NEXT GEN NCLEX QUESTIONS AND ANSWERS
Acid Reflux (GERD) - Answers :Heartburn (pyrosis)
What test confirms Gerd? - Answers :Barium swallow Fluoroscopy (X-ray using
fluoroscope)
What body part malfunction occurs in gerd - Answers :lower esophageal sphincter
Clinical teaching points for acid reflux - Answers :Teach the patient to eat small frequent
meals which creates less hydrochloric acid
Patient should remain upright for 30 minutes after every meal
Patients should avoid foods with acid
Use antacids one hour before and after every meal can cause constipation
How is HIV transmitted? - Answers :blood, semen, vaginal secretions, breast milk, sex
What are symptoms of HIV? - Answers :Fever, weight loss, night sweats, diarrhea,
fatigue
How is the presence of HIV confirmed? - Answers :Screening is done FIRST to see if
HIV antibodies are present. The test is performed to specifically identify the HIV
antibodies
What is the name of the screening test for HIV? - Answers :ElISA
What is the ELISA test? - Answers :Enzyme-Linked Immunosorbent Assay test
- allows for the detection of the presence and quantity of a protein in a sample
What confirms the screening test? - Answers :HIV differentiation assay (Western Blot is
no longer used)
How does HIV attack the body? - Answers :It attacks the immune system by destroying
T-lymphocytes. The virus also rapidly self-replicates.
What is so important about T-lymphocytes? - Answers :T cells help immune system
recognize and fight pathogens.
What is another name for T lymphocytes - Answers :CD4 cells
Why is the CD4 count important? - Answers :The lower the CD4 count the more
damage the virus has done to the body.
,What is the normal CD4 count in a patient without HIV? - Answers :500-1500 in healthy
adults
What is the normal CD4 count in a Patient with HIV - Answers :Anything at or above
500 means the patient is in good health if cd4 count is below 200 the hiv has
progressed to AIDS
If a patient CD4 count is below 200 - Answers :The patient is at risk for opportunistic
infections
nucleic acid test - Answers :HIV test that is used for diagnosis and looks for the virus
List some opportunistic infections associated with HIV - Answers :Oral pharyngeal
candida infection (mouth fungus)
Kaposi sarcoma (skin cancer)
Meningitis
Cytomegalovirus (blindness)
Pneumocystis (pneumonia)
Medication for HIV - Answers :Zidovudine
isolation precautions for HIV - Answers :Universal precautions
How do the isolation precautions change with AIDS? - Answers :If the patient has a low
CD4 count and is at risk of an opportunistic infection:
The patient should have a
-Private room
-Reverse isolation
-RN/PN should wear gloves, gown, goggles, mask when in direct contact with blood or
body fluids.
What are the teaching points for patients who have a child with HIV? - Answers :Use
water and bleach
Child should have all vaccines except for live ones such as MMR, VARICELLA, or
poliovirus
Feed high calorie protein diet
Use gloves when changing diaper
acute renal failure (ARF) - Answers :Sudden loss of kidney function to excrete toxins,
and regulate fluid and electrolytes
Three possible causes of ARF - Answers :Infection
Obstruction
Shock
,Three phases of ARF - Answers :Oliguric, diuretic, recovery
During the oliguric phase, in ARF what should the nurse expect to see clinically? -
Answers :Low urine output of less than 400 ML per day
Hyperkalemia
Hypertension
Elevated BUN /creatinine levels
Fluid overload
Two electrolytes in ARF that will be elevated - Answers :Sodium and phosphate
The diuretic phase of ARF - Answers :Urine output slowly returns Hypovolemia,
hypotension, dehydration - BUN, Creatinine levels still elevated -BUN and Creatinine
levels begin to normalize
Recovery phase of ARF - Answers :Kidneys recover slowly
The GFR increases
BUN and creatinine return to normal
Diet for ARF - Answers :Low protein
high carbs
restrict potassium and phosphorus (no bananas, citrus, tomatoes, melons, dairy
products, beans, nuts, legumes, carbonated beverages)
Restrict caffeine
adam stokes syndrome - Answers :Heart conditions
Client experiences what with Adam Stokes syndrome? - Answers :Sudden attacks of
syncope
Fainting
Seizures
With Adam Stokes syndrome, what will you see on a EKG/ECG - Answers :Asystole or
ventricular arrhythmias
Adam Stokes syndrome - Answers :There will be no tissue perfusion during the attacks
Treatment for Adam Stokes syndrome - Answers :Client will need an internal
pacemaker inserted during surgery
Digoxin can be given after surgery?
