NCLEX Prep Content Mastery Final Exam

Follow each step in the CRITICAL THINKING PATHWAY to analyze this question: The nurse is caring for an 18-month-old client 2 hours after surgery to repair an inguinal hernia. A. Instruct the parent how to care for the incision site. B. Observe for behavioral changes. C. Ask the client, "are you feeling any pain?" D. Give the client 81 mg chewable aspirin.

B. Observe for behavioral changes

The nurse is observing an unlicensed assistive personnel (UAP) who is performing morning care for a bedfast client with Huntington's disease. Which care measure is most important for the nurse to supervise? A. Bathing B. Oral care C. Foot care D. Catheter care

B. Oral care

What type of drug classification is METHYLPHENIDATE? A. Antidepressant B. Stimulant C. Anticonvulsant D. Antipsychotic

B. Stimulant

What class of drug is azole? A. antibiotic B. antifungal C. Benzodiazepine D. beta agonist (bronchodilator) E. xanthine derivative (bronchodilator)

B. antifungal

what class of drug is sone? A. antibiotic B. corticosteroid C. diuretic D. beta agonist (bronchodilator) E. proton pump inhibitor

B. corticosteroid

Select all the drugs that should not be taken with grapefruit (Select all that apply) A. rituximab B. nifedipine C. tricyclic antidepressants D. clozapine E. atorvastatin

B. nifedipine C. tricyclic antidepressants E. atorvastatin

A person with a history of alcohol abuse is treated in the Emergency Department for Acute Alcohol Intoxication. Which question is most critical for the nurse to ask? A. "How much alcohol have you had?" B. "Have you ever used drinking in the morning to get rid of a hangover?" C. "When did you have your last drink?" D. How many drinks do you need before you feel high?

"When did you have your last drink?" CORRECT: Most important to know timing so medication can be given to minimize withdrawal s/s) Alcohol withdrawal is 5-35 hours after the last drink; grandma seizures 48 hour after; delirium tremens 72 - 96 hours after.)

What are the 5 steps of the Critical Thinking Pathway?

1- Determine the topic 2- Assessment vs. Implementation 3- Eliminate Psych/social 4- Apply ABCs 5- Evaluate the outcome

Heparin 5,000 units subcutaneously is ordered every 12 hours for a client. The result of the client's most recent PTT is 44 seconds. Which action by the nurse is MOST appropriate? 1. Document the result and administer the heparin. 2. Withhold the heparin. PTT is in therapeutic range 3. Notify the health care provider. PTT is in therapeutic range 4. Have the test repeated.

1. Document the result and administer the heparin.

What type of drug classification is SERTRALINE? A. Antidepressant B. Stimulant C. Anticonvulsant D. Antipsychotic

A. Antidepressant

The father of a 7-year-old boy post appendectomy is upset because he feels his son should be given pain medication earlier than scheduled. The father becomes verbally abusive and throws a magazine across the room. How would this situation be handled best? A. Ask the father to sit down and tell the nurse his concerns. B. Call Security and evacuate the patient rooms around the angry father. C. Do not approach the father and notify the nursing supervisor D. In a firm voice tell the father that his son cannot have any more pain medication until it is scheduled

A. Ask the father to sit down and tell the nurse his concerns (CORRECT: having the agitated person sit down is an effective non-verbal defusing technique

What type of drug classification is DIAZEPAM? A. Benzodiazepine B. Mood Stabilizer C. Anticonvulsant D. Anticholinergic

A. Benzodiazepine

What type of drug classification is PHENYTOIN? A. Benzodiazepine B. Mood Stabilizer C. Anticonvulsant D. Anticholinergic

C. Anticonvulsant

Pain is generally considered a "Psychosocial" issue in NCLEX and therefore of lower priority. However, there are times when pain should be considered a higher priority "Physical" issue when determining the priority of answers in the question. Select all the following that would be considered a "Physical" issue according to the Welcome to NCLEX World handout: (Select all that apply) A. The patient who is 1 day post op reports unrelenting pain of his fractured left tibia B B. Margot requests pain medication before it is scheduled due to generalized back pain C. A patient is evaluated in the ER for severe flank pain and hematuria. He has a history of renal calculi. D. A 6-year-old child has a medical history of Sickle Cell anemia. E. Irwin is being treated in the Neuro Unit for a stroke when he develops sudden chest pain.

