NGN NCLEX RN ACTUAL EXAM LATEST 2023 TEST BANK
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES |AGRADE
QUESTION 58
A 38-year-old pregnant woman visits her nurse practitioner for her regular prenatal checkup.
She is 30 weeks’ gestation. The nurse should be alert to which condition related to her age?
• Iron-deficiency anemia
• Sexually transmitted disease (STD)
• Intrauterine growth retardation
• Pregnancy-induced hypertension (PIH)
Answer: D Explanation:
(A) Iron-deficiency anemia can occur throughout pregnancy and is not age related. (B) STDs
can occur prior to or during pregnancy and are not age related. (C) Intrauterine growth
retardation is an abnormal process where fetal development and maturation are delayed. It is
not age related. (D) Physical risks for the pregnant client older than 35 include increased risk
for PIH, cesarean delivery, fetal and neonatal mortality, and trisomy.
QUESTION 59
A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would
expect which
of the following to be present in relation to his blood sugar level?
• A normal blood sugar level
• A decreased blood sugar level
• An increased blood sugar level
• Fluctuating levels with a predawn increase
Answer: C Explanation:
(A) Blood sugar levels increase when the body responds to stress and illness. (B) Blood sugar
levels increase when the body responds to stress and illness. (C) Hyperglycemia occurs
because glucose is produced as the body responds to the stress and illness of cellulitis. (D)
Blood sugar levels remain elevated as long as the body responds to stress and illness.
QUESTION 60
A laboratory technique specific for diagnosing Lyme disease is:
• Polymerase chain reaction
• Heterophil antibody test
• Decreased serum calcium level
• Increased serum potassium level Answer: A
,Explanation:
(A) Polymerase chain reaction is the laboratory technique specific for Lyme disease. (B)
Heterophil antibody test is used to diagnose mononucleosis. (C) Lyme disease does not
decrease the serum calcium level. (D) Lyme disease does not increase the serum potassium
level.
QUESTION 61
The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be
exhibiting a toxic reaction to:
• Digoxin (Lanoxin)
• Lidocaine (Xylocaine)
• Quinidine gluconate or sulfate (Quinaglute, Quinidex)
• Nitroglycerin IV (Tridil)
Answer: B Explanation:
• Side effects of digoxin include headache, hypotension, AV block, blurred vision, and
yellow-green halos.
• Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor,
lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity,
thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include
postural hypotension, headache, dizziness, and flushing.
QUESTION 62
A 27-year-old man was diagnosed with type I diabetes 3 months ago. Two weeks ago he
complained of pain, redness, and tenderness in his right lower leg. He is admitted to the
hospital with a slight elevation of temperature and vague complaints of “not feeling well.” At
4:30 PM on the day of his admission, his blood glucose level is 50 mg; dinner will be
served at 5:00 PM. The best nursing action would be to:
• Give him 3 tbsp of sugar dissolved in 4 oz of grape juice to drink
• Ask him to dissolve three pieces of hard candy in his mouth
• Have him drink 4 oz of orange juice
• Monitor him closely until dinner arrives
Answer: C Explanation:
(A) The combination of sugar and juice will increase the blood sugar beyond the normal
range. (B) Concentrated sweets are not absorbed as fast as juice; consequently, they elevate
the blood sugar beyond the normal limit. (C) Four ounces of orange juice will act
immediately to raise the blood sugar to a normal level and sustain it for 30 minutes until
supper is served. (D) There is an increased potential for the client’s blood sugar to decrease
even further, resulting in diabetic coma.
QUESTION 63
, After 3 weeks of treatment, a severely depressed client suddenly begins to feel better and starts
interacting appropriately with other clients and staff. The nurse knows that this client has an
increased risk for:
• Suicide
• Exacerbation of depressive symptoms
• Violence toward others
• Psychotic behavior
Answer: A Explanation:
(A) When the severely depressed client suddenly begins to feel better, it often indicates that
the client has made the decision to kill himself or herself and has developed a plan to do so.
(B) Improvement in behavior is not indicative of an exacerbation of depressive symptoms.
(C) Thedepressed client has a tendency for self-violence, not violence toward others. (D)
Depressive behavior is not always accompanied by psychotic behavior.
QUESTION 64
Discharge teaching was effective if the parents of a child with atopic dermatitis could state the
importance of:
• Maintaining a high-humidified environment
• Furry, soft stuffed animals for play
• Showering 3–4 times a day
• Wrapping hands in soft cotton gloves
Answer: D Explanation:
(A) Maintaining a low-humidified environment. (B) Avoiding furry, soft stuffed animals for
play, which may increase symptoms of allergy. (C) Avoiding showering, which irritates the
dermatitis, and encouraging bathing 4 times a day in colloid bath for temporary relief. (D)
Wrapping hands in soft cotton gloves to prevent skin damage during scratching.
QUESTION 65
Which of the following would differentiate acute from chronic respiratory acidosis in the
assessment of the trauma client?
• Increased PaCO2
• Decreased PaO2
• Increased HCO3
• Decreased base excess
Answer: C Explanation:
(A) Increased CO2 will occur in both acute and chronic respiratory acidosis. (B) Hypoxia
does not determine acid-base status. (C) Elevation of HCO3 is a compensatory mechanism in
acidosis that occurs almost immediately, but it takes hours to show any effect and days to
reach maximum compensation. Renal disease and diuretic therapy may impair the ability of
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES |AGRADE
QUESTION 58
A 38-year-old pregnant woman visits her nurse practitioner for her regular prenatal checkup.
