NCLEX RN NEWEST 2024 EXAM 200
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY GRADED A+
You are caring for a child who has HIV with a positive Mantoux test. The physician orders isoniazid
(INH). You instruct the child's mother that the patient will have to take the medication for how long?
• 4 months
• 6 months
• 9 months
• 12 months - answer-d. 12 months
The child will need to take the medication for 12 months. A child with HIV would need to take the
medication for longer to prevent latent infection from progressing to active infection. Children who
are not immune compromised will need to take the drug for 2 to 4 months.
What is the maximum suction time for a patient with a tracheostomy?
• 5 seconds
• 10 seconds
• 30 seconds
• 1 minute - answer-b. 10 seconds
What is the most appropriate nursing intervention if your patient's heart rate drops during suctioning?
• Continue to suction.
• Limit suctioning to 15 seconds.
• Stop and reoxygenate the patient.
• Notify the physician. - answer-c. Stop and reoxygenate the patient.
You are caring for an unconscious patient who has had an arterial blood gas drawn. The results reveal
a pH of 7.30, low bicarbonate, a normal carbon dioxide level, normal oxygen level and an elevated
potassium level. What would the diagnosis be for this patient based on the laboratory results?
,• Metabolic acidosis
• Respiratory acidosis
• Combined respiratory and metabolic acidosis
• Overcompensated respiratory acidosis - answer-a. Metabolic acidosis
What sign would indicate that a patient with a blunt injury to the chest has developed a pneumothorax?
• A sucking sound at the site of injury
• Diminished breath sounds
• A low respiratory rate
• Presence of a barrel chest - answer-b. Diminished breath sounds
You are assessing a patient with acute exacerbation of COPD. What would you expect to find on this
assessment?
• Increased oxygen saturation
• Hypocapnia
• A hyperinflated chest on x-ray film
• A widened diaphragm on chest x-ray film - answer-A hyperinflated chest on x-ray film
The patient with COPD in exacerbation would have a hyperinflated chest on x-ray film. Other signs and
symptoms would include hypoxemia, hypercapnia, dyspnea and use of accessory muscles. The
diaphragm would be flattened with this patient.
In which position would a patient with emphysema be able to enhance the effectiveness of their
breathing?
• On the side, lying in bed
• Sitting in a recliner
• Sitting up in bed
• Sitting on the side of the bed and leaning on an overbed table - answer-d. Sitting on the side of
the bed and leaning on an overbed table
Which diagnostic test would confirm a diagnosis of tuberculosis?
,• Bronchoscopy
• Chest x-ray
• Sputum culture
• Tuberculin skin test - answer-c. Sputum culture
Your patient with emphysema is receiving oxygen. What flow rate would you not want to exceed for
this patient?
a. 1 L/min
b. 2 L/min
c. 6 L/min
d. 10 L/min - answer-b. 2 L/min
The oxygen level for an emphysema patient should not exceed 2 L/min. The patient has been in a
long- standing hypercapnia, which leads to the patient's drive to breathe being triggered by low
oxygen levels. Too much oxygen would lead to the patient losing their drive to breathe.
You are reviewing an arterial blood gas for a patient. Which result would lead you to believe this
patient has respiratory acidosis?
a. pH of 7.48
b, PCO2 of 32 mm Hg
c. pH of 7.30
d. HCO3 of 20 mEq/L - answer-c. pH of 7.30
What is the primary action of aminophylline (theophylline) when given for acute bronchitis?
• Promote expectoration
• Suppress the cough
• Relax the smooth muscles of the bronchial airway
• Prevent infection - answer-c. Relax the smooth muscles of the bronchial airway
Which of the laboratory results would indicate that a patient's theophylline level is therapeutic?
• 5 mcg/ml
, • 15 mcg/ml
• 25 mcg/ml
• 30 mcg/ml - answer-b. 15 mcg/ml
The normal range is 10 to 20 mcg/ml. Anything greater than 20 is considered toxic, meaning that
the patient will start having side effects. Anything less than 10 indicates that the patient needs
additional medication.
Which of the following would you expect to find in a patient with acute respiratory distress syndrome?
• Decreased respiratory rate
• Pallor
• Low arterial PAO2
• An elevated arterial PAO2 - answer-c. Low arterial PAO2
The patient would exhibit a low arterial PAO2. Increased respiratory rate would be the earliest sign
that the nurse would see. Then the patient will begin to display air hunger, labored breathing,
retractions and cyanosis. Hypoxia is evidenced by the arterial blood gas.
Which clinical manifestation would a patient with a pulmonary embolus display?
• Decreased respirations
• Bradypnea
• Dyspnea
• Bradycardia - answer-c. Dyspnea
The clinical manifestation that the nurse would most likely see with a pulmonary embolus is dyspnea.
Other clinical manifestations that the nurse might see include tachypnea, tachycardia and chest pain.
This is a medical emergency, and the physician should be notified immediately if pulmonary embolus is
suspected.
What is a distinctive sign that a patient has flail chest?