A, C, E

Follow each step in the CRITICAL THINKING PATHWAY to analyze this question: The home care nurse observes an elderly woman on a low-sodium diet eating a dill pickle that her son gave her with lunch. Which response by the nurse is most appropriate? A. "Tell me what you know about your mother's dietary requirements." B. "I guess you're not aware that giving your mother salty food will make her condition worse." C. "I will contact the health care provider to get a copy of your mother's diet restrictions for you." D. "Let's make an appointment for you to meet with the dietician

A. "Tell me what you know about your mother's dietary requirements."

Mr. Gold is discussing his prescription for disulfiram with the nurse. Which comment indicates Mr. Gold requires further teaching about this medication: A. "This Medication will keep me from drinking alcohol" B. "I should not take cough syrup when taking this medication" C. "I know even a small drink of alcohol will make me throw-up while I am taking this medicine." D. "If I stop taking this medicine, I will not drink anything with alcohol in it for 2 weeks.

A. "This Medication will keep me from drinking alcohol"

You are acting as preceptor for a newly graduated RN during her second week of orientation. You would assign the new RN under your supervision to provide care to which patients? Select all that apply. A. A 38-year-old with admitted for management of moderate asthma awaiting discharge. B. A 63-year-old with a tracheostomy needing tracheostomy care every shift. C. A 56-year-old with lung cancer who has just undergone left lower lobectomy D. A 49-year-old just admitted with a new diagnosis of esophageal cancer. E. A 68-year-old who returned from bronchoscopy and biopsy one half hour ago.

A. A 38-year-old with admitted for management of moderate asthma awaiting discharge. B. A 63-year-old with a tracheostomy needing tracheostomy care every shift.

The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months experience) pulled from the surgical unit to the medical unit? A. A 72-year-old who needs teaching about the use of incentive spirometry B. A 68-year-old just returned from bronchoscopy and biopsy C. A 58-year-old on airborne precautions for tuberculosis (TB) D. A 69-year-old with COPD who is ventilator dependent

A. A 72-year-old who needs teaching about the use of incentive spirometry

Identify which patients are at risk to develop metabolic alkalosis? Select all that apply. A. A client with continuous nasogastric drainage. B. A client with bulimia Nervosa C. A client who is hyperventilating due to a panic attack D. A client with type 1 diabetes mellitus E. A client with post-op atelectasis.

A. A client with continuous nasogastric drainage. B. A client with bulimia Nervosa

Identify which patients are at risk to develop metabolic acidosis? Select all that apply. A. A client with type 1 diabetes mellitus B. A client with acute renal failure. C. A client with bacterial pneumonia. D. A client with continuous nasogastric drainage. E. A client with severe diarrhea.

A. A client with type 1 diabetes mellitus (CORRECT: caused by buildup of acidic ketones due to break down of fatty acids for fuel - DKA) B. A client with acute renal failure. (CORRECT: due to retention of hydrogen and potassium ions→ increased acid) E. A client with severe diarrhea. (CORRECT: diarrhea leads to "base-out-the-butt" which results in high acid levels in the body

A nurse cares for a client recently diagnosed with Crohn's disease. The client receives adalimumab as part of the treatment. What is the BEST action for the nurse to take while caring for the client? A. Advise the client to not receive a "live" vaccine while using adalimumab. B. Tell the client he must take this medication regularly to heal the Crohn's disease. C. Provide patient teaching regarding the need for a low-sodium diet while taking adalimumab. D. Instruct the client to expect flu-like signs and symptoms while receiving this drug.

A. Advise the client to not receive a "live" vaccine while using adalimumab. Answer A: Drugs with the "-mab" ending are monoclonal antibodies that suppress the immune system.Patients should avoid exposure to people with colds or the flu. They are instructed to not receive vaccineswith a live virus (i.e., flu, measles, mumps, rubella, chicken pox vaccines) while they are on this family ofdrugs

In which situation would the nurse be justified in overriding a client's right to confidentiality? A. An older client discloses to the nurse that her adult son occasionally hits her. B. A client states that he does not want to know the results of his recent diagnostic test. C. A client does not want her husband to know that she is a client on the unit. D. A teenage client asks the nurse not to tell her parents that she is pregnant

A. An older client discloses to the nurse that her adult son occasionally hits her.

There are several medications that should not be stopped or discontinued abruptly due to serious reactions. Patients taking which of the following medications should be advised that the drug must be tapered off slowly. (Select all that apply) A. Benzodiazepines B. Clozapine (antipsychotic) C. Anticonvulsants (carbamazepine/Tegretol) D. NSAIDs E. Diphenoxylate (Lomotil)

A. Benzodiazepines B. Clozapine (antipsychotic) C. Anticonvulsants (carbamazepine/Tegretol)

A patient arrives at the clinic reporting lack of appetite, nausea, vomiting, and diarrhea. The patient is taking digoxin for heart failure and the physician suspects digoxin toxicity. Which lab value would confirm this: A. Digoxin level greater than 2.5 B. Digoxin level less than 1.2 C. Digoxin level greater than 0.5 D. Digoxin level of 1.7

