NCLEX Pratice Test 4
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1. A child is admitted to the hospital with a diagnosis of Wilm's tumor, stage II. Which of the following statements most accurately describes this stage?
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The tumor is less than 3 cm. in size and requires no chemotherapy.
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The tumor did not extend beyond the kidney and was completely resected.
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The tumor extended beyond the kidney but was completely resected.
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The tumor has spread into the abdominal cavity and cannot be resected.
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NCLEX Practice Test 4 assesses knowledge crucial for nursing practice, focusing on pediatric oncology, nephrology, vascular diseases, and cardiac health. It tests understanding of disease stages, symptoms, and patient care, enhancing readiness for the NCLEX exam.
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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.
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A. Urine specific gravity of 1.040.
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B. Urine output of 350 ml in 24 hours.
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C. Brown ("tea-colored") urine.
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D. Generalized edema.
Correct Answer
A. A. Urine specific gravity of 1.040.Explanation
A,B, and C are correctRate this question:
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- 3.
3. Which of the following conditions most commonly causes acute glomerulonephritis?
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A congenital condition leading to renal dysfunction.
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Prior infection with group A Streptococcus within the past 10-14 days.
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Viral infection of the glomeruli.
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Nephrotic syndrome.
Correct Answer
A. Prior infection with group A Streptococcus within the past 10-14 days.Explanation
Acute glomerulonephritis is most commonly caused by a prior infection with group A Streptococcus within the past 10-14 days. This is because the immune response to the infection can cause inflammation and damage to the glomeruli, which are the filtering units of the kidneys. This condition is known as poststreptococcal glomerulonephritis and is characterized by symptoms such as hematuria, proteinuria, and hypertension. Other conditions mentioned in the options, such as congenital conditions, viral infections, and nephrotic syndrome, can also cause glomerulonephritis, but they are not the most common cause.Rate this question:
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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?
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Massaging the groin area twice a day until the fluid is gone.
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Referral to a surgeon for repair.
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No treatment is necessary; the fluid is reabsorbing normally.
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Keeping the infant in a flat, supine position until the fluid is gone.
Correct Answer
A. No treatment is necessary; the fluid is reabsorbing normally.Explanation
Hydrocele is a condition where fluid accumulates in the scrotum, causing it to swell. In infants, hydroceles often resolve on their own as the body reabsorbs the fluid. The fact that the scrotum is smaller than at birth indicates that the fluid is indeed being reabsorbed. Therefore, no treatment is necessary, and the physician is likely to recommend monitoring the condition without intervention.Rate this question:
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- 5.
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?
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Inadequate tissue perfusion leading to nerve damage.
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Fluid overload leading to compression of nerve tissue.
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Sensation distortion due to psychiatric disturbance.
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Inflammation of the skin on the hands and feet.
Correct Answer
A. Inadequate tissue perfusion leading to nerve damage.Explanation
The patient's symptoms of burning and tingling in the hands and feet, as well as intolerance to touch, are consistent with nerve damage. Inadequate tissue perfusion, which refers to a decreased blood flow to the affected areas, can lead to nerve damage. When tissues do not receive enough oxygen and nutrients due to poor blood flow, the nerves in those areas can become damaged, resulting in these symptoms. This explanation aligns with the patient's diagnosis of peripheral vascular disease, which is characterized by reduced blood flow to the extremities.Rate this question:
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6. A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?
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Family history of heart disease.
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Overweight.
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Smoking
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Age
Correct Answer
A. Family history of heart disease.Explanation
A family history of heart disease is a hereditary risk factor for developing atherosclerosis. This means that if a person has close relatives, such as parents or siblings, who have had heart disease, they are at a higher risk for developing atherosclerosis themselves. This is because certain genes and genetic factors can increase the likelihood of developing the condition. Overweight, smoking, and age are not hereditary risk factors, but they can contribute to the development of atherosclerosis in other ways.Rate this question:
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7. Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct?
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It results when oxygen demand is greater than oxygen supply.
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It is characterized by pain that often occurs duing rest.
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It is a result of tissue hypoxia.
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It is characterized by cramping and weakness.
Correct Answer
A. It results when oxygen demand is greater than oxygen supply.Explanation
A, C and D is correctRate this question:
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- 8.
8. A nurse is providing discharge information to a patient with peripheral vascular disease. Which of the following information should be included in instructions?
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Walk barefoot whenever possible.
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Use a heating pad to keep feet warm.
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Avoid crossing the legs.
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Use antibacterial ointment to treat skin lesions at risk of infection.
Correct Answer
A. Avoid crossing the legs.Explanation
Patients with peripheral vascular disease have decreased blood flow to the extremities, which can lead to complications such as poor wound healing and increased risk of infection. Crossing the legs can further restrict blood flow and exacerbate these issues. Therefore, it is important for patients with peripheral vascular disease to avoid crossing their legs. The other options mentioned in the question are incorrect and may even be harmful for patients with this condition.Rate this question:
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- 9.
