NCLEX & Mastery Questions

For which client would the nurse expect to teach intermittent catheterization?

35-year-old woman who has multiple sclerosis and incontinence

Which client being managed for dehydration does the nurse consider at greatest risk for possible reduced kidney function?

An 80-year-old man who has benign prostatic hyperplasia

A 23 year old female patient reports having red, raised lesions at the base of her tongue and on the inside of her mouth for the past 3 weeks. What priority assessment question should the nurse ask?

"Do you have a history of HPV?"

After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning?

"Have you passed flatus?"

Which question will the nurse ask the client who has a urinary tract infection to assess the risk for pyelonephritis?

"How long have you had diabetes?"

Which patient statement alerts the nurse to perform a thorough GI history and focused assessment?

"I take ibuprofen three times daily for arthritis"

The primary health care provider prescribes bismuth subsalicylate for a client as part of treating H. pylori infection. What health teaching will the nurse include for the client about this drug?

"The drug may cause your tongue and stool to turn black."

For which hospitalized client does the nurse recommend the ongoing use of a urinary catheter?

A 74-year-old man who has lung cancer with brain metastasis and is being transitioned to hospice

A client who had the Stretta procedure to treat severe GERD is being discharged. Which client statement requires further nursing teaching? (SATA) A. "Dysphagia after this procedure is normal." B. "It's important to stop my proton pump inhibitor." C. "I will not take NSAIDs and aspirin for at least 10 days." D. "I might cough up some blood following this procedure." E. "Today I will drink clear liquids and tomorrow I can eat soft food."

A. B. D.

A nurse is caring for a 34-year-old client newly diagnosed with GERD. Which lifestyle change will the nurse suggest? (SATA) A. Lose weight if needed. B. Do not eat before bed. C. Elevate the foot of your bed by 6 to 12 inches. D. Avoid pants with a tight waistband or belt. E. Eat fatty foods to minimize ongoing hunger.

A. B. D.

What health teaching will the nurse include to promote gastric health for an adult client? (SATA) A. "Stop smoking or using tobacco of any form." B. "Do not drink excessive amounts of alcohol." C. "Consume high-fat foods and decrease carbohydrates." D. "