Addison's disease - Answers :Low production of hormones by the adrenal glands
Glucocorticoids and mineralocorticoids
Major symptoms of Addison's disease - Answers :Lethargy
Weakness
, Weight loss
Bronze color skin
Hyperpigmentation
Assess palms and the crease of skin and over pressure points
No weight loss is common
Addison's disease - Answers :Blood glucose levels are low
Sodium levels are low
Salts should be increased
Serum potassium levels are high
Lifelong glucocorticoid therapy Is the treatment
Allergies - Answers :Clients allergic to latex may also be allergic to - Bananas, kiwi,
chestnuts
Hospital equipment that contains latex
Blood pressure cuff
Tourniquet
Band-Aids
Indwelling catheters
Allergy is contradicted for IV contrast dye - iodine/shellfish allergy
amputation - Answers :Major complications are infections
Skin breakdown
Phantom limp pain
Joint contracture
Positioning for postop care for amputation (above knee amputation) - Answers :Elevate
first 24 hours then prone
Please client in the position twice daily to prevent hip flexion
BKA (below knee amputation) - Answers :foot of bed elevated for first 24 hours. position
prone to provide hip extension.
Phantom limb pain - is pain felt where the leg was that is no longer there
Anemias - Answers :low red blood cell count
aplastic anemia signs - Answers :Decreased erythrocytes, bleeding mucous
membranes, thrombocytopenia
Aplastic Anemia Treatment - Answers :bone marrow transplant
Blood transfusion
Iron deficiency, anemia signs - Answers :-Low hgb & hct,
Acid Reflux (GERD) - Answers :Heartburn (pyrosis)
What test confirms Gerd? - Answers :Barium swallow Fluoroscopy (X-ray using
fluoroscope)
What body part malfunction occurs in gerd - Answers :lower esophageal sphincter
Clinical teaching points for acid reflux - Answers :Teach the patient to eat small frequent
meals which creates less hydrochloric acid
Patient should remain upright for 30 minutes after every meal
Patients should avoid foods with acid
Use antacids one hour before and after every meal can cause constipation
How is HIV transmitted? - Answers :blood, semen, vaginal secretions, breast milk, sex
What are symptoms of HIV? - Answers :Fever, weight loss, night sweats, diarrhea,
fatigue
How is the presence of HIV confirmed? - Answers :Screening is done FIRST to see if
HIV antibodies are present. The test is performed to specifically identify the HIV
antibodies
What is the name of the screening test for HIV? - Answers :ElISA
What is the ELISA test? - Answers :Enzyme-Linked Immunosorbent Assay test
- allows for the detection of the presence and quantity of a protein in a sample
What confirms the screening test? - Answers :HIV differentiation assay (Western Blot is
no longer used)
How does HIV attack the body? - Answers :It attacks the immune system by destroying
T-lymphocytes. The virus also rapidly self-replicates.
What is so important about T-lymphocytes? - Answers :T cells help immune system
recognize and fight pathogens.
What is another name for T lymphocytes - Answers :CD4 cells
Why is the CD4 count important? - Answers :The lower the CD4 count the more
damage the virus has done to the body.
,What is the normal CD4 count in a patient without HIV? - Answers :500-1500 in healthy
adults
What is the normal CD4 count in a Patient with HIV - Answers :Anything at or above
500 means the patient is in good health if cd4 count is below 200 the hiv has
progressed to AIDS
If a patient CD4 count is below 200 - Answers :The patient is at risk for opportunistic
infections
nucleic acid test - Answers :HIV test that is used for diagnosis and looks for the virus
List some opportunistic infections associated with HIV - Answers :Oral pharyngeal
candida infection (mouth fungus)
Kaposi sarcoma (skin cancer)
Meningitis
Cytomegalovirus (blindness)
Pneumocystis (pneumonia)
Medication for HIV - Answers :Zidovudine
isolation precautions for HIV - Answers :Universal precautions
How do the isolation precautions change with AIDS? - Answers :If the patient has a low
CD4 count and is at risk of an opportunistic infection:
The patient should have a
-Private room
-Reverse isolation
-RN/PN should wear gloves, gown, goggles, mask when in direct contact with blood or
body fluids.
What are the teaching points for patients who have a child with HIV? - Answers :Use
water and bleach
Child should have all vaccines except for live ones such as MMR, VARICELLA, or
poliovirus
Feed high calorie protein diet
Use gloves when changing diaper
acute renal failure (ARF) - Answers :Sudden loss of kidney function to excrete toxins,
and regulate fluid and electrolytes
Three possible causes of ARF - Answers :Infection
Obstruction
Shock
,Three phases of ARF - Answers :Oliguric, diuretic, recovery
During the oliguric phase, in ARF what should the nurse expect to see clinically? -
Answers :Low urine output of less than 400 ML per day
Hyperkalemia
Hypertension
Elevated BUN /creatinine levels
Fluid overload
Two electrolytes in ARF that will be elevated - Answers :Sodium and phosphate
The diuretic phase of ARF - Answers :Urine output slowly returns Hypovolemia,
hypotension, dehydration - BUN, Creatinine levels still elevated -BUN and Creatinine
levels begin to normalize
Recovery phase of ARF - Answers :Kidneys recover slowly
The GFR increases
BUN and creatinine return to normal
Diet for ARF - Answers :Low protein
high carbs
restrict potassium and phosphorus (no bananas, citrus, tomatoes, melons, dairy
products, beans, nuts, legumes, carbonated beverages)
Restrict caffeine
adam stokes syndrome - Answers :Heart conditions
Client experiences what with Adam Stokes syndrome? - Answers :Sudden attacks of
syncope
Fainting
Seizures
With Adam Stokes syndrome, what will you see on a EKG/ECG - Answers :Asystole or
ventricular arrhythmias
Adam Stokes syndrome - Answers :There will be no tissue perfusion during the attacks
Treatment for Adam Stokes syndrome - Answers :Client will need an internal
pacemaker inserted during surgery
Digoxin can be given after surgery?
Addison's disease - Answers :Low production of hormones by the adrenal glands
Glucocorticoids and mineralocorticoids
Major symptoms of Addison's disease - Answers :Lethargy
Weakness
, Weight loss
Bronze color skin
Hyperpigmentation
Assess palms and the crease of skin and over pressure points
No weight loss is common
Addison's disease - Answers :Blood glucose levels are low
Sodium levels are low
Salts should be increased
Serum potassium levels are high
Lifelong glucocorticoid therapy Is the treatment
Allergies - Answers :Clients allergic to latex may also be allergic to - Bananas, kiwi,
chestnuts
Hospital equipment that contains latex
Blood pressure cuff
Tourniquet
Band-Aids
Indwelling catheters
Allergy is contradicted for IV contrast dye - iodine/shellfish allergy
amputation - Answers :Major complications are infections
Skin breakdown
Phantom limp pain
Joint contracture
Positioning for postop care for amputation (above knee amputation) - Answers :Elevate
first 24 hours then prone
Please client in the position twice daily to prevent hip flexion
BKA (below knee amputation) - Answers :foot of bed elevated for first 24 hours. position
prone to provide hip extension.
Phantom limb pain - is pain felt where the leg was that is no longer there
Anemias - Answers :low red blood cell count
aplastic anemia signs - Answers :Decreased erythrocytes, bleeding mucous
membranes, thrombocytopenia
Aplastic Anemia Treatment - Answers :bone marrow transplant
Blood transfusion
Iron deficiency, anemia signs - Answers :-Low hgb & hct,