9. A patient who has been diagnosed with vasospastic disorder (Raynaud's disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient?
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An adolescent male.
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An elderly woman.
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A young woman.
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An elderly man
Correct Answer
A. A young woman.Explanation
A young woman is most likely to fit the description of a patient with vasospastic disorder (Raynaud's disease). Raynaud's disease is more common in women, especially young women. It is characterized by episodes of vasospasm in the small arteries of the fingers and toes, leading to coldness, numbness, and stiffness in the affected areas. This condition is often triggered by cold temperatures or emotional stress.Rate this question:
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10. A 23 year old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?
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Myocardial infarction due to a history of atherosclerosis.
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Pulmonary embolism due to deep vein thrombosis (DVT).
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Anxiety attack due to worries about her baby's health.
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Congestive heart failure due to fluid overload.
Correct Answer
A. Pulmonary embolism due to deep vein thrombosis (DVT).Explanation
The most likely cause of the patient's symptoms is a pulmonary embolism due to deep vein thrombosis (DVT). This is because the patient is pregnant and has been on complete bed rest, which increases the risk of developing blood clots. The sudden shortness of breath and chest pain are classic symptoms of a pulmonary embolism, which occurs when a blood clot in the leg (DVT) breaks free and travels to the lungs, causing a blockage in the pulmonary arteries. Myocardial infarction, anxiety attack, and congestive heart failure are less likely causes in this scenario.Rate this question:
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11. Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy?
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Air embolus.
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Cerebral hemorrhage.
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Expansion of the clot.
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Resolution of the clot.
Correct Answer
A. Cerebral hemorrhage.Explanation
Thrombolytic therapy is a treatment used to dissolve blood clots in the body. However, it can also increase the risk of bleeding, including cerebral hemorrhage, which is bleeding in the brain. This complication occurs because thrombolytic therapy can cause the blood to become too thin, leading to the rupture of blood vessels in the brain and subsequent bleeding. Therefore, cerebral hemorrhage is a significant complication associated with thrombolytic therapy.Rate this question:
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- 12.
12. An infant is brought to the clinic by his mother, who has noticed that he holds his head in an unusual position and always faces to one side. Which of the following is the most likely explanation?
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Torticollis, with shortening of the sternocleidomastoid muscle.
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Craniosynostosis, with premature closure of the cranial sutures.
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Plagiocephaly, with flattening of one side of the head.
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Hydrocephalus, with increased head size.
Correct Answer
A. Torticollis, with shortening of the sternocleidomastoid muscle.Explanation
The most likely explanation for the infant's unusual head position and always facing to one side is torticollis, which is characterized by the shortening of the sternocleidomastoid muscle. This condition causes the head to tilt to one side and can result from a variety of factors such as birth trauma, muscle imbalance, or abnormal positioning in the womb. Treatment for torticollis may include stretching exercises, physical therapy, or in severe cases, surgery.Rate this question:
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- 13.
13. An adolescent brings a physician's note to school stating that he is not to participate in sports due to a diagnosis of Osgood-Schlatter disease. Which of the following statements about the disease is correct?
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A. The condition was caused by the student's competitive swimming schedule.
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B. The student will most likely require surgical intervention.
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C. The student experiences pain in the inferior aspect of the knee.
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D. The student is trying to avoid participation in physical education.
Correct Answer
A. C. The student experiences pain in the inferior aspect of the knee.Explanation
Osgood-Schlatter disease is a condition that commonly affects adolescents who are involved in activities that involve frequent jumping and running, such as sports. It is characterized by pain and swelling in the area below the kneecap, known as the inferior aspect of the knee. The condition is not caused by a specific sport or activity, and surgical intervention is usually not required. Therefore, the correct statement is that the student experiences pain in the inferior aspect of the knee.Rate this question:
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14. The clinic nurse asks a 13-year-old female to bend forward at the waist with arms hanging freely. Which of the following assessments is the nurse most likely conducting?
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A. Spinal flexibility.
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B. Leg length disparity.
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C. Hypostatic blood pressure.
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D. Scoliosis.
Correct Answer
A. D. Scoliosis.Explanation
The nurse is most likely conducting an assessment for scoliosis. Bending forward at the waist with arms hanging freely allows the nurse to observe the curvature of the spine. This position is commonly used to screen for scoliosis, a condition characterized by an abnormal sideways curvature of the spine. By observing the alignment of the spine in this position, the nurse can assess for any signs of scoliosis.Rate this question:
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15. A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse LEAST likely to find in an abusing parent?
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A. Low self-esteem.
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B. Unemployment.
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C. Self-blame for the injury to the child.