She is 30 weeks’ gestation. The nurse should be alert to which condition related to her age?
• Iron-deficiency anemia
• Sexually transmitted disease (STD)
• Intrauterine growth retardation
• Pregnancy-induced hypertension (PIH)
Answer: D Explanation:
(A) Iron-deficiency anemia can occur throughout pregnancy and is not age related. (B) STDs
can occur prior to or during pregnancy and are not age related. (C) Intrauterine growth
retardation is an abnormal process where fetal development and maturation are delayed. It is
not age related. (D) Physical risks for the pregnant client older than 35 include increased risk
for PIH, cesarean delivery, fetal and neonatal mortality, and trisomy.
QUESTION 59
A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would
expect which
of the following to be present in relation to his blood sugar level?
• A normal blood sugar level
• A decreased blood sugar level
• An increased blood sugar level
• Fluctuating levels with a predawn increase
Answer: C Explanation:
(A) Blood sugar levels increase when the body responds to stress and illness. (B) Blood sugar
levels increase when the body responds to stress and illness. (C) Hyperglycemia occurs
because glucose is produced as the body responds to the stress and illness of cellulitis. (D)
Blood sugar levels remain elevated as long as the body responds to stress and illness.
QUESTION 60
A laboratory technique specific for diagnosing Lyme disease is:
• Polymerase chain reaction
• Heterophil antibody test
• Decreased serum calcium level
• Increased serum potassium level Answer: A
,Explanation:
(A) Polymerase chain reaction is the laboratory technique specific for Lyme disease. (B)
Heterophil antibody test is used to diagnose mononucleosis. (C) Lyme disease does not
decrease the serum calcium level. (D) Lyme disease does not increase the serum potassium
level.
QUESTION 61
The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be
exhibiting a toxic reaction to:
• Digoxin (Lanoxin)
• Lidocaine (Xylocaine)
• Quinidine gluconate or sulfate (Quinaglute, Quinidex)
• Nitroglycerin IV (Tridil)
Answer: B Explanation:
• Side effects of digoxin include headache, hypotension, AV block, blurred vision, and
yellow-green halos.
• Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor,
lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity,
thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include
postural hypotension, headache, dizziness, and flushing.
QUESTION 62
A 27-year-old man was diagnosed with type I diabetes 3 months ago. Two weeks ago he
complained of pain, redness, and tenderness in his right lower leg. He is admitted to the
hospital with a slight elevation of temperature and vague complaints of “not feeling well.” At
4:30 PM on the day of his admission, his blood glucose level is 50 mg; dinner will be
served at 5:00 PM. The best nursing action would be to:
• Give him 3 tbsp of sugar dissolved in 4 oz of grape juice to drink
• Ask him to dissolve three pieces of hard candy in his mouth
• Have him drink 4 oz of orange juice
• Monitor him closely until dinner arrives
Answer: C Explanation:
(A) The combination of sugar and juice will increase the blood sugar beyond the normal
range. (B) Concentrated sweets are not absorbed as fast as juice; consequently, they elevate
the blood sugar beyond the normal limit. (C) Four ounces of orange juice will act
immediately to raise the blood sugar to a normal level and sustain it for 30 minutes until
supper is served. (D) There is an increased potential for the client’s blood sugar to decrease
even further, resulting in diabetic coma.
QUESTION 63
, After 3 weeks of treatment, a severely depressed client suddenly begins to feel better and starts
interacting appropriately with other clients and staff. The nurse knows that this client has an
increased risk for:
• Suicide
• Exacerbation of depressive symptoms
• Violence toward others
• Psychotic behavior
Answer: A Explanation:
(A) When the severely depressed client suddenly begins to feel better, it often indicates that
the client has made the decision to kill himself or herself and has developed a plan to do so.
(B) Improvement in behavior is not indicative of an exacerbation of depressive symptoms.
(C) Thedepressed client has a tendency for self-violence, not violence toward others. (D)
Depressive behavior is not always accompanied by psychotic behavior.
QUESTION 64
Discharge teaching was effective if the parents of a child with atopic dermatitis could state the
importance of:
• Maintaining a high-humidified environment
• Furry, soft stuffed animals for play
• Showering 3–4 times a day
• Wrapping hands in soft cotton gloves
Answer: D Explanation:
(A) Maintaining a low-humidified environment. (B) Avoiding furry, soft stuffed animals for
play, which may increase symptoms of allergy. (C) Avoiding showering, which irritates the
dermatitis, and encouraging bathing 4 times a day in colloid bath for temporary relief. (D)
Wrapping hands in soft cotton gloves to prevent skin damage during scratching.
QUESTION 65
Which of the following would differentiate acute from chronic respiratory acidosis in the
assessment of the trauma client?
• Increased PaCO2
• Decreased PaO2
• Increased HCO3
• Decreased base excess
Answer: C Explanation:
(A) Increased CO2 will occur in both acute and chronic respiratory acidosis. (B) Hypoxia
does not determine acid-base status. (C) Elevation of HCO3 is a compensatory mechanism in
acidosis that occurs almost immediately, but it takes hours to show any effect and days to
reach maximum compensation. Renal disease and diuretic therapy may impair the ability of
