mrs.hubers nclex questions

The nurse at a health promotion fair has taught a group of parents about car seat and seat belt safety. Which of the following statements, if made by the parent, would indicate a correct understanding of the information given?

"I will place my newborn infant in a rear facing car seat in the middle of the rear seat."

Which information should the nurse teach the client post-barium enema procedure?

"You need a mild laxative to help expel the barium"

yellow

- Delayed (about 2hrs)

Droplet precautions

-rubella, mumps, diphtheria, adenovirus infections -private rm, door closed -PPE -surg mask on pt w/ transport -keep visitor 3 ft from pt

Lithium

0.6-1.2 mEq/L

Magnesium

1.3-2.1 mEq/L

Sodium

135-145 mEq/L

A client is being discharged from the emergency department after an evaluation for a concussion. The nurse reinforces teaching regarding follow-up should the client develop complications. Which of the following complications, if listed by the client, would require further instruction? 1.Vomiting 2.Minor headache 3.Difficulty speaking 4.Difficulty awakening

2.Minor headache

Potassium

3.5-5 mEq/L

The nurse is reviewing medical prescriptions for newly admitted clients. It would be a priority for the nurse to follow up with the primary care provider if a client with A. potassium level of 4.0 mEq/L has Kayexalate (sodium polystyrene) prescribed B. Dilantin (phenytoin) level of 8 mcg/ml is placed on seizure precautions C.sensitivity to Aspirin (acetylsalicylic acid) is prescribed Tylenol (acetaminophen) D.sensitivity to Penicillin is prescribed Zithromax (azithromycin)

A.. The normal potassium level is 3.5 - 5.0 mEq/L. Giving Kayexalate in this situation may cause the client to lose potassium, causing hypokalemia, therefore the drug is not indicated; the therapeutic level for Dilantin is 10 - 20 mcg/ml, a level of 8 is sub therapeutic thereby increasing the risk of seizure activity. Acetaminophen can be safely prescribed to clients with ASA sensitivity. Azithromycin (Zithromax) can be safely prescribed for clients with sensitivity to Penicillin

The nurse manager of a medical-surgical unit is asked to select the hospitalized clients who can be discharged so that hospital beds can be made available for victims of a community disaster. Which clients can be safely discharged?

A.Client postoperative day 1 after inguinal herniorrhaphy, vital signs stable B. Client 5 days after a myocardial infarction, vital signs stable, absence of dysrhythmias C. Client 1 day after cardiac catheterization, normal study results, groin site free of hematoma

A nursing instructor questions a nursing student about corticosteroids. The nursing student shows an understanding of the production of corticosteroids by stating the hormones are produced in which location of the body?

Adrenal cortex.

The nurse provides teaching for a patient diagnosed with gastroesophageal reflux disease. The nurse should instruct the patient to avoid what types of foods and drinks?

Alcohol. Fried chicken. coffee.

A five year old and her parents check in to the emergency room. The parents are complaining that the babysitter is abusing their child? What would the registered nurse do next?

Assess the child

What actions could a registered nurse delegate to the LPN/LVN for the care of a patient with hypothyroidism?

Assessing and recording the rate and depth of respirations, Auscultating lung sounds every 4 hours, Checking blood pressure, heart rate, and respirations every 4 hours, Reminding the patient to report any episodes of chest pain or discomfort

The nurse is caring for 4 pediatric clients. After receiving reports from the night shift, which child should the nurse assess first? (Scroll for Answer) A. A 6-year-old child being treated for bacterial meningitis and on the tenth day of antibiotic treatment B. A 6-week-old infant admitted to the hospital for decreased level of consciousness; shaken baby syndrome is suspected C. A 2-year-old child with cerebral palsy being admitted to the hospital for surgical placement of a gastrostomy feeding tube the next day D. A 16-year-old child with a ventriculoperitoneal shunt that was placed at birth for hydrocephalus; possible shunt malfunction is suspected, and the child is scheduled and ready for a computed tomography (CT) scan of the head

B. A 6-week-old infant admitted to the hospital for decreased level of consciousness; shaken baby syndrome is suspected

The nurse is admitting a client with major depression. It would be a priority for the nurse to A.Determine if the client was voluntarily admitted B.Ask the client if suicide has been contemplated C.Have the client's possessions searched for sharps D.Administer to the client the prescribed antidepressant

B.Ask the client if suicide has been contemplated

Which medication would be first-line for acne vulgaris?