A. Digoxin level greater than 2.5

Select all the drugs that should not be taken with grapefruit or grapefruit juice. (Select all that apply) A. Erythromycin B. cyclosporine C. Librium D. carbamazepine E. sertraline

A. Erythromycin B. cyclosporine C. Librium

Helen has been admitted for treatment of severe dehydration. With one exception all of the following lab values are affected by fluid balance and therefore can be used to determine Helen's hydration status. Which one is NOT affected by fluid levels in the body: A. HGB B. BUN C. Specific Gravity D. Hct

A. HGB

A nurse in a hospital is caring for a client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of138/min and no uterine contractions. The client's vital signs are: blood pressure 98/52 mm Hg, heart rate 118/min, respiratory rate 24/min, and temperature 36.4 C (97.6 F). Which of the following is the priority nursing action? A. Initiate IV access. B. Insert an indwelling urinary catheter C. Witness the signature for informed consent for surgery D. Prepare the abdominal and perineal areas

A. Initiate IV access. Correct Answer. Step #4 - ABCs - circulation issue. Medical history and vital signs indicate ruptured ectopic and shock due to hemorrhage. Patient needs urgent fluid replacement.

Mrs. Baker has developed C. Diff. after completing a lengthy course of antibiotic therapy. She s at risk for developing: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis Correct Answer - C. Difficile causes severe diarrhea with loss of "base" (alkaline) bicarb. So, acid is high. Condition is not related to lung issue, so imbalance is metabolic. ("base-out-the-butt")

The "Pharmacology Study Tips" handout includes all the following EXCEPT: A. NCLEX requires you to know dosage ranges for medications. B. It is more effective to study drugs by categories and not as individual drugs. C. Only generic names of medications are used on NCLEX. D. NCLEX will test your understanding of drug side effects

A. NCLEX requires you to know dosage ranges for medications.

Which of the following medications can affect blood sugar? (Select All That Apply) A. Propranolol B. fluconazole C. Prednisone D. erythromycin E. Diazepam

A. Propranolol C. Prednisone

What class of drug is Prazole/oprazole? A. Proton pump inhibitor B. Alpha blocker (anti HTN) C. H2 blocker antacid D. ACE inhibitor E. Benzodiazepine

A. Proton pump inhibitor

Examples of tasks a Registered Nurse may delegate to a LPN (licensed practical nurse) include all of the following: (Select all that apply) A. Reinforce patient teaching from a standard care plan B. Perform tracheostomy care C. Complete oral suctioning D. Check nasogastric (NG) tube for correct placement E. Insert a urinary catheter F. Administer IV medications

A. Reinforce patient teaching from a standard care plan B. Perform tracheostomy care C. Complete oral suctioning E. Insert a urinary catheter

The nurse plans care for a client with fever, vomiting, and diarrhea. Which laboratory value demonstrates an improvement in the client's condition? A. Specific gravity of urine 1.020 and hematocrit 42%. B. Specific gravity of urine 1.039 and hematocrit 50%. C. Specific gravity of urine 1.010 and hematocrit 52%. D. Specific gravity of urine 1.030 and hematocrit 35%.

A. Specific gravity of urine 1.020 and hematocrit 42%.

Which of the following medications can affect blood sugar? (Select All That Apply) A. Sulfonamides B. Furosemide C. Estrogen-progesterone D. Atorvastatin E. Lisinopril

A. Sulfonamides B. Furosemide C. Estrogen-progesterone D. Atorvastatin

The nurse supervises an RN, LPN/LVN and nursing assistive personnel (NAP) on an acute care medical unit. The nurse should intervene if which is observed? A. The LPN/LVN inspects and documents the condition of a sacral decubitus ulcer. B. The RN asks a client if a durable power of attorney for health care document has been completed. C. The NAP obtains and records a pulse oximetry reading on a client. D. The LPN/LVN completes tracheostomy care.

A. The LPN/LVN inspects and documents the condition of a sacral decubitus ulcer.

What class of drug is floxacin? A. antibiotic B. antifungal C. Benzodiazepine D. beta agonist (bronchodilator) E. xanthine derivative (bronchodilator)

A. antibiotic

what class of drug is cef- A. antibiotic B. corticosteroid C. diuretic D. beta agonist (bronchodilator) E. proton pump inhibitor

A. antibiotic

Which would be correct based on the rules in NCLEX World (Select all that apply): A. The nurse calls the laboratory to have them draw a complete blood count for a patient. B. You can assume that the diagnosis is given for all the patients in NCLEX world. C. A patient who is sitting calmly watching TV but reports a pain level of 10 out of 10 should be given pain medication. D. The RN who is doing a patient intervention remains with her patient even though the nurse receives a request to take a telephone order from a physician. E. The nurse is asked to take a patient's pulse. The nurse does this by palpating the radial artery rather than using the blood pressure machine with a heart rate readout.

