NCLEX Pratice Test 5
- 1.
1. A nurse is administering IV furosemide to a patient admitted with congestive heart failure. After the infusion, which of the following symptoms is NOT expected?
- A.
A. Increased urinary output.
- B.
B. Decreased edema.
- C.
C. Decreased pain.
- D.
D. Decreased blood pressure.
Correct Answer
C. C. Decreased pain.Explanation
When administering IV furosemide to a patient with congestive heart failure, the expected symptoms include increased urinary output, decreased edema, and decreased blood pressure. Furosemide is a diuretic that helps the body eliminate excess fluid and reduce swelling. However, it does not have any direct effect on pain relief. Therefore, it is not expected to cause a decrease in pain.Rate this question:
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- 2.
2. There are a number of risk factors associated with coronary artery disease. Which of the following is a modifiable risk factor?
- A.
Obesity
- B.
B. Heredity.
- C.
C. Gender.
- D.
Age
Correct Answer
A. ObesityExplanation
Obesity is a modifiable risk factor for coronary artery disease. This means that individuals have control over this risk factor and can take steps to reduce their risk. Obesity is associated with various health issues, including high blood pressure, high cholesterol levels, and diabetes, all of which are risk factors for coronary artery disease. By adopting a healthy lifestyle, including regular exercise and a balanced diet, individuals can reduce their weight and lower their risk of developing coronary artery disease.Rate this question:
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- 3.
3. Tissue plasminogen activator (t-PA) is considered for treatment of a patient who arrives in the emergency department following onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA?
- A.
A. Worsening chest pain that began earlier in the evening.
- B.
B. History of cerebral hemorrhage.
- C.
C. History of prior myocardial infarction.
- D.
Hypertension
Correct Answer
B. B. History of cerebral hemorrhage.Explanation
A history of cerebral hemorrhage is a contraindication for treatment with t-PA because t-PA is a thrombolytic agent that works by dissolving blood clots. If a patient has a history of cerebral hemorrhage, it means they have had bleeding in the brain before, and using a thrombolytic agent like t-PA could increase the risk of another hemorrhage. Therefore, it is not safe to administer t-PA to patients with a history of cerebral hemorrhage.Rate this question:
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- 4.
4. Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the following choices reflects the purpose of exercise for this patient?
- A.
A. Increases fitness and prevents future heart attacks.
- B.
B. Prevents bedsores.
- C.
C. Prevents DVT (deep vein thrombosis).
- D.
D. Prevent constipations.
Correct Answer
C. C. Prevents DVT (deep vein thrombosis).Explanation
Following a myocardial infarction (heart attack), patients are at an increased risk for developing deep vein thrombosis (DVT), which is the formation of blood clots in the deep veins of the legs. Leg exercises and ambulation help to promote blood flow and prevent blood clots from forming in the legs, reducing the risk of DVT. This is why the patient is encouraged to practice frequent leg exercises and ambulate in the hallway.Rate this question:
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- 5.
5. A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock?
- A.
Hypertension
- B.
Bradycardia
- C.
C. Bounding pulse.
- D.
Confusion
Correct Answer
D. ConfusionExplanation
Cardiogenic shock is a life-threatening condition that occurs when the heart is unable to pump enough blood to meet the body's needs. This leads to decreased blood flow and oxygen delivery to vital organs, including the brain. Confusion is a common symptom of cardiogenic shock because the brain is not receiving enough oxygen and nutrients. Hypertension and bounding pulse are not expected symptoms because the heart is not able to effectively pump blood. Bradycardia is also unlikely because the heart is usually working harder to compensate for the decreased cardiac output.Rate this question:
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- 6.
6. A patient with a history of congestive heart failure arrives at the clinic complaining of dyspnea. Which of the following actions is the first the nurse should perform?
- A.
A. Ask the patient to lie down on the exam table.
- B.
B. Draw blood for chemistry panel and arterial blood gas (ABG).
- C.
C. Send the patient for a chest x-ray.
- D.
D. Check blood pressure.
Correct Answer
D. D. Check blood pressure.Explanation
The nurse should first check the patient's blood pressure because it is important to assess the patient's hemodynamic status. In a patient with congestive heart failure, dyspnea can be a sign of worsening cardiac function and fluid overload, which can lead to elevated blood pressure. Checking the blood pressure can help determine if the patient is experiencing hypertensive crisis or if there are other urgent cardiovascular concerns that need to be addressed. This initial assessment will guide further interventions and treatment for the patient.Rate this question:
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- 7.
7. A clinic patient has recently been prescribed nitroglycerin for treatment of angina. He calls the nurse complaining of frequent headaches. Which of the following responses to the patient is correct?
- A.
A. "Stop taking the nitroglycerin and see if the headaches improve."
- B.
B. "Go to the emergency department to be checked because nitroglycerin can cause bleeding in the brain."
- C.
C. "Headaches are a frequent side effect of nitroglycerine because it causes vasodilation."
- D.
D. "The headaches are unlikely to be related to the nitroglycerin, so you should see your doctor for further investigation."