Benzoyl peroxide

Hypercalcemia S/S

Bone pain Arrythmias Cardiac arrest Kidney stones Muscle weakness Excessive urination

The nurse is caring for a patient with Alzheimer's disease who is taking Donepezil. The nurse should assess for which side effects associated?

Bradycardia- Donepezil is an acetylcholinesterase inhibitor increase the availability to acetylcholine. Side effects include Bradycardia, nausea, vomiting, diarrhea, and anorexia.

The nurse is assessing a patient diagnosed with hypothyroidism. The nurse educates the patent regarding the pathophysiology of the disease. The nurse shows an understanding of hypothyroidism by explaining to the patient the signs of hypothyroidism which include what cardiovascular manifestations

Bradycardia. Hypotension

No unread replies.No replies. Which client should the emergency department triage nurse classify as emergent?

C. A client with crushing substernal pain who is short of breath

The nurse is caring for a client with disseminated intravascular coagulation (DIC) who is receiving a unit of packed red cells. Thirty minutes after the start of the transfusion, the client reports chills and flank pain. The nurse should first A.Flush the intravenous tubing with normal saline B.Assess the client's vital signs C.Stop the transfusion D.Notify the primary health care provider

C.Stop the transfusion

The nurse has received report on four clients. The nurse should first assess the client who has: A.Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry reading of 89% B.Parkinson's Disease and is demanding to leave the hospital against medical advice (AMA) C.been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy D.Congestive Heart Failure (CHF) whose pitting edema has increased to 2(+)

C.been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy

standard precautions

CMV, HIV, Hep B&C,

Hypocalcemia S/S

Convulsions Arrhythmias Tetany Stridor and spasms

Hypersecretion of the adrenal cortex is associated with what diagnosis?

Cushing's disease.

The charge nurse of a medical-surgical unit notices a nurse walking with an unsteady gait, slurred speech and a faint smell of alcohol on the breath immediately following a lunch break. The charge nurse's priority action would be to A.notify the nursing supervisor B.asking the nurse about recent alcohol consumption C.complete an incident report D.relieve the nurse of assigned clients

D.relieve the nurse of assigned clients

What assessment findings might the nurse encounter if a patient has inadequate nutrition as a result of chronic esophageal problems?

Difficulty swallowing.

A nurse is caring for a patient diagnosed with hypertension. The nurse expects the physician to prescribe what type of medication for this patient?

Diuretic

primary prevention

Efforts to prevent an injury or illness from ever occurring.

A client with an acute respiratory infection is admitted to the hospital with a diagnosis of sinus tachycardia. Which nursing action should be included in the client's plan of care?

Eliminating sources of caffeine from meal trays

A patient is prescribed an antihypertensive medication to control blood pressure. The patient tells the nurse they are taking an over the counter supplement. How should the nurse respond to the patient?

Encourage the patient to discuss the use of supplements with the prescribing physician.

A client asks why a diagnostic test has been ordered and the nurse replies, "I'm unsure but will find out for you." When the nurse later returns and provides an explanation' the nurse is acting under what principle?

Fidelity

A 67-year-old female client post-op day two of thyroidectomy surgery. Assessment of the Chvostek's sign and Trousseau's sign checks for which complication?

Hypocalcemia

A patient with hypoparathyroidism has a positive Chvostek's sign. Which electrolyte imbalance would be suspected?

Hypocalcemia

Loop diuretics ending

IDE (furosemide)

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?

IV fluids containing dextrose

red

Immediate (See first)

The nurse understands adrenocortical steroid production in the body may be decreased as a result of what?

Inadequate secretion of adrenocorticotropic hormone (ACTH).

The nurse can expect patients to routinely be prescribed what treatment after surgery?

Incentive spirometry.

The nurse is providing instructions to the mother of a breast-fed newborn who has hyperbilirubinemia. Which instruction should the nurse provide to the mother?

Increase the frequency of the breast-feeding.

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription?

Intravenous infusion of normal saline

The beta-blockers ending

LOL (acebutolol)

A patient with hypertension is started on a new medication for treatment and is reporting a continuous dry cough. Which of the following medications do you suspect is causing this problem?*

Lisinopril

Endoscopic retrograde cholangiopancreatography (ERCP) is used to identify the location of obstruction in which organs?

