NCLEX-RN Practice Quiz Test Bank
#11 (75 Questions)
NCLEXRN-11-001
Question Tag: hyperparathyroidism
Question Category: Physiological Integrity, Reduction of Risk Potential
A patient is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nurse checking the patient’s lab results would expect
which of the following changes in laboratory findings?
A. Elevated serum calcium.
B. Low serum parathyroid hormone (PTH)
C. Elevated serum vitamin D
D. Low urine calcium
Correct Answer: A. Elevated serum calcium
The parathyroid glands regulate the calcium level in the blood. In
hyperparathyroidism, the serum calcium level will be elevated. A normal PTH in
the presence of hypercalcemia is considered inappropriate and still consistent
with PTH-dependent hypercalcemia. PTH levels should be very low in those
patients with PTH-independent hypercalcemia. A comprehensive clinical
evaluation complemented by routine laboratory and radiologic studies should be
sufficient to establish a diagnosis of primary hyperparathyroidism in a patient
with persistent hypercalcemia and an elevated serum level of parathyroid
hormone.
Option B: Parathyroid hormone levels may be high or normal but not low.
Patients with primary hyperparathyroidism and other causes of PTH-
dependent hypercalcemia often have frankly elevated levels of PTH, while
some will have values that fall within the reference range for the general
population. It is uncommon for clinically occult malignancies to cause
hypercalcemia. Most patients with malignancy-associated hypercalcemia
, are known to have cancer, or cancer is readily detectable on initial
evaluation, and PTH levels will be suppressed.
Option C: Parathyroid hormone levels may be high or normal but not low.
The body will lower the level of vitamin D in an attempt to lower calcium.
Option D: Urine calcium may be elevated, with calcium spilling over from
elevated serum levels. This may cause renal stones. A review of previous
medical records can often be of significant value in establishing the cause
of hypercalcemia. Most patients with hyperparathyroidism have persistent
or intermittent hypercalcemia for many years before a definitive diagnosis
is established.
NCLEXRN-11-002
Question Tag: Addison’s disease
Question Category: Health Promotion and Maintenance
A patient with Addison’s disease asks a nurse for nutrition and diet advice. Which
of the following diet modifications is not recommended?
A. A diet high in grains.
B. A diet with adequate caloric intake.
C. A high protein diet.
D. A restricted sodium diet.
Correct Answer: D. A restricted sodium diet.
A patient with Addison’s disease requires normal dietary sodium to prevent
excess fluid loss. Do not reduce salt in the diet. The client may need to add extra
salt to his food during hot and humid weather or after exercise to replace salt lost
through sweating. Do not use salt substitutes.
Option A: Addison’s disease is a rare condition. It develops when the
adrenal glands, which are located above the kidneys, do not make enough
of certain hormones. These hormones are important for normal body
function. They help the body cope with stress, hold salt and water, and
, maintain blood pressure. The client should include complex carbohydrates
in his diet, including grains.
Option B: A high protein diet is recommended for the client with
Addison’s disease. The adrenal fatigue diet aims to stabilize blood sugar
and balance cortisol levels by limiting sugar while increasing the intake of
protein, healthy fats, veggies, and whole grains. Healthy fats and high-
quality proteins slow the blood sugar rollercoaster and promote stable
blood sugar levels throughout the day.
Option C: Adequate caloric intake is recommended. Refined carbohydrates
quickly break down into sugar after you ingest them, which causes a spike
in blood sugar followed by a steep decline. The diet discourages foods that
are inflammatory or hard to digest and may contribute to gut health issues.
The adrenal fatigue diet is more about eating more foods that make the
client feel good and nourish the body versus restricting.
NCLEXRN-11-003
Question Tag: cholecystectomy
Question Category: Physiological Integrity, Physiological Adaptation
A patient with a history of diabetes mellitus is in the second postoperative day
following cholecystectomy. She has complained of nausea and isn’t able to eat
solid foods. The nurse enters the room to find the patient confused and shaky.