Correct Answer
C. C. "Headaches are a frequent side effect of nitroglycerine because it causes vasodilation."Explanation
Nitroglycerin is a medication commonly prescribed for angina, a condition characterized by chest pain due to reduced blood flow to the heart. Nitroglycerin works by causing vasodilation, which means it widens the blood vessels and increases blood flow. However, this vasodilation can also cause headaches as a side effect. Therefore, it is correct to inform the patient that headaches are a frequent side effect of nitroglycerin due to its vasodilatory effects.Rate this question:
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- 8.
8. A patient received surgery and chemotherapy for colon cancer, completing therapy 3 months previously, and she is now in remission. At a follow-up appointment, she complains of fatigue following activity and difficulty with concentration at her weekly bridge games. Which of the following explanations could account for her symptoms?
- A.
A. The symptoms may be the result of anemia caused by chemotherapy.
- B.
B. The patient may be immunosuppressed.
- C.
C. The patient may be depressed.
- D.
D. The patient may be dehydrated.
Correct Answer
A. A. The symptoms may be the result of anemia caused by chemotherapy.Explanation
The patient's symptoms of fatigue following activity and difficulty with concentration can be explained by anemia caused by chemotherapy. Chemotherapy can lead to a decrease in red blood cells, causing anemia. Anemia can result in reduced oxygen delivery to tissues, leading to fatigue and difficulty with concentration. Therefore, it is a plausible explanation for the patient's symptoms.Rate this question:
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- 9.
9. A clinic patient has a hemoglobin concentration of 10.8 g/dL and reports sticking to a strict vegetarian diet. Which of the follow nutritional advice is appropriate?
- A.
A. The diet is providing adequate sources of iron and requires no changes.
- B.
B. The patient should add meat to her diet; a vegetarian diet is not advised.
- C.
C. The patient should use iron cookware to prepare foods, such as dark green, leafy vegetables and legumes, which are high in iron.
- D.
D. A cup of coffee or tea should be added to every meal.
Correct Answer
B. B. The patient should add meat to her diet; a vegetarian diet is not advised. -
- 10.
10. A hospitalized patient is receiving packed red blood cells (PRBCs) for treatment of severe anemia. Which of the following is the most accurate statement?
- A.
A. Transfusion reaction is most likely immediately after the infusion is completed.
- B.
B. PRBCs are best infused slowly through a 20g. IV catheter.
- C.
C. PRBCs should be flushed with a 5% dextrose solution.
- D.
D. A nurse should remain in the room during the first 15 minutes of infusion.
Correct Answer
D. D. A nurse should remain in the room during the first 15 minutes of infusion.Explanation
The correct answer is D. A nurse should remain in the room during the first 15 minutes of infusion. This is the most accurate statement because during the initial 15 minutes of the PRBC infusion, the patient is at the highest risk for an adverse reaction. By having a nurse present in the room, any signs or symptoms of a transfusion reaction can be quickly detected and appropriate interventions can be initiated. This ensures the safety and well-being of the patient during the critical period of the infusion.Rate this question:
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- 11.
11. A patient who has received chemotherapy for cancer treatment is given an injection of Epoetin. Which of the following should reflect the findings in a complete blood count (CBC) drawn several days later?
- A.
A. An increase in neutrophil count.
- B.
B. An increase in hematocrit.
- C.
C. An increase in platelet count.
- D.
D. An increase in serum iron.
Correct Answer
B. B. An increase in hematocrit.Explanation
After receiving chemotherapy, a patient may experience a decrease in red blood cell production, leading to a decrease in hematocrit levels. Epoetin is a medication that stimulates the production of red blood cells, so if it is administered to the patient, it should lead to an increase in hematocrit levels when a complete blood count (CBC) is drawn several days later. Therefore, the correct answer is B. An increase in hematocrit.Rate this question:
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- 12.
12. A patient is admitted to the hospital with suspected polycythemia vera. Which of the following symptoms is consistent with the diagnosis?
- A.
A. Weight loss.
- B.
B. Increased clotting time.
- C.
Hypertension
- D.
Headaches
Correct Answer
B. B. Increased clotting time.Explanation
B, C and D are correctRate this question:
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- 13.
13. A nurse is caring for a patient with a platelet count of 20,000/microliter. Which of the following is an important intervention?
- A.
A. Observe for evidence of spontaneous bleeding.
- B.
B. Limit visitors to family only.
- C.
C. Give aspirin in case of headaches.
- D.
D. Impose immune precautions.
Correct Answer
A. A. Observe for evidence of spontaneous bleeding.Explanation
A platelet count of 20,000/microliter indicates severe thrombocytopenia, which means there is a low number of platelets in the blood. Platelets are responsible for blood clotting, so a low platelet count increases the risk of spontaneous bleeding. Therefore, it is important for the nurse to observe for any evidence of spontaneous bleeding in the patient. This could include signs such as petechiae (small red or purple spots on the skin), easy bruising, or prolonged bleeding from cuts or injuries.Rate this question:
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- 14.
14. A nurse in the emergency department assesses a patient who has been taking long-term corticosteroids to treat renal disease. Which of the following is a typical side effect of corticosteroid treatment? Note: More than one answer may be correct.
- A.
A. Hypertension.
- B.
B. Cushingoid features.
- C.
C. Hyponatremia.
- D.
D. Low serum albumin.
Correct Answer
A. A. Hypertension.Explanation
A, B and D are correctRate this question:
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- 15.
15. A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for a neutropenic patient?
- A.
A. Change the disposable mask immediately after use.
- B.
B. Change gloves immediately after use.
- C.
C. Minimize patient contact.
- D.
D. Minimize conversation with the patient.
Correct Answer
B. B. Change gloves immediately after use.Explanation
The most important nursing action when caring for a neutropenic patient is to change gloves immediately after use. Neutropenic patients have a weakened immune system, making them more susceptible to infections. Changing gloves after each use helps prevent the spread of harmful bacteria and pathogens that could potentially cause infections. This action is crucial in maintaining the patient's health and preventing complications.Rate this question:
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- 16.
16. A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectious precautions. Which of the following statements by family members indicates that the family needs more education?
- A.
A. We will bring in books and magazines for entertainment.
- B.
B. We will bring in personal care items for comfort.
- C.
C. We will bring in fresh flowers to brighten the room.
- D.
D. We will bring in family pictures and get well cards.
Correct Answer
C. C. We will bring in fresh flowers to brighten the room.Explanation
During the induction stage of treatment for leukemia, the patient's immune system is compromised, making them more susceptible to infections. Bringing in fresh flowers can introduce bacteria and other potential sources of infection into the room, which can be harmful to the patient. Therefore, the family needs more education about the importance of avoiding potential sources of infection.Rate this question:
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- 17.
17. A nurse is caring for a patient with acute lymphoblastic leukemia (ALL). Which of the following is the most likely age range of the patient?
- A.
A. 3-10 years.
- B.
B. 25-35 years.
- C.
C. 45-55 years.
- D.
D. over 60 years.
Correct Answer
A. A. 3-10 years.Explanation
The most likely age range for a patient with acute lymphoblastic leukemia (ALL) is 3-10 years. ALL is the most common type of cancer in children, with the peak incidence occurring between the ages of 2 and 5 years. While ALL can occur in adults, it is much more common in children. Therefore, the most likely age range for a patient with ALL is 3-10 years.Rate this question:
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- 18.
18. A patient is admitted to the oncology unit for diagnosis of suspected Hodgkin's disease. Which of the following symptoms is typical of Hodgkin's disease?
- A.
A. Painful cervical lymph nodes.
- B.
B. Night sweats and fatigue.
- C.
C. Nausea and vomiting.
- D.
D. Weight gain.
Correct Answer
B. B. Night sweats and fatigue.Explanation
Night sweats and fatigue are typical symptoms of Hodgkin's disease. Hodgkin's disease is a type of lymphoma that affects the lymphatic system. Night sweats, particularly drenching sweats that require changing clothes or bedding, are a common symptom of Hodgkin's disease. Fatigue is also a common symptom, often described as a constant lack of energy or extreme tiredness. These symptoms can be caused by the body's immune response to the disease and the release of chemicals called cytokines. Painful cervical lymph nodes, nausea and vomiting, and weight gain are not typically associated with Hodgkin's disease.Rate this question:
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- 19.
19. The Hodgkin's disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin's disease were correct, which of the following cells would the pathologist expect to find?
- A.
A. Reed-Sternberg cells.
- B.
B. Lymphoblastic cells.
- C.
C. Gaucher's cells.
- D.
D. Rieder's cells
Correct Answer
A. A. Reed-Sternberg cells.Explanation
The correct answer is A. Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal cells that are characteristic of Hodgkin's disease. They are found in the lymph nodes of individuals with Hodgkin's disease and are an important diagnostic feature for this condition. Lymphoblastic cells are associated with acute lymphoblastic leukemia, Gaucher's cells are associated with Gaucher's disease, and Rieder's cells are not associated with any specific disease. Therefore, the presence of Reed-Sternberg cells would support the diagnosis of Hodgkin's disease.Rate this question:
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- 20.
20. A patient is about to undergo bone marrow aspiration and biopsy and expresses fear and anxiety about the procedure. Which of the following is the most effective nursing response?
- A.
A. Warn the patient to stay very still because the smallest movement will increase her pain.
- B.
B. Encourage the family to stay in the room for the procedure.
- C.
C. Stay with the patient and focus on slow, deep breathing for relaxation.
- D.
D. Delay the procedure to allow the patient to deal with her feelings.
Correct Answer
C. C. Stay with the patient and focus on slow, deep breathing for relaxation.Explanation
The most effective nursing response in this situation is to stay with the patient and focus on slow, deep breathing for relaxation. This response acknowledges the patient's fear and anxiety and provides support by staying with them. By focusing on slow, deep breathing, the nurse can help the patient relax and reduce their anxiety during the procedure. This response shows empathy and provides a practical technique to help the patient cope with their fear and anxiety.Rate this question:
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Mar 22, 2023Quiz Edited by
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Jan 08, 2012Quiz Created by
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