• Cyanosis
• Hypotension
• Dyspnea, especially on exhalation
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY GRADED A+
You are caring for a child who has HIV with a positive Mantoux test. The physician orders isoniazid
(INH). You instruct the child's mother that the patient will have to take the medication for how long?
• 4 months
• 6 months
• 9 months
• 12 months - answer-d. 12 months
The child will need to take the medication for 12 months. A child with HIV would need to take the
medication for longer to prevent latent infection from progressing to active infection. Children who
are not immune compromised will need to take the drug for 2 to 4 months.
What is the maximum suction time for a patient with a tracheostomy?
• 5 seconds
• 10 seconds
• 30 seconds
• 1 minute - answer-b. 10 seconds
What is the most appropriate nursing intervention if your patient's heart rate drops during suctioning?
• Continue to suction.
• Limit suctioning to 15 seconds.
• Stop and reoxygenate the patient.
• Notify the physician. - answer-c. Stop and reoxygenate the patient.
You are caring for an unconscious patient who has had an arterial blood gas drawn. The results reveal
a pH of 7.30, low bicarbonate, a normal carbon dioxide level, normal oxygen level and an elevated
potassium level. What would the diagnosis be for this patient based on the laboratory results?
,• Metabolic acidosis
• Respiratory acidosis
• Combined respiratory and metabolic acidosis
• Overcompensated respiratory acidosis - answer-a. Metabolic acidosis
What sign would indicate that a patient with a blunt injury to the chest has developed a pneumothorax?
• A sucking sound at the site of injury
• Diminished breath sounds
• A low respiratory rate
• Presence of a barrel chest - answer-b. Diminished breath sounds
You are assessing a patient with acute exacerbation of COPD. What would you expect to find on this
assessment?
• Increased oxygen saturation
• Hypocapnia
• A hyperinflated chest on x-ray film
• A widened diaphragm on chest x-ray film - answer-A hyperinflated chest on x-ray film
The patient with COPD in exacerbation would have a hyperinflated chest on x-ray film. Other signs and
symptoms would include hypoxemia, hypercapnia, dyspnea and use of accessory muscles. The
diaphragm would be flattened with this patient.
In which position would a patient with emphysema be able to enhance the effectiveness of their
breathing?
• On the side, lying in bed
• Sitting in a recliner
• Sitting up in bed
• Sitting on the side of the bed and leaning on an overbed table - answer-d. Sitting on the side of
the bed and leaning on an overbed table
Which diagnostic test would confirm a diagnosis of tuberculosis?
,• Bronchoscopy
• Chest x-ray
• Sputum culture
• Tuberculin skin test - answer-c. Sputum culture
Your patient with emphysema is receiving oxygen. What flow rate would you not want to exceed for
this patient?
a. 1 L/min
b. 2 L/min
c. 6 L/min
d. 10 L/min - answer-b. 2 L/min
The oxygen level for an emphysema patient should not exceed 2 L/min. The patient has been in a
long- standing hypercapnia, which leads to the patient's drive to breathe being triggered by low
oxygen levels. Too much oxygen would lead to the patient losing their drive to breathe.
You are reviewing an arterial blood gas for a patient. Which result would lead you to believe this
patient has respiratory acidosis?
a. pH of 7.48
b, PCO2 of 32 mm Hg
c. pH of 7.30
d. HCO3 of 20 mEq/L - answer-c. pH of 7.30
What is the primary action of aminophylline (theophylline) when given for acute bronchitis?
• Promote expectoration
• Suppress the cough
• Relax the smooth muscles of the bronchial airway
• Prevent infection - answer-c. Relax the smooth muscles of the bronchial airway
Which of the laboratory results would indicate that a patient's theophylline level is therapeutic?
• 5 mcg/ml
, • 15 mcg/ml
• 25 mcg/ml
• 30 mcg/ml - answer-b. 15 mcg/ml
The normal range is 10 to 20 mcg/ml. Anything greater than 20 is considered toxic, meaning that
the patient will start having side effects. Anything less than 10 indicates that the patient needs
additional medication.
Which of the following would you expect to find in a patient with acute respiratory distress syndrome?
• Decreased respiratory rate
• Pallor
• Low arterial PAO2
• An elevated arterial PAO2 - answer-c. Low arterial PAO2
The patient would exhibit a low arterial PAO2. Increased respiratory rate would be the earliest sign
that the nurse would see. Then the patient will begin to display air hunger, labored breathing,
retractions and cyanosis. Hypoxia is evidenced by the arterial blood gas.
Which clinical manifestation would a patient with a pulmonary embolus display?
• Decreased respirations
• Bradypnea
• Dyspnea
• Bradycardia - answer-c. Dyspnea
The clinical manifestation that the nurse would most likely see with a pulmonary embolus is dyspnea.
Other clinical manifestations that the nurse might see include tachypnea, tachycardia and chest pain.
This is a medical emergency, and the physician should be notified immediately if pulmonary embolus is
suspected.
What is a distinctive sign that a patient has flail chest?
• Cyanosis
• Hypotension
• Dyspnea, especially on exhalation