ACDE

A patient with schizophrenia is brought to the clinic by his adult son for an evaluation. Which assessment question by the nurse is most appropriate? A. "Does your father have a history of taking street drugs?" B. "Has your father become withdrawn and paranoid?" C. "Is your father gaining weight?" D. "Have you noticed your father being jittery and nervous?"

B. "Has your father become withdrawn and paranoid?" (CORRECT: Paranoid delusions are most dangerous since the person could act out violently trying to "protect" himself from an enemy in his hallucination.

The nurse cares for patients in a memory care facility. The nurse observes a woman with a diagnosis of mild to moderate dementia putting a large amount of food from the lunch into her purse. Which statement by the nurse is best? A. "What are you going to do with all that food?" B. "You can get food from the kitchen whenever you want." C. "You need to stay in your room until the next meal is served." D. "We need to create a contract to manage your eating disorder."

B. "You can get food from the kitchen whenever you want." (CORRECT - gives factual information. Provide orientation).

"Who Do You See First" style question. Which phone call will the home health nurse return FIRST? A. A 45-year-old client reports leg pain after walking 2 blocks to the grocery store. B. A 50-year-old client diagnosed with hypertension reports pain between the shoulder blades. C. A 60-year-old client diagnosed with rheumatoid arthritis experiences cold hands and feet during cold weather. D. A 66-year-old client experiences increased pain when coughing after a bilateral hernia repair

B. A 50-year-old client diagnosed with hypertension and reports pain between the shoulder blades Focus on the "complications" each patient has. Eliminate as you go through each answer. The complication of "pain between the shoulder blades" could be a myocardial infarction which is a new Unstable condition, and NOT EXPECTED for individuals who have chronic high B/P. Also, if using ABCs, this answer is cardiac related and is the highest priority. The other patients have complications that are not a higher priority

The physician calls in an order for, "LFTs on Mr. Henderson. Call me with the results." The nurse will draw which of the following sets of labs A. Albumin, bilirubin B. ALP/ALT/AST C. Cholesterol, LDL, HDL, Triglycerides D. BUN, Creatinine

B. ALP/ALT/AST

An experienced LPN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN? A. Evaluate the patient's technique for using his metered-dose inhaler (MDI) B. Administer medications via metered-dose inhaler (MDI) C. Complete the in-depth admission assessment D. Prepare the nursing care plan

B. Administer medications via metered-dose inhaler (MDI)

What class of drug is Zosin? A. Proton pump inhibitor B. Alpha blocker (anti HTN) C. H2 blocker antacid D. ACE inhibitor E. Benzodiazepine

B. Alpha blocker (anti HTN)

A nurse is delegating care of clients to the certified nursing assistant (CNA) and LPN. Which of the following would be an appropriate assignment? A. CNA: Change a non-infected dressing; LPN/LVN: Administer IV piggyback medications B. CNA: Measure vital signs; LPN/LVN: Give oral medications on assigned clients C. CNA: Ambulate a client who had a stroke; LPN/LVN: Assess two clients D. CNA: Measure vital signs; LPN/LVN: Complete a head-to-toe assessment on a newly admitted client

B. CNA: Measure vital signs; LPN/LVN: Give oral medications on assigned clients

15. A nurse delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action? A. Assertively state the expectation that delegated tasks will be completed on time B. Determine exactly why the nurse did not complete the delegated tasks C. Document the nurse's insubordination and arrange a private meeting D. Take action to reestablish the authority power gap

B. Determine exactly why the nurse did not complete the delegated tasks

Which of the following medications affect blood sugar? A. Sulfonamides B. Furosemide C. Estrogen-progesterone D. sertraline E. Librium

B. Furosemide C. Estrogen-progesterone E. Librium

The nurse provides care for a client prescribed atorvastatin. Which value indicates to the nurse that treatment with atorvastatin is effective? A. Serum triglyceride level 210 mg/dL (2.4 mmol/L) B. Low-density lipoprotein (LDL) cholesterol 100 mg/dL (2.6 mmol/L) C. Serum cholesterol 220 mg/dL (5.7 mmol/L) D. High-density lipoprotein (HDL) level 25 mg/dL (0.7 mmol/L)

B. Low-density lipoprotein (LDL) cholesterol 100 mg/dL (2.6 mmol/L)

What type of drug classification is LITHIUM? A. Benzodiazepine B. Mood Stabilizer C. Anticonvulsant D. Anticholinergic