Liver. Gallbladder. Bile ducts. Pancreas.

The most commonly reported for of elder maltreatment form

Neglect- not providing adequate nutrition, hygiene, shelter, or access to necessary health care. Unsafe environment.

A client with rheumatoid arthritis is receiving Hydroxychloroquine (Plaquenil) in recent months. The nurse tells the client to visit which of the following while on the treatment?

Ophthalmologist.

Ca channel blockers ending

PINE (nifedipine) and then there is diltiazem

ACE inhibitors ending

PRIL (lisinopril)

Five Ps of fractures and compartment syndrome

Pain Pallor Pulselessness Paresthesia Polar (cold)

A nurse is teaching a patient with dehydration about fluid loss. The patient shows an understanding of insensible water loss when she includes what patients in the list of individuals at risk for insensible water loss?

Patients with severe diarrhea

The nurse is providing dietary teaching to a patient diagnosed with cirrhosis. The nurse encourages the patient to increase foods that are high in thiamine. What food should the nurse suggest for the patient to include in their diet?

Pork.

The nurse is assessing a patient after returning from surgery. After reviewing the patient's lab results, the nurse should notify the healthcare provider of: 1. Sodium 143 mEq/L 2. Potassium 3.1 mEq/L 3. Magnesium 1.7 mEq/L 4. Calcium 8.9 mg/dL

Potassium 3.1 mEq/L

The nurse assesses a patient after a fall and determines the patient did not sustain any injury from the fall. After documenting in the patient's chart and completing the incident report what action should the nurse perform next?

Reassess the patient.

Which of the following is a warning sign of colon cancer?

Rectal bleeding

The nurse is assessing a patient after oral endotracheal extubation. What assessment findings will the nurse report immediately to the physician?

Stridor

The nurse is caring for a client who is receiving feedings by nasogastric tube. The client suddenly begins to vomit, and the nurse quickly repositions the client. The client is coughing and having difficulty breathing. What is the nurse's priority action? (Scroll for Answer)

Suction the client.

A patient is diagnosed with oral candidiasis and the physician prescribes nystatin (Mycostatin) oral suspension for treatment. What instruction should the nurse include in the patient teaching?

Swish the medication around in your mouth for several minutes before swallowing.

Thiazide diuretics ending

THIAZIDE (hydrochlorothiazide)

The 5 assessment findings found in most shock victims are

Tachycardia Tachypnea Hypotension Cool clammy skin A decrease in Urine Output

A patient is scheduled to have a radiological examination of the large intestine and a barium enema is prescribed by the physician. What teaching will the nurse provide?

Tell the nurse if you have a sensation of flatulence after the exam. Instruct the patient that stool may be chalky for up to 72 hours after the exam. Instruct the patient to drink plenty of fluids and take laxatives as prescribed after the exam

A patient is scheduled to have a radiological examination of the large intestine and a barium enema is prescribed by the physician. What teaching will the nurse provide?

Tell the nurse if you have a sensation of flatulence after the exam. Instruct the patient that stool may be chalky for up to 72 hours after the exam. Instruct the patient to drink plenty of fluids and take laxatives as prescribed after the exam.

Occult/Guaiac test

Test for blood in the stool

Alpha-blockers ending

ZOSIN (prazosin

Hypokalemia

alters the way digitalis is metabolized in the body and predisposes to digitalis toxicity

A client is receiving furosemide 20 mg by mouth twice per day. In the plan of care, the nurse should emphasize teaching the client about the importance of consuming:a) bananas and oranges.b) creamed corn.c) fresh, green vegetables.d) low-fat milk.

bananas and oranges are high in potassium. Furosemide depletes potassium

Hypervolemia

bounding pulse, SOB, dyspnea, rares/crackles, peripheral edema, HTN, urine specific gravity <1.010; Semi-Fowler's

SIADH (increased ADH)

change in LOC, decreased deep tendon reflexes, tachycardia, n/v/a, HA; administer Declomycin, diuretics

A 74 year old female was diagnosed with bladder cancer. The son of the patient asks the nurse which risk factor contributes most to bladder cancer. The nurse correctly responds by saying:

cigarette smoking

The nurse is assessing the functioning of a chest tube drainage system in a client who has just returned from the recovery room. Which are the expected assessment findings?

drainage system maintained below the client's chest , 40 mL of drainage in the drainage collection chamber, Occlusive dressing in place over the chest tube insertion site, The fluctuation of water in the tube in the water seal chamber during inhalation and exhalation

A patient with diabetes mellitus (DM) asks the nurse why he is always so thirsty. What is the correct response?

excessive thirst is a result of dehydration caused by frequent and excessive urination.