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Single Status
Correct Answer
A. C. Self-blame for the injury to the child.Explanation
An abusing parent is least likely to exhibit self-blame for the injury to the child. Abusers often lack empathy and tend to blame others or external factors for their actions. They may deny responsibility or minimize the harm caused to the child. This behavior is a defense mechanism to avoid feelings of guilt or shame. Therefore, it is unlikely for an abusing parent to take self-blame for the injury to the child.Rate this question:
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16. A nurse is assigned to the pediatric rheumatology clinic and is assessing a child who has just been diagnosed with juvenile idiopathic arthritis. Which of the following statements about the disease is most accurate?
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A. The child has a poor chance of recovery without joint deformity.
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B. Most children progress to adult rheumatoid arthritis.
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C. Nonsteroidal anti-inflammatory drugs are the first choice in treatment.
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D. Physical activity should be minimized.
Correct Answer
A. B. Most children progress to adult rheumatoid arthritis.Explanation
Most children with juvenile idiopathic arthritis progress to adult rheumatoid arthritis. This statement is accurate because juvenile idiopathic arthritis is a chronic autoimmune disease that primarily affects children and can continue into adulthood. While some children may experience joint deformities, it is not true that all children with this condition will have poor chances of recovery without joint deformity. Nonsteroidal anti-inflammatory drugs may be used in the treatment of juvenile idiopathic arthritis, but they are not always the first choice. Physical activity is actually encouraged as it can help improve joint mobility and overall well-being in children with this condition.Rate this question:
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17. A child is admitted to the hospital several days after stepping on a sharp object that punctured her athletic shoe and entered the flesh of her foot. The physician is concerned about osteomyelitis and has ordered parenteral antibiotics. Which of the following actions is done immediately before the antibiotic is started?
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A. The admission orders are written.
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B. A blood culture is drawn.
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C. A complete blood count with differential is drawn.
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D. The parents arrive.
Correct Answer
A. B. A blood culture is drawn.Explanation
Before starting parenteral antibiotics, it is important to draw a blood culture to identify the specific bacteria causing the infection. This will help determine the most appropriate antibiotic to use for treatment. The blood culture will also provide information about the severity of the infection and whether it has spread to the bloodstream, which can help guide further management decisions. Therefore, drawing a blood culture is the immediate action that should be done before starting antibiotics in this case.Rate this question:
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18. A two-year-old child has sustained an injury to the leg and refuses to walk. The nurse in the emergency department documents swelling of the lower affected leg. Which of the following does the nurse suspect is the cause of the child's symptoms?
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A. Possible fracture of the tibia.
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B. Bruising of the gastrocnemius muscle.
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C. Possible fracture of the radius.
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D. No anatomic injury, the child wants his mother to carry him.
Correct Answer
A. A. Possible fracture of the tibia.Explanation
The nurse suspects that the child's symptoms, including swelling of the lower affected leg and refusal to walk, may be caused by a possible fracture of the tibia. This is the most likely explanation given the symptoms described.Rate this question:
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19. A toddler has recently been diagnosed with cerebral palsy. Which of the following information should the nurse provide to the parents? Note: More than one answer may be correct. 19. A toddler has recently been diagnosed with cerebral palsy. Which of the following information should the nurse provide to the parents? Note: More than one answer may be correct.
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A. Regular developmental screening is important to avoid secondary developmental delays.
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B. Cerebral palsy is caused by injury to the upper motor neurons and results in motor dysfunction, as well as possible ocular and speech difficulties.
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C. Developmental milestones may be slightly delayed but usually will require no additional intervention.
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D. Parent support groups are helpful for sharing strategies and managing health care issues.
Correct Answer
A. A. Regular developmental screening is important to avoid secondary developmental delays.Explanation
A, B and D are correctRate this question:
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- 20.
20. A child has recently been diagnosed with Duchenne's muscular dystrophy. The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?
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A. Duchenne's is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.
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B. Duchenne's is an X-linked recessive disorder, so both daughters and sons have a 50% chance of developing the disease.
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C. Each child has a 1 in 4 (25%) chance of developing the disorder.
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D. Sons only have a 1 in 4 (25%) chance of developing the disorder.
Correct Answer
A. A. Duchenne's is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.Explanation
Duchenne's muscular dystrophy is an X-linked recessive disorder, which means that it is caused by a mutation on the X chromosome. Since males have one X and one Y chromosome, if they inherit the mutated X chromosome, they will develop the disease. On the other hand, females have two X chromosomes, so even if they inherit one mutated X chromosome, the other normal X chromosome can compensate for the mutation, making them carriers of the disease. Therefore, daughters have a 50% chance of being carriers and sons have a 50% chance of developing the disease.Rate this question:
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Dec 14, 2023Quiz Edited by
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Jan 08, 2012Quiz Created by
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