Which of the following is the most likely explanation for the patient’s symptoms?
A. Anesthesia reaction
B. Hyperglycemia
C. Hypoglycemia
D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic patient who is unable to eat is likely to be suffering from
hypoglycemia. The actual treatment recommendations for a given patient should
be individualized, based on diabetes classification, usual diabetes regimen, state
, of glycemic control, nature and extent of surgical procedure, and available
expertise.
Option A: An anesthesia reaction would not occur on the second
postoperative day. Anesthesia and surgery cause a stereotypical metabolic
stress response that could overwhelm homeostatic mechanisms in patients
with pre-existing abnormalities of glucose metabolism. The invariant
features of the metabolic stress response include release of the catabolic
hormones epinephrine, norepinephrine, cortisol, glucagons, and growth
hormone and inhibition of insulin secretion and action.
Option B: Confusion is a late sign of hyperglycemia. Shakiness is not one
of its symptoms. The management approach in these categories of
patients always includes insulin therapy in combination with dextrose and
potassium infusion. Major surgery is defined as one requiring general
anesthesia of ≥1 h. At a minimum, blood glucose should be monitored
before and immediately after surgery in all patients. Those undergoing
extensive procedures should have hourly glucose monitoring during and
immediately following surgery.
Option D: Symptoms of DKA include excessive thirst, frequent urination,
abdominal pain, fruity-scented breath, confusion, and shortness of breath.
However, shakiness is not a sign of DKA. The stress of surgery itself results
in metabolic perturbations that alter glucose homeostasis, and persistent
hyperglycemia is a risk factor for endothelial dysfunction,
postoperative sepsis, impaired wound healing, and cerebral ischemia. The
stress response itself may precipitate diabetic crises (diabetic ketoacidosis
[DKA].
NCLEXRN-11-004
Question Tag: fiberoptic colonoscopy
Question Category: Physiological Integrity, Reduction of Risk Potential
A nurse assigned to the emergency department evaluates a patient who
underwent fiberoptic colonoscopy 18 hours previously. The patient reports
#11 (75 Questions)
NCLEXRN-11-001
Question Tag: hyperparathyroidism
Question Category: Physiological Integrity, Reduction of Risk Potential
A patient is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nurse checking the patient’s lab results would expect
which of the following changes in laboratory findings?
A. Elevated serum calcium.
B. Low serum parathyroid hormone (PTH)
C. Elevated serum vitamin D
D. Low urine calcium
Correct Answer: A. Elevated serum calcium
The parathyroid glands regulate the calcium level in the blood. In
hyperparathyroidism, the serum calcium level will be elevated. A normal PTH in
the presence of hypercalcemia is considered inappropriate and still consistent
with PTH-dependent hypercalcemia. PTH levels should be very low in those
patients with PTH-independent hypercalcemia. A comprehensive clinical
evaluation complemented by routine laboratory and radiologic studies should be
sufficient to establish a diagnosis of primary hyperparathyroidism in a patient
with persistent hypercalcemia and an elevated serum level of parathyroid
hormone.
Option B: Parathyroid hormone levels may be high or normal but not low.
Patients with primary hyperparathyroidism and other causes of PTH-
dependent hypercalcemia often have frankly elevated levels of PTH, while
some will have values that fall within the reference range for the general
population. It is uncommon for clinically occult malignancies to cause
hypercalcemia. Most patients with malignancy-associated hypercalcemia
, are known to have cancer, or cancer is readily detectable on initial
evaluation, and PTH levels will be suppressed.
Option C: Parathyroid hormone levels may be high or normal but not low.
The body will lower the level of vitamin D in an attempt to lower calcium.
Option D: Urine calcium may be elevated, with calcium spilling over from
elevated serum levels. This may cause renal stones. A review of previous
medical records can often be of significant value in establishing the cause
of hypercalcemia. Most patients with hyperparathyroidism have persistent
or intermittent hypercalcemia for many years before a definitive diagnosis
is established.
