NCLEX Practice Test 3

The patient's symptoms of confusion and shakiness are consistent with hypoglycemia, which is low blood sugar. Since the patient has a history of diabetes mellitus, it is possible that her blood sugar levels have dropped too low, leading to these symptoms. Anesthesia reaction is less likely as the symptoms are more specific to hypoglycemia. Hyperglycemia and diabetic ketoacidosis would present with different symptoms such as increased thirst, frequent urination, and high blood sugar levels. Therefore, hypoglycemia is the most likely explanation for the patient's symptoms.

Repeated vomiting after a head trauma in a child is a cause for concern as it can be a sign of increased intracranial pressure. Increased intracranial pressure can occur due to bleeding or swelling in the brain, and can be life-threatening if not promptly treated. Therefore, the nurse should closely monitor the child for this symptom and report it to the healthcare provider. The other options, such as bulging anterior fontanel, signs of sleepiness at 10 PM, and inability to read short words from a distance of 18 inches, may not necessarily indicate increased intracranial pressure and may have other explanations.

Hepatitis A is primarily transmitted through the fecal-oral route, which means that it is most commonly spread through contaminated food or water. This can occur when food or water is contaminated with the feces of an infected person. Sexual contact with an infected partner, blood transfusion, and illegal drug use are not typical routes of transmission for hepatitis A.

A history of hepatitis C five years previously would prevent the relative from donating blood for transfusion because hepatitis C is a viral infection that can be transmitted through blood transfusion. Even if the relative's infection is no longer active, there is still a risk of residual virus in their blood, which could potentially infect the leukemia patient. Therefore, it is important to exclude individuals with a history of hepatitis C from donating blood to ensure the safety of the recipient.

The symptoms of increasing abdominal pain, fever, and chills after fiberoptic colonoscopy suggest a potential complication, such as bowel perforation. Bowel perforation is a serious condition that requires immediate medical attention as it can lead to peritonitis and sepsis. Viral gastroenteritis, colon cancer, and diverticulitis may cause abdominal pain, but they are not typically associated with fever and chills immediately after a colonoscopy.

A pacemaker is a contraindication for an MRI scan because the strong magnetic fields and radio waves used in an MRI can interfere with the functioning of the pacemaker, potentially causing harm to the patient.

A platelet count of 25,000/microliter indicates severe thrombocytopenia, which increases the risk of bleeding. Checking for signs of bleeding, including examining urine and stool for blood, is important in monitoring the patient's condition and detecting any potential bleeding. Monitoring for fever (option A) is not directly related to the platelet count. Requiring visitors to wear respiratory masks and protective clothing (option B) is not necessary for platelet count monitoring. Transfusion of packed red blood cells (option C) is not indicated for thrombocytopenia.

The nurse most likely observed the patient suddenly complaining of chest pain and shortness of breath. This is indicative of a pulmonary embolism, as it is a common symptom. A pulmonary embolism occurs when a blood clot travels to the lungs and blocks the blood flow. This can cause chest pain and difficulty in breathing. The other options do not align with the symptoms of a pulmonary embolism.

The correct answer is C because a rapidly enlarging abdominal aortic aneurysm is a surgical emergency. Immediate intervention is required to prevent rupture and potentially fatal complications. The patient will be admitted to the surgical unit for further evaluation and a resection procedure will be scheduled to repair or remove the aneurysm. Observation and medication (option A) or sclerotherapy (option B) are not appropriate management options for a rapidly enlarging abdominal aortic aneurysm. Discharging the patient home (option D) would be unsafe and could lead to a life-threatening situation.

The correct answer is D. The patient should limit fatty foods. Cholecystitis is inflammation of the gallbladder, and fatty foods can trigger symptoms such as pain and discomfort in patients with this condition. Limiting fatty foods can help reduce the workload on the gallbladder and alleviate symptoms.

In primary hyperparathyroidism, there is an overproduction of parathyroid hormone (PTH) by the parathyroid glands. PTH increases the release of calcium from the bones into the bloodstream and enhances the reabsorption of calcium by the kidneys. As a result, there is an elevated level of serum calcium in the blood. Therefore, option A is the correct answer.

A patient with a history of ventricular tachycardia and syncopal episodes is most likely to have an implantation of an automatic internal cardioverter-defibrillator. Ventricular tachycardia is a potentially life-threatening arrhythmia that can lead to sudden cardiac arrest. Syncopal episodes indicate that the patient has experienced loss of consciousness, which could be due to the arrhythmia. An automatic internal cardioverter-defibrillator is a device that can detect and treat dangerous arrhythmias by delivering an electric shock to restore normal heart rhythm. Therefore, this patient would benefit the most from this procedure to prevent future cardiac events.

A patient with Addison's disease has a deficiency in adrenal hormones, specifically cortisol and aldosterone. Cortisol helps regulate blood pressure and sodium levels, while aldosterone helps regulate sodium and potassium levels. Therefore, a restricted sodium diet is not recommended because it can further lower sodium levels in the body, potentially leading to low blood pressure and electrolyte imbalances.

The correct pediatric dose for Diphenhydramine is 5 mg/kg/day. In this case, the child weighs 30 kg, so the correct dose would be 150 mg/day (30 kg x 5 mg/kg/day). However, the prescribed dose is only 25 mg 3 times a day, which amounts to only 75 mg/day. Therefore, the prescribed dose is too low and should be increased to reach the correct dosage.

Normally, the testes descend into the scrotum by one year of age. It is not uncommon for one or both testes to be undescended at birth, but they usually descend on their own within the first year. Surgical intervention is not typically necessary unless the testes have not descended by one year of age. The presence of only one testis in the scrotal sac is not necessarily indicative of a problem, as it is possible for one testis to be undescended while the other has descended normally.

Naproxen sodium (Naprosyn) would be contraindicated for a patient diagnosed with acute gastritis because it is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach lining and worsen the inflammation and symptoms of gastritis. NSAIDs can increase the risk of gastrointestinal bleeding and ulcers, which is why they should be avoided in patients with gastritis. Calcium carbonate, clarithromycin, and furosemide do not have the same irritating effects on the stomach and would not be contraindicated for this patient.

Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria. It is characterized by symptoms such as a red and swollen pharynx, a characteristic sign known as "strawberry tongue," and the presence of petechiae, which are small red or purple spots, on the skin. However, petechiae do not occur on the soft palate, making option C incorrect.

A patient with severe pulmonary edema is likely to exhibit symptoms of air hunger. This is because pulmonary edema is the accumulation of fluid in the lungs, which can lead to difficulty breathing and a sensation of not getting enough air. Slow, deep respirations (option A) are not typically seen in pulmonary edema, as the patient may be struggling to breathe. Stridor (option B) is a high-pitched sound that occurs with upper airway obstruction, not pulmonary edema. Bradycardia (option C) refers to a slow heart rate, which is not directly related to pulmonary edema.

The presence of small blue-white spots on the oral mucosa is a characteristic sign of rubeola (measles). This is known as Koplik spots and is a specific feature of measles. The rash of measles typically starts on the face and spreads downward to the trunk and extremities. Low-grade fever is also commonly associated with measles. However, the "tear drop on a rose petal" appearance of lesions is not a characteristic finding of measles.

A,B, and C are correct