B. Mood Stabilizer

Follow each step in the CRITICAL THINKING PATHWAY to analyze this question: The nurse is assigned to a patient 4 hours after admission to the hospital for treatment of an anterior wall myocardial infarction. The client suddenly reports difficulty breathing and appears very anxious. Which action should the nurse take first? A. Obtain a 12-lead ECG B. Check for cyanosis in the hands and toes C. Auscultate the client's posterior lung fields D. Notify the client's healthcare provider

C. Auscultate the client's posterior lung fields

What class of drug is zepam? A. antibiotic B. antifungal C. Benzodiazepine D. beta agonist (bronchodilator) E. xanthine derivative (bronchodilator)

C. Benzodiazepine

The mother of a child taking methylphenidate reports that the child has lost 4 pounds in 2 weeks. Which response is most appropriate? A. "How much does your child exercise on a daily basis?" B. "Stop giving the medication for several days to see if his appetite improves." C. "When do you give your child the methylphenidate during the day?" D. "This is an expected result of taking methylphenidate and not of concern."

C. "When do you give your child the methylphenidate during the day?" CORRECT: Methylphenidate/Ritalin is an amphetamine that should be given AFTER a meal to decrease appetite suppression)

The nursing assistive personnel (NAP) says to the RN, "I would like to take care of the client in Room 230 today." Which response by the nurse is BEST? A. "Since you are interested in caring for this client, I will assign this client to you." B. "Why do you want to care for this client?" C. "You are assigned to the clients in Rooms 220, 240, and 242." D. "I assigned you to other clients because I feel it is a better assignment."

C. "You are assigned to the clients in Rooms 220, 240, and 242."

10. The nurse hears a female with chronic schizophrenia say to another patient, "I hate you. Get away from me or I'll kill you." Which response is best? A. "You can relax, I will not ever let anyone hurt you." B. "There is no reason for you to be angry with that patient." C. "You seem to be frightened by that person." D. "I don't think you really mean that."

C. "You seem to be frightened by that person."

A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse? A. A client with a cast for a fractured femur and who has numbness and discoloration of the toes B. A client with balanced skeletal traction and who needs assistance with morning care C. A client who had a total hip replacement 2 days ago and needs blood glucose monitoring D. A client who had an above-the-knee amputation yesterday and has a temperature of 101.4F

C. A client who had a total hip replacement 2 days ago and needs blood glucose monitoring

The charge nurse is planning client care assignments for a registered nurse (RN) and licensed practical/vocational nurse (LPN/VN). Which of the following clients would be most appropriate to assign to the RN? A. A client who was recently diagnosed with Graves' disease and is requesting a fan to be placed in the room. B. A client with acute pancreatitis who is reporting greenish-yellow emesis and abdominal pain. C. A client who was recently diagnosed with diabetes mellitus (type 2) and is requesting teaching to administer insulin. D. A client with Crohn's disease who is reporting diarrhea, weight loss, and steratorrhea.

C. A client who was recently diagnosed with diabetes mellitus (type 2) and is requesting teaching to administer insulin.

The nurse demonstrates correct delegation when assigning which client to the LPN under RN supervision? A. A 62-year-old client admitted 8 hours ago with exacerbation of COPD B. A 25-year-old client with a concussion from a motorcycle accident the prior evening C. An 81-year-old client with chronic heart failure and emphysema admitted 3 days ago D. A 34-year old client newly diagnosed with GERD who will be discharged today

C. An 81-year-old client with chronic heart failure and emphysema admitted 3 days ago

What type of drug classification is CARBAMAZEPINE? A. Antidepressant B. Stimulant C. Anticonvulsant D. Antipsychotic

C. Anticonvulsant

A patient's chart indicates they are receiving cyclophosphamide so the nurse will monitor the patient for which expected side effects related to this medication: A. Respiratory rate less than 8 breaths/minute B. Indications of hypoglycemia C. Decreased white blood cell count D. Dependent edema and fluid retention

C. Decreased white blood cell count (Chemo drug cause leukopenia from bone marrow destruction and N/V from GI tract)

4. Which would be the best nursing intervention for a patient with Alzheimer's dementia? A. Assign a staff member to check on the client a minimum of every 8 hours. B. Provide the client with current newspapers and magazines. C. Frequently inform the client of his room and bathroom location. D. Leave the television on all day in the patient's room to provide stimulation.

C. Frequently inform the client of his room and bathroom location CORRECT: Reorient to reality frequently(date/time/place, etc.)