NCLEXRN-11-002
Question Tag: Addison’s disease
Question Category: Health Promotion and Maintenance
A patient with Addison’s disease asks a nurse for nutrition and diet advice. Which
of the following diet modifications is not recommended?
A. A diet high in grains.
B. A diet with adequate caloric intake.
C. A high protein diet.
D. A restricted sodium diet.
Correct Answer: D. A restricted sodium diet.
A patient with Addison’s disease requires normal dietary sodium to prevent
excess fluid loss. Do not reduce salt in the diet. The client may need to add extra
salt to his food during hot and humid weather or after exercise to replace salt lost
through sweating. Do not use salt substitutes.
Option A: Addison’s disease is a rare condition. It develops when the
adrenal glands, which are located above the kidneys, do not make enough
of certain hormones. These hormones are important for normal body
function. They help the body cope with stress, hold salt and water, and
, maintain blood pressure. The client should include complex carbohydrates
in his diet, including grains.
Option B: A high protein diet is recommended for the client with
Addison’s disease. The adrenal fatigue diet aims to stabilize blood sugar
and balance cortisol levels by limiting sugar while increasing the intake of
protein, healthy fats, veggies, and whole grains. Healthy fats and high-
quality proteins slow the blood sugar rollercoaster and promote stable
blood sugar levels throughout the day.
Option C: Adequate caloric intake is recommended. Refined carbohydrates
quickly break down into sugar after you ingest them, which causes a spike
in blood sugar followed by a steep decline. The diet discourages foods that
are inflammatory or hard to digest and may contribute to gut health issues.
The adrenal fatigue diet is more about eating more foods that make the
client feel good and nourish the body versus restricting.
NCLEXRN-11-003
Question Tag: cholecystectomy
Question Category: Physiological Integrity, Physiological Adaptation
A patient with a history of diabetes mellitus is in the second postoperative day
following cholecystectomy. She has complained of nausea and isn’t able to eat
solid foods. The nurse enters the room to find the patient confused and shaky.
Which of the following is the most likely explanation for the patient’s symptoms?
A. Anesthesia reaction
B. Hyperglycemia
C. Hypoglycemia
D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic patient who is unable to eat is likely to be suffering from
hypoglycemia. The actual treatment recommendations for a given patient should
be individualized, based on diabetes classification, usual diabetes regimen, state
, of glycemic control, nature and extent of surgical procedure, and available
expertise.
Option A: An anesthesia reaction would not occur on the second
postoperative day. Anesthesia and surgery cause a stereotypical metabolic
stress response that could overwhelm homeostatic mechanisms in patients
with pre-existing abnormalities of glucose metabolism. The invariant
features of the metabolic stress response include release of the catabolic
hormones epinephrine, norepinephrine, cortisol, glucagons, and growth
hormone and inhibition of insulin secretion and action.
Option B: Confusion is a late sign of hyperglycemia. Shakiness is not one
of its symptoms. The management approach in these categories of
patients always includes insulin therapy in combination with dextrose and
potassium infusion. Major surgery is defined as one requiring general
anesthesia of ≥1 h. At a minimum, blood glucose should be monitored
before and immediately after surgery in all patients. Those undergoing
extensive procedures should have hourly glucose monitoring during and
immediately following surgery.
Option D: Symptoms of DKA include excessive thirst, frequent urination,
abdominal pain, fruity-scented breath, confusion, and shortness of breath.
However, shakiness is not a sign of DKA. The stress of surgery itself results
in metabolic perturbations that alter glucose homeostasis, and persistent
hyperglycemia is a risk factor for endothelial dysfunction,
postoperative sepsis, impaired wound healing, and cerebral ischemia. The
stress response itself may precipitate diabetic crises (diabetic ketoacidosis
[DKA].
NCLEXRN-11-004
Question Tag: fiberoptic colonoscopy
Question Category: Physiological Integrity, Reduction of Risk Potential
A nurse assigned to the emergency department evaluates a patient who
underwent fiberoptic colonoscopy 18 hours previously. The patient reports
