NCLEX Practice Exam 8 (10 Questions)

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

Sexual contact with an infected partner.

Contaminated food.

Blood transfusion.

Illegal drug use.

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.

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.

2. A patient with a history of diabetes mellitus is on the second post-operative day following cholecystectomy. She has complained of nausea and isn't able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient's symptoms?

Anesthesia reaction.

Hyperglycemia.

Hypoglycemia.

Diabetic ketoacidosis.

A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. An anesthesia reaction would not occur on the second post-operative day. Hyperglycemia and ketoacidosis do not cause confusion and shakiness.

Explanation

A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. An anesthesia reaction would not occur on the second post-operative day. Hyperglycemia and ketoacidosis do not cause confusion and shakiness.

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

A history of hepatitis C five years previously.

Cholecystitis requiring cholecystectomy one year previously.

Asymptomatic diverticulosis.

Crohn’s disease in remission.

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.

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.

4. A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings?

Elevated serum calcium.

Low serum parathyroid hormone (PTH).

Elevated serum vitamin D.

Low urine calcium.

The parathyroid glands regulate the calcium level in the blood. In hyperparathyroidism. the serum calcium level will be elevated. Parathyroid hormone levels may be high or normal but not low. The body will lower the level of vitamin D in an attempt to lower calcium. Urine calcium may be elevated. with calcium spilling over from elevated serum levels. This may cause renal stones.

Explanation

The parathyroid glands regulate the calcium level in the blood. In hyperparathyroidism. the serum calcium level will be elevated. Parathyroid hormone levels may be high or normal but not low. The body will lower the level of vitamin D in an attempt to lower calcium. Urine calcium may be elevated. with calcium spilling over from elevated serum levels. This may cause renal stones.

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

The patient must maintain a low-calorie diet.

The patient must maintain a high protein/low carbohydrate diet.

The patient should limit sweets and sugary drinks.

The patient should limit fatty foods.

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.

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.

6. A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain. fever. and chills. Which of the following conditions poses the most immediate concern?

Bowel perforation.

Viral gastroenteritis.

Colon cancer.

Diverticulitis.

Bowel perforation is the most serious complication of fiberoptic colonoscopy. Important signs include progressive abdominal pain. fever. chills. and tachycardia. which indicate advancing peritonitis. Viral gastroenteritis and colon cancer do not cause these symptoms. Diverticulitis may cause pain. fever. and chills. but is far less serious than perforation and peritonitis.

Explanation

Bowel perforation is the most serious complication of fiberoptic colonoscopy. Important signs include progressive abdominal pain. fever. chills. and tachycardia. which indicate advancing peritonitis. Viral gastroenteritis and colon cancer do not cause these symptoms. Diverticulitis may cause pain. fever. and chills. but is far less serious than perforation and peritonitis.

7. A patient with Addison's disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is NOT recommended?

A diet high in grains.

A diet with adequate caloric intake.

A high protein diet.

A restricted sodium diet.

A patient with Addison’s disease requires normal dietary sodium to prevent excess fluid loss. Adequate caloric intake is recommended with a diet high in protein and complex carbohydrates. including grains.

Explanation

A patient with Addison’s disease requires normal dietary sodium to prevent excess fluid loss. Adequate caloric intake is recommended with a diet high in protein and complex carbohydrates. including grains.

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

Naproxen sodium (Naprosyn).

Calcium carbonate.

Clarithromycin (Biaxin).

Furosemide (Lasix).

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 NOT contraindicated in a patient with gastritis.

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 NOT contraindicated in a patient with gastritis.

9. 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?

Slow. deep respirations.

Stridor.

Bradycardia.

Air hunger.

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.

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.

10. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following laboratory tests assesses coagulation?

Partial thromboplastin time.

Prothrombin time.

Platelet count.

Hemoglobin

Prothrombin time. partial thromboplastin time. and platelet count are all included in coagulation studies. The hemoglobin level. though important information prior to an invasive procedure like liver biopsy. does not assess coagulation.

Explanation

Prothrombin time. partial thromboplastin time. and platelet count are all included in coagulation studies. The hemoglobin level. though important information prior to an invasive procedure like liver biopsy. does not assess coagulation.

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