What class of drug is Tidine? A. Proton pump inhibitor B. Alpha blocker (anti HTN) C. H2 blocker antacid D. ACE inhibitor E. Benzodiazepine

C. H2 blocker antacid

Mr. Rico has chronic atrial fibrillation and is being medically regulated on warfarin. Which lab results indicates Mrs. Rico is in the therapeutic range: A. PT 1 - 4 seconds B. PTT 20 - 45 seconds C. INR 2 - 3 D. PT 20 - 112 seconds

C. INR 2 - 3

The pediatric nurse is conducting a seminar at the local community center. When discussing the dangers of lead in the environment, the nurse states that according to the CDC, the lead level in children's blood needs to be: A. Higher than 0.1 B. At least 5 C. No higher than 3.5 D. Less than 0.5

C. No higher than 3.5 NOTE: For some reason "lead levels" and results of lead exposure questions are popular on NCLEX. Toxic exposure leads to mental retardation in children.

All the following characterize a "Who Do You See First" priority-style question EXCEPT: A. See the unstable patient before the stable patient. B. Apply the ABCs as a prioritization tool. C. These types of questions are about infection control. D. A patient with status asthmaticus should be seen before a patient with a cut that might become infected.

C. These types of questions are about infection control. (Negative Polarity question. This answer applies to "Room Assignment" questions, not "Who Do You See First)

The measurement and documentation of vital signs is expected for clients in a long-term facility. Which staff type would it be a priority to delegate these tasks to? A. Licensed Practical nurse (LPN) B. Registered Nurse (RN) C. Unlicensed assistive personnel (UAP) D. Trained volunteer

C. Unlicensed assistive personnel (UAP)

A nurse is preparing a medication for IV delivery that is known to cause respiratory depression. All the following can either slow or stop respirations in standard doses EXCEPT: A. Diprivan B. Magnesium sulfate C. albuterol D. phenobarbital

C. albuterol

what class of drug is thiazide? A. antibiotic B. corticosteroid C. diuretic D. beta agonist (bronchodilator) E. proton pump inhibitor

C. diuretic

The nurse is teaching Mrs. Green about neutropenia precautions due to drug-induced immunosuppression. Which of the following drug classes could be the cause of her low white blood cell count? (Select all that apply) A. Benzodiazepines B. statin drugs C. sulfonamides D. monoclonal antibodies E. anticonvulsant

C. sulfonamides D. monoclonal antibodies E. anticonvulsant

Anton has worked as an LPN in the medical surgical unit of the hospital for 16 years. You know the charge nurse is delegating an assignment to Anton properly when you hear: A. "Watch Mr. Gregory to make sure he is using his incentive spirometer correctly." B. "Mrs. Cliff was just brought back from having a colonoscopy. She needs a set of vitals done." C. "Ask Mr. Homer what his breathing effort is now and give him an inhaler treatment if needed. D. "Mrs. Elliot is going to physical therapy in an hour and needs her IM injection of Toradol."

D. "Mrs. Elliot is going to physical therapy in an hour and needs her IM injection of Toradol."

A 39-year-old man is admitted with a diagnosis of Acquired Immune Deficiency Syndrome (AIDS). His lab results are hemoglobin 12.3 g/dL, hematocrit 37%, platelets 170,000/mm3, white cell count 1,500/mm3. Which order will the nurse implement FIRST? A. "Infuse 2 units of packed red cells." B. "High-protein, high-carbohydrate diet as tolerated." C. "Administer 2 units platelets." D. "Place the client on neutropenia precautions."

D. "Place the client on neutropenia precautions." CORRECT - At risk for acquiring life threatening infection due to leukopenia

what class of drug is tadine? A. antibiotic B. corticosteroid C. diuretic D. antihistamine E. proton pump inhibitor

D. antihistamine

what class of drug is terol? A. antibiotic B. antifungal C. Benzodiazepine D. beta agonist (bronchodilator) E. xanthine derivative (bronchodilator)

D. beta agonist (bronchodilator)

The medical-surgical nursing unit is short-staffed for the shift and a registered nurse from the pediatric unit has been floated to the Neurologic unit. Which client should the nurse assign to the float nurse? A. A 32-year-old client with diabetes who needs discharge instructions and medication information B. A 56-year-old client newly admitted with Guillain-Barre syndrome who has severe leg weakness. C. An 86-year-old client with a T4 spinal cord injury who is experiencing autonomic dysreflexia. D. A 59-year-old client who will be returning from surgery following resection of a brain tumor.

D. A 59-year-old client who will be returning from surgery following resection of a brain tumor.

What class of drug is -pril? A. Proton pump inhibitor B. Alpha blocker (anti HTN) C. H2 blocker antacid D. ACE inhibitor E. Benzodiazepine

D. ACE inhibitor

You are reviewing with Mr. Phelps the results of his Complete Blood Count which is: RBC 4.6; WBC 18,000 [Neutrophils 47%; Lymphocytes59%; and Platelets 350,000. Based on these lab results you will: A. Tell Mr. Phelps that he is at higher risk for developing blood clots. B. Examine the inside of the patient's mouth for pale gums. C. Know these results indicate the presence of an acute bacterial infection. D. Advise Mr. Phelps that he most likely has an infection caused by a virus.