Diabetes Insipidus (decreased ADH):

excessive urine output and thirst, dehydration, weakness, administer Pitressin

The nurse from the postpartum unit has been temporarily assigned to the medical surgical unit. It would be most appropriate to assign this nurse to the client who A.has returned from right total hip replacement surgery four hours ago B.is being observed for increased intracranial pressure C.had surgery two hours ago to remove the appendix D.is two weeks post partum being maintained on a mechanical ventilator for respiratory failure

had surgery two hours ago to remove the appendix

In an older adult, the greatest risk of long term complication is associated with fracture of the:

hip

Cushings

hyperNa, hypoK, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump

Pheochromocytoma

hypersecretion of epi/norepi, persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bating and rest breaks, avoid cold and stimulating foods, surgery to remove tumor

Addison's:

hypoNa, hyperK, hypoglycemia, dark pigmentation, decreased resistance to stress, fractures, alopecia, weight loss, GI distress

A 74 year old male complains of new onset of headaches. The headaches are described as bilateral frontal and most severe when arises in the morning; and when coughing. The history is consistent with headaches caused by:

increased intracranial pressure

Hypovolemia

increased temp, rapid/weak pulse, increase respiration, hypotension, anxiety, urine specific gravity >1.030

Hypernatremia:

increased temp, weakness, disorientation/delusions, hypotension, tachycardia; hypotonic solution

What is an interdisciplinary conference?

members of treatment team to coordinate care and to document the communication among all members of the team

A client with amebiasis, an intestinal infection, is prescribed metronidazole (Flagyl). When teaching the client about adverse reactions to this drug, the nurse should mention:

metallic taste

Hyponatremia:

nausea, muscle cramps, increased ICP, muscular twitching, convulsion; osmotic diuretics, fluids

In which nursing interaction can Situation, Background, Assessment, Recommendation (SBAR) be used:

nurse to nurse nurse to physician nurse to social worker

A nurse is assessing a patient for lithium toxicity. Which signs or symptoms would be seen in the patient?

polyuria, confusion, hand tremors

The most common mode of influenza virus transmission is via...

respiratory droplet

Metoprolol 5mg IV Now is which type of medication order?

stat order

A 26-year-old pregnant mother calls the nurse in the office complaining of severe headache and blurred. What should happen next?

tell her to hang up and dial 911 immediately.

Which of the following is most consistent with patients with Parkinson disease?

tremor at rest and bradykinesia

Lithium side effects

•Increased urination, thirsty, tremors, hair thinning, nausea/vomiting, muscle weakness, acne

Which client statement indicates that the nurse's teaching about hepatitis A has been effective?

"I should wash my hands frequently."

A client diagnosed with schizophrenia says to the nurse, "Will you protect me from the Grand Duchess?" and points to an older client who is sitting reading a book. Which statement is the therapeutic response by the nurse?

"You will be safe here. Your thinking will be clearer after your medication starts to work."

The nurse is caring for the following clients. It would be a priority for the nurse to initiate a multidisciplinary conference for the client who is A.12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract infection) B.19 years old, has type 1 Diabetes Mellitus, is unemployed and had a recent Hemoglobin A1c of 13% C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and is employed as a mail carrier D.70 years old, has schizophrenia, lives alone and reports hearing non threatening voices.

19 years old, has type 1 Diabetes Mellitus, is unemployed and had a recent Hemoglobin A1c of 13%

Calcium

8.5-10.2 mg/dL

When giving an I.M. influenza vaccine, the nurse should insert the needle at what angle?

90 degrees

The nurse is caring for several patients and determines which patient is most likely at risk for infection?

A patient taking high doses of steroids.

The nurse is reviewing the client's arterial blood gas (ABG) results and notes the following values:pH: 7.35; PaO2: 80 mm Hg; PaCO2: 55mmHg;HCO: 30mEq/L. The nurse should recognize that this result is suggestive of which acid base imbalance?

Compensated respiratory acidosis - the pH is within normal range while the carbon dioxide level is increased indicating compensated respiratory acidosis

A patient with moderate acute pain wants to minimize opioid use. The patient asks the nurse to explain alternative and complementary therapies for pain. How should the nurse describe complementary and alternative therapies for pain?

Complementary and alternative medicines include guided imagery, meditation, music therapy, pet therapy, yoga, and massage therapy among others.

A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which test(s) before administering the first dose of this medication to the client?

Complete blood cell count

A nurse is assessing a patient and finds the patient to have swelling in both ankles and feet. What should the nurse expect to find in the patient's history?

Congestive heart failure.

To assist an adult client to sleep better the nurse recommends which of the following?

Drinking a small glass of warm milk at bedtime

A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder?

Dysuria and penile discharge

When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is:

Excessive daytime sleepiness

Which factor associates chronic gastritis with pernicious anemia?

Inability to absorb vitamin B12

A nurse is instructing a patient to use an incentive spirometer correctly. What instruction should the nurse include in the patient teaching?

Inhale slowly with your lips tightly sealed around the mouthpiece.

Four clients recently returned to the unit following invasive diagnostic testing. The nurse should immediately intervene if one of the clients: A.Reports blood tinged sputum following a bronchoscopy B.Has decreased abdominal girth following paracentesis C.Reports a headache following a lumbar puncture D.Is observed flexing and extending the legs two hours after femoral cardiac catheterization

Is observed flexing and extending the legs two hours after femoral cardiac catheterization

When educating a patient about inject-able influenza immunization, the nurse considers the following..

Its use is recommended for virtually all children age 6 months to 18 years old.

contact precautions

MRSA, Cdiff, HEP A, Chicken pox, lice,RSV, herpes simplex, Herpes Zoster

Airborne precautions

Measles, Chicken Pox, and TB; client's need private room, negative airflow w/ 6-12 air exchanges/hr, and N95 usage

green

Minor ("walking wounded") (4-6hrs)

black

Morgue (dead or dying)

A nurse is providing care for a patient with dehydration. What is the focus of managing patient care for the dehydrated patient?

Prevent injury, increase fluid compartment volumes to normal ranges, and prevent further fluid loss.

Hyperparathyroidism causes the body to produce increased levels of parathyroid hormone (PTH) putting patients at risk for what potential problem?

Renal calculi. High levels of PTH cause increased absorption of calcium and increased accumulation of calcium deposits in the soft tissue of the kidneys

The nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation?

Requires nasogastric suction

A patient's arterial blood gas results indicate the ph is 7.28, Pco2 is 49, and HCO3 is 28 mEq/L. The nurse identifies the patient is experiencing an acid-base imbalance. What acid-base imbalance is present in this patient? Metabolic alkalosis. Respiratory alkalosis. Metabolic acidosis. Respiratory acidosis.

Respiratory acidosis.The ph is decreased and Pco2 is increased indicating respiratory acidosis. The HCO3 is beginning to rise indicating the body is attempting to compensate.

The nurse in the mental health unit plans to use which therapeutic communication techniques when communicating with a client?

Restating, Listening, Maintaining neutral responses, Providing acknowledgement and feedback

Angiotensin II receptor blockers ending

SARTAN (valsartan)

A nurse is assisting in admitting a client with suspected pulmonary tuberculosis (TB). Which of the following actions should the nurse take?

The client with Tuberculosis (TB) is placed on airborne precautions which include placement in a negative pressure room with the door closed and use of a particulate respirator mask; a gown and gloves are not needed when talking with the client or taking the blood pressure

The RN is assessing a client suspected of hypocalcemia. Which clinical manifestation would the nurse expect to see?

Twitching

The nurse should expect to find elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) is a patient with what diagnosis?

Viral hepatitis.

tertiary prevention

focus of rehabilitation of already diagnosed

secondary prevention

focuses on early detection and screening

Hypokalemia:

muscle weakness, dysrhythmias, increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery)

Hyperkalemia:

muscle weakness, urine (oliguria/anuria), respiratory depression, decreased cardiac contractility, ECG changes, reflexes

Addisonian crisis

n/v, confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP