NCLEX-PN Review Questions and Correct Answers |
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The nurse is taking the health history of a patient being treated for
Emphysema and Chronic Bronchitis. After being told the patient has been
smoking cigarettes for 30 years, the nurse expects to note which
assessment finding?
1. Increase in Forced Vital Capacity (FVC)
2. A narrowed chest cavity
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3. Clubbed fingers
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4. An increased risk of cardiac failure
Ans: 3. Clubbed fingers - CORRECT
Clubbed fingers are a sign of a long-term, or chronic, decrease in oxygen
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levels.
The nurse is taking the health history of a 70-year-old patient being
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treated for a Duodenal Ulcer. After being told the patient is complaining
of epigastric pain, the nurse expects to note which assessment finding?
1. Melena
2. Nausea
3. Hernia
4. Hyperthermia
Ans: 1. Melena - CORRECT
Melena is the finding that there are traces of blood in the stool which
presents as black, tarry feces. This is a common manifestation of
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Duodenal Ulcers, since the Duodenum is further down the gastric
anatomy.
A nurse is providing discharge teaching for a patient with severe
Gastroesophogeal Reflux Disease. Which of these statements by the
patient indicates a need for more teaching?
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
2. "I'm going to make sure to remain upright after meals and elevate my
head when I sleep"
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3. "I won't be drinking tea or coffee or eating chocolate any more."
4. "I'm going to start trying to lose some weight."
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Ans: 1. "I'm going to limit my meals to 2-3 per day to reduce acid
secretion."
CORRECT - Large meals increase the volume and pressure in the stomach
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and delay gastric emptying. It's recommended instead to eat 4-6 small
meals a day.
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The nurse in the Emergency Room is treating a patient suspected to have
a Peptic Ulcer. On assessing lab results, the nurse finds that the patient's
blood pressure is 95/60, pulse is 110 beats per minute, and the patient
reports epigastric pain. What is the PRIORITY intervention?
1. Start a large-bore IV in the patient's arm
2. Ask the patient for a stool sample
3. Prepare to insert an NG Tube
4. Administer intramuscular morphine sulphate as ordered
Ans: 1. Start a large-bore IV in the patient's arm
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CORRECT - The nurse should suspect that the patient is haemorrhaging
and will need need a fluid replacement therapy, which requires a large
bore IV.
A female patient with atrial fibrillation has the following lab results:
Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and
potassium of 2.7 mEq/L. Which result is critical and should be reported
to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
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3. INR of 2.5
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4. Potassium of 2.7 mEq/L
Ans: 4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of
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dysrhythmia can be life-threatening and can lead to cardiac distress.
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While receiving normal saline infusions to treat a GI bleed, the nurse
notes that the patient's lower legs have become edematous and
auscultates crackles in the lungs. What should the nurse do first?
1. Stop the saline infusion immediately
2. Notify Physician
3. Elevate the patient's legs
4. Continue the infusion, since these are normal findings
Ans: 1. Stop the saline infusion immediately
CORRECT - the patient has a fluid volume overload as a result of overly
rapid fluid replacement. The nurse should stop the infusion and notify
the physician.
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The nurse is working in a support group for clients with HIV. Which point
is most important for the nurse to stress?
1. They must inform household members of their condition
2. They must take their medications exactly as prescribed
3. They must abstain from substance use
4. They must avoid large crowds
Ans: 2. They must take their medications exactly as prescribed
Assignment Expert
CORRECT - Antiretrovirals must be taken exactly as prescribed to prevent
drug-resistant strains. Even missed doses can reduce the effectiveness of
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future treatment.
A nurse finds a 30-year-old woman experiencing anaphylaxis from a bee
sting. Emergency personnel have been called. The nurse notes the woman
is breathing but short of breath. Which of the following interventions
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should the nurse do first?
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1. Initiate cardiopulmonary resuscitation
2. Check for a pulse
3. Ask the woman if she carries an emergency medical kit
4. Stay with the woman until help comes
Ans: 3. Ask the woman if she carries an emergency medical kit
CORRECT - Many patients who have a known history of anaphylaxis carry
epi-pens in their pockets or belongings. This is the best way to stop a
hypersensitivity reaction before it becomes life-threatening.
A man is prescribed lithium to treat bipolar disorder. The nurse is most
concerned about lithium toxicity when he notices which of these
assessment findings?