NCLEX Practice Exam 45 (10 Questions)

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Questions: 10 | Attempts: 1,439 | Updated: Mar 21, 2023

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Questions and Answers

1.

A child is admitted to the hospital with a diagnosis of Wilms tumor. stage II. Which of the following statements most accurately describes this stage?
- A.
  
  The tumor is less than 3 cm. in size and requires no chemotherapy.
- B.
  
  The tumor did not extend beyond the kidney and was completely resected.
- C.
  
  The tumor extended beyond the kidney but was completely resected.
- D.
  
  The tumor has spread into the abdominal cavity and cannot be resected.
Correct Answer
C. The tumor extended beyond the kidney but was completely resected.

Explanation
The staging of Wilms tumor is confirmed at surgery as follows: Stage I. the tumor is limited to the kidney and completely resected; stage II. the tumor extends beyond the kidney but is completely resected; stage III. residual non hematogenous tumor is confined to the abdomen; stage IV. hematogenous metastasis has occurred with spread beyond the abdomen; and stage V. bilateral renal involvement is present at diagnosis.

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2.

A teen patient is admitted to the hospital by his physician who suspects a diagnosis of acute glomerulonephritis. Which of the following findings is consistent with this diagnosis? Note: More than one answer may be correct.
- A.
  
  Urine specific gravity of 1.040.
- B.
  
  Urine output of 350 ml in 24 hours.
- C.
  
  Brown (“tea-colored”) urine.
- D.
  
  Generalized edema.
Correct Answer(s)
A. Urine specific gravity of 1.040.
B. Urine output of 350 ml in 24 hours.
C. Brown (“tea-colored”) urine.

Explanation
Acute glomerulonephritis is characterized by high urine specific gravity related to oliguria as well as dark “tea colored” urine caused by large amounts of red blood cells. There is periorbital edema. but generalized edema is seen in nephrotic syndrome. not acute glomerulonephritis.

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3.

Which of the following conditions most commonly causes acute glomerulonephritis?
- A.
  
  A congenital condition leading to renal dysfunction.
- B.
  
  Prior infection with group A Streptococcus within the past 10-14 days.
- C.
  
  Viral infection of the glomeruli.
- D.
  
  Nephrotic syndrome.
Correct Answer
B. Prior infection with group A Streptococcus within the past 10-14 days.

Explanation
Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection. resulting in scant. dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis.

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4.

An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth. but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?
- A.
  
  Massaging the groin area twice a day until the fluid is gone.
- B.
  
  Referral to a surgeon for repair.
- C.
  
  No treatment is necessary; the fluid is reabsorbing normally.
- D.
  
  Keeping the infant in a flat. supine position until the fluid is gone.
Correct Answer
C. No treatment is necessary; the fluid is reabsorbing normally.

Explanation
A hydrocele is a collection of fluid in the scrotum that results from a patent tunica vaginalis. Illumination of the scrotum with a pocket light demonstrates the clear fluid. In most cases the fluid reabsorbs within the first few months of life and no treatment is necessary. Massaging the area or placing the infant in a supine position would have no effect. Surgery is not indicated.

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5.

A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms?
- A.
  
  Inadequate tissue perfusion leading to nerve damage.
- B.
  
  Fluid overload leading to compression of nerve tissue.
- C.
  
  Sensation distortion due to psychiatric disturbance.
- D.
  
  Inflammation of the skin on the hands and feet.
Correct Answer
A. Inadequate tissue perfusion leading to nerve damage.

Explanation
Patients with peripheral vascular disease often sustain nerve damage as a result of inadequate tissue perfusion. Fluid overload is not characteristic of PVD. There is nothing to indicate psychiatric disturbance in the patient. Skin changes in PVD are secondary to decreased tissue perfusion rather than primary inflammation.

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6.

A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission?
- A.
  
  Sexual contact with an infected partner.
- B.
  
  Contaminated food.
- C.
  
  Blood transfusion.
- D.
  
  Illegal drug use.
Correct Answer
B. Contaminated food.

Explanation
Hepatitis A is the only type that is transmitted by the fecal-oral route through contaminated food. Hepatitis B. C. and D are transmitted through infected bodily fluids.

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7.

A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?
- A.
  
  A history of hepatitis C five years previously.
- B.
  
  Cholecystitis requiring cholecystectomy one year previously.
- C.
  
  Asymptomatic diverticulosis.
- D.
  
  Crohn’s disease in remission.
Correct Answer
A. A history of hepatitis C five years previously.

Explanation
Hepatitis C is a viral infection transmitted through bodily fluids. such as blood. causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Cholecystitis (gallbladder disease). diverticulosis. and history of Crohn’s disease do not preclude blood donation.

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8.

A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?
- A.
  
  Naproxen sodium (Naprosyn).
- B.
  
  Calcium carbonate.
- C.
  
  Clarithromycin (Biaxin).
- D.
  
  Furosemide (Lasix).
Correct Answer
A. Naproxen sodium (Naprosyn).

Explanation
Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason. it is contraindicated in a patient with gastritis. Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Furosemide is a loop diuretic and is contraindicated in a patient with gastritis.

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9.

The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?
- A.
  
  The patient must maintain a low calorie diet.
- B.
  
  The patient must maintain a high protein/low carbohydrate diet.
- C.
  
  The patient should limit sweets and sugary drinks.
- D.
  
  The patient should limit fatty foods.
Correct Answer
D. The patient should limit fatty foods.

Explanation
Cholecystitis. inflammation of the gallbladder. is most commonly caused by the presence of gallstones. which may block bile (necessary for fat absorption) from entering the intestines. Patients should decrease dietary fat by limiting foods like fatty meats. fried foods. and creamy desserts to avoid irritation of the gallbladder.

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10.

A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?
- A.
  
  Slow. deep respirations.
- B.
  
  Stridor.
- C.
  
  Bradycardia.
- D.
  
  Air hunger.
Correct Answer
D. Air hunger.

Explanation
Patients with pulmonary edema experience air hunger. anxiety. and agitation. Respiration is fast and shallow and heart rate increases. Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema.

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NCLEX Practice Exam 45 (10 Questions)

A child is admitted to the hospital with a diagnosis of Wilms tumor. stage II. Which of the following statements most accurately describes this stage?

A teen patient is admitted to the hospital by his physician who suspects a diagnosis of acute glomerulonephritis. Which of the following findings is consistent with this diagnosis? Note: More than one answer may be correct.

Which of the following conditions most commonly causes acute glomerulonephritis?

An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth. but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?

A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms?

A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission?

A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?

A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?

The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?

A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?