensitive imaging modality available for examination of the thyroid gland and associated abnormalities. Ultrasound scanning is non-invasive, widely available, less expensive, and does not use any ionizing radiation. Further, real-time ultrasound imaging helps to guide diagnostic and therapeutic interventional procedures in cases of thyroid disease. • 75. Question A 20-year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first? o A. Blood sugar check o B. CT scan o C. Blood cultures o D. Arterial blood gases Correct Answer: C. Blood cultures Blood cultures would be performed to investigate the fever and rash symptoms. A blood culture is a test that checks for foreign invaders like bacteria, yeast, and other microorganisms in the blood. Having these pathogens in the bloodstream can be a sign of a blood infection, a condition known as bacteremia. A positive blood culture means that there are bacteria in the blood. o Option A: Blood sugar check is necessary for clients who are suspected of having an increase in blood sugar and whose symptoms include excessive thirst and hunger, and excessive sweating. o Option B: CT scan is unnecessary at the time for a client with fever and rash. A computerized tomography (CT) scan combines a series of X- ray images taken from different angles around the body and uses computer processing to create cross- sectional images (slices) of the bones, blood vessels, and soft tissues inside the body. CT scan images provide more detailed information than plain X-rays do. o Option D: An arterial blood gas (ABG) test measures oxygen and carbon dioxide levels in the blood. It also measures the body’s acid- base (pH) level, which is usually in balance when healthy.