D. Advise Mr. Phelps that he most likely has an infection caused by a virus. CORRECT - Elevated lymphocytes are an indication of either a viral or CHRONIC bacterial infection.

At the start of the shift there was one RN and one LPN to care for three newborns in the nursery. Within two hours, three more newborns were admitted, one requiring Level II care, and the parents of two newborns needed discharge teaching so they could go home. The RN was needed full time in the Level II nursery as the newborn was being stabilized. What staffing activity is needed to provide appropriate care in this situation? A. The LPN can complete the admission assessments and discharge teaching for the five Level 1newborns. B. An UAP from the postpartum unit can be reassigned to the nursery to do the discharge teaching. C. The RN can complete the admission assessments while continuing to stabilize the Level II newborn. D. Another RN needs to be assigned to the nursery to perform admission assessments and discharge teaching

D. Another RN needs to be assigned to the nursery to perform admission assessments and discharge teaching

What type of drug classification is BENZTROPINE? A. Benzodiazepine B. Mood Stabilizer C. Anticonvulsant D. Anticholinergic

D. Anticholinergic

What type of drug classification is HALDOL? A. Antidepressant B. Stimulant C. Anticonvulsant D. Antipsychotic

D. Antipsychotic

During the admission interview, the client reports a red, itchy raised rash on the chest and lip swelling after use of aspirin and penicillin. The orders include bed rest, soft diet as tolerated, naproxen and cefaclor. Which action by the nurse is most appropriate? A. Administer the cefaclor as ordered but withhold naproxen. B. Give the naproxen but withhold the cefaclor. C. Administer both medications as ordered. D. Do not administer any medication; notify the health care provider.

D. Do not administer any medication; notify the health care provider. ANSWER: Must withhold naproxen because it is in the same NSAID family as aspirin. Must withhold cefaclor (a cephalosporin) because it shares a "cross-over" allergic reaction with penicillin

The NCLEX test is a specialized assessment that has questions designed to: A. Give hints that help the candidate select the right choice. B. Determine how much you know about pathophysiology. C. Lower the test-taker's anxiety level. D. Evaluate your judgement, not just your knowledge.

D. Evaluate your judgement, not just your knowledge

A patient being treated for depression is being evaluated by the nurse. Which statement by the client indicates improvement? A. "I slept 13 hours yesterday" B. "I gained 4 pounds this week." C. "I saw a movie last night." D. "I went to a book club meeting with some friends."

D. I went to a book club meeting with some friends CORRECT: Patient is engaging in an activity with others.

11. A patient with OCD is admitted to the hospital due to ritualistic hand washing that occupies several hours each day. All the following would be an appropriate intervention EXCEPT? A. Develop a structured schedule of activities throughout the day B. Gradually decrease time for the client to carry out ritualistic behaviors C. Use techniques to manage anxiety D. Impose negative consequences for ritual performance

D. Impose negative consequences for ritual performance

Which of the following is an example of the adverse effects of a medication doing its job "too well"? A. Mike has a sleepless night after having a steroid injection into his knee joint. B. The patient is given furosemide and later his urine output is 150 mL. C. Blood sugar is 250 after an insulin injection. D. Patient has syncope when standing 20 minutes after receiving IV atenolol

D. Patient has syncope when standing 20 minutes after receiving IV atenolol

The nursing team consists of 2 RNs, one LPN/LVN, and one nursing assistive personnel. The nurse will consider the assignment appropriate if the LPN/LVN is required to complete which task? A. Ambulate a client 8 hours after a thoracotomy. B. Give an enema to a client prior to a colonoscopy. C. Complete a bed bath for a client with burns on the arms and legs. D. Perform a dressing change on a client 3 days after a cholecystectomy.

D. Perform a dressing change on a client 3 days after a cholecystectomy.

To compensate for the negative effects of severe anemia, a patient is now tachypneic. What disorder of acid-base balance will the patient most likely experience? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

D. Respiratory alkalosis Tachypnea (rapid breathing) will blow off CO2 which will result in high base level - alkalosis. The problem is caused by lungs, so it is respiratory alkalosis.

A client at the mental health clinic is scheduled for a haloperidol injection. Which observation by the nurse indicates the client is having a major negative side effect of this medication? A. Photosensitivity B. Dizziness and heart rate of 58 beats per minute C. Extreme sleepiness. D. Tongue protrusion and muscle rigidity.

D. Tongue protrusion and muscle rigidity. (CORRECT: indication of extrapyramidal signs which can become permanent if not treated

3. Interpret the following ABG value to determine what type of Acid-Base Imbalance is present: pH = 7.32 PaCO2 = 55 HCO3 = 25 A. Compensated B. Over-compensated C. Partially compensated D. Uncompensated

D. Uncompensated

A nurse is caring for an adolescent who has been diagnosed with a spleen laceration resulting from a skateboard accident. Which nursing diagnosis is the highest priority? A. Risk for injury B. Pain related to shoulder trauma C. Deficient fluid volume. D. Risk for infection

Deficient fluid volume Correct Answer: Step #4 - ABCs. Spleen is highly vascular and can result in serious internal hemorrhage if injured.

What class of drug is zolam? A. Proton pump inhibitor B. Alpha blocker (anti HTN) C. H2 blocker antacid D. ACE inhibitor E. Benzodiazepine

E. Benzodiazepine

What class of drug is phylline? A. antibiotic B. antifungal C. Benzodiazepine D. beta agonist (bronchodilator) E. xanthine derivative (bronchodilator)

E. xanthine derivative (bronchodilator)

77-year-old woman has been brought to the emergency department by her daughter because of a sudden an unprecedented onset of confusion. The patient admits to ingesting large amounts of baking soda since the morning in an effort to treat indigestion. How will the woman's body attempt to resolve this disruption in acid-base balance? A. Hyperventilation B. Increasing renal H+ excretion C. Increased renal HCO3 reabsorption D. Hypoventilation

Hypoventilation Correct Answer - Patient has metabolic alkalosis (too high of base), so body will compensate by retaining carbon dioxide (an acid).

Arterial blood gases of a patient with a diagnosis of acute renal failure reveal a pH 7.25, PCO2 32, HCO3 23, What disorder of acid-base balance is the patient most likely experiencing? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Metabolic acidosis Correct Answer - Due to excess build-up of hydrogen ion and Potassium excess due tocell damage releasing K+ into blood stream. These cations cannot be excreted through the damaged kidneyand causes metabolic acidosis.

A woman is 8 weeks pregnant and experiencing excessive morning sickness with vomiting (hyperemesis gravidarum).She is at risk for developing: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Metabolic alkalosis Loss of stomach acid leaves behind too much base

The nurse prepares to administer gentamicin (an aminoglycoside) to a 65-year-old client. What is the most important action for the nurse to take prior to administration of the medication? A. Request a daily hemoglobin and hematocrit test. B. Monitor the serum BUN and creatinine levels. C. Request a highly-sensitive C-reactive Protein D. Monitor the erythrocyte sedimentation rate.

Monitor the serum BUN and creatinine levels. (CORRECT - Aminoglycosides are nephrotoxic resulting in proteinuria, oliguria, hematuria, thirst, increased BUN, decreased creatinine clearance.)

A patient is admitted to your unit with new onset of shortness of breath, fever, and productive purulent cough. His diagnosis is bacterial pneumonia. Which lab value will you expect for this patient based on this information: A. Neutrophils 37% B. Neutrophils 73% C. Total white blood cell count 9,890 D. Lymphocytes 54% Indicates a viral or chronic condition.

Neutrophils 73% Correct: High neutrophils indicate an ACUTE Bacterial infection

Arterial blood gases of a patient who was admitted after being in a night club fight reveal a pH 7.23, PCO2 54, HCO326, What disorder of acid-base balance is the patient most likely experiencing? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Respiratory acidosis Correct Answer - Low pH = acidosis. pH , CO2 [REverse direction = REspiratory]

A nurse is caring for a client who has a high fever and is hyperventilating. The nurse should identify that the client will have which of the following acid-base imbalances? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

Respiratory alkalosis Correct Answer - Hyperventilation is causing respiratory alkalosis due to patient "blowing off" too much acid in the form of carbon dioxide.

A hospitalized client tells the nurse that a living will is being prepared and that the lawyer will be bringing the will to the hospital today for witness signatures. The client asks the nurse for assistance obtaining a witness to the will. Which is the most appropriate response to the client? a. "I will be happy to sign as a witness to your signature." b. "I will check with my charge nurse to seek assistance regarding your request." c. "Whoever is available at the time will sign as a witness for you." d. "This is outside of a nurse's scope of practice so you will need to find a witness on your own."

b. "I will check with my charge nurse to seek assistance regarding your request."

17. The nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle, attached to a syringe containing clear liquid, in the antecubital area. Which is the most appropriate action by the nurse? a. Call security b. Call the police c. Call the nursing supervisor d. Lock the co-worker in the medication room until help is obtain

c. Call the nursing supervisor

16. The nurse arrives at work and is told to report (float) to the intensive care unit (ICU) for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which action first? a. Call the hospital lawyer b. Refuse to float to the ICU c. Identify tasks that can be performed safely in the ICU d. Call the nursing supervisor

c. Identify tasks that can be performed safely in the ICU