NCLEX Practice Exam 15 (10 Questions)

1. A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What could you tell him to help him reduce his discomfort?

“Hold your cough as much as possible.”

“Place the head of your bed flat to help with coughing.”

“Restrict fluids to help decrease the amount of sputum.”

“Splint your chest wall with a pillow for comfort.”

Showing this patient how to splint his chest wall will help decrease discomfort when coughing.

Explanation

Showing this patient how to splint his chest wall will help decrease discomfort when coughing.

2. A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute. and he appears to be in acute respiratory distress. Which of the following actions should you take first?

Take a full medical history.

Give a bronchodilator by nebulizer.

Apply a cardiac monitor to the patient.

Provide emotional support for the patient.

The patient having an acute asthma attack needs more oxygen delivered to his lungs and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered.

Explanation

The patient having an acute asthma attack needs more oxygen delivered to his lungs and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered.

3. Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma?

Bradycardia.

Large amounts of very dilute urine.

Restlessness and confusion.

Widened pulse pressure.

The earliest sign of increased ICP is a change in mental status.

Explanation

The earliest sign of increased ICP is a change in mental status.

4. A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks' gestation. She's at risk for which of the following blood dyscrasias?

Thrombocytopenia.

Idiopathic thrombocytopenic purpura (ITP).

Disseminated intravascular coagulation (DIC).

Heparin-associated thrombosis and thrombocytopenia (HATT).

Abruptio placentae is a cause of DIC because it activates the clotting cascade after hemorrhage.

Explanation

Abruptio placentae is a cause of DIC because it activates the clotting cascade after hemorrhage.

5. A patient infected with human immunodeficiency virus (HIV) begins zidovudine therapy. Which of the following statements best describes this drug's action?

It destroys the outer wall of the virus and kills it.

It interferes with viral replication.

It stimulates the immune system.

It promotes excretion of viral antibodies.

Zidovudine inhibits DNA synthesis in HIV. thus interfering with viral replication. The drug doesn’t destroy the viral wall. stimulate the immune system. or promote HIV antibody excretion.

Explanation

Zidovudine inhibits DNA synthesis in HIV. thus interfering with viral replication. The drug doesn’t destroy the viral wall. stimulate the immune system. or promote HIV antibody excretion.

6. A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He develops severe hypoxia 48 hours after the incident. requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed?

Acute respiratory distress syndrome (ARDS).

Atelectasis.

Bronchitis.

Pneumonia.

Severe hypoxia after smoke inhalation typically is related to ARDS. The other choices aren’t typically associated with smoke inhalation.

Explanation

Severe hypoxia after smoke inhalation typically is related to ARDS. The other choices aren’t typically associated with smoke inhalation.

7. Corticosteroids are potent suppressors of the body's inflammatory response. Which of the following conditions or actions do they suppress?

Cushing syndrome.

Pain receptors.

Immune response.

Neural transmission.

Corticosteroids suppress eosinophils. lymphocytes. and natural-killer cells. inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation. stabilizes lysosomal membranes. decreases capillary permeability. and depresses phagocytosis of tissues by white blood cells. thus blocking the release of more inflammatory materials. Excessive corticosteroid therapy can lead to Cushing’s syndrome.

Explanation

Corticosteroids suppress eosinophils. lymphocytes. and natural-killer cells. inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation. stabilizes lysosomal membranes. decreases capillary permeability. and depresses phagocytosis of tissues by white blood cells. thus blocking the release of more inflammatory materials. Excessive corticosteroid therapy can lead to Cushing’s syndrome.

8. Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube?

You see a lot of drainage from the chest tube.

Arterial blood gas (ABG) levels are normal.

The chest X-ray continues to show the lung is 35% deflated.

The water-seal chamber doesn’t fluctuate when no suction is applied.

The chest tube isn’t removed until the patient’s lung has adequately re-expanded and is expected to stay that way. One indication of reexpansion is the cessation of fluctuation in the water-seal chamber when suction isn’t applied.

Explanation

The chest tube isn’t removed until the patient’s lung has adequately re-expanded and is expected to stay that way. One indication of reexpansion is the cessation of fluctuation in the water-seal chamber when suction isn’t applied.

9. Which of the following nursing interventions should you use to prevent footdrop and contractures in a patient recovering from a subdural hematoma?

High-top sneakers.

Low-dose heparin therapy.

Physical therapy consultation.

Sequential compressive device.

High-top sneakers are used to prevent foot drop and contractures in patients with neurologic conditions.

Explanation

High-top sneakers are used to prevent foot drop and contractures in patients with neurologic conditions.

10. A 16-year-old patient involved in a motor vehicle accident arrives in the ED unconscious and severely hypotensive. He's suspected to have several fractures of his pelvis and legs. Which of the following parenteral fluids is the best choice for his current condition?

Fresh frozen plasma.

0.9% sodium chloride solution.

Lactated Ringer’s solution.

Packed red blood cells.

In a trauma situation. the first blood product given is unmatched (O negative) packed red blood cells.

Explanation

In a trauma situation. the first blood product given is unmatched (O negative) packed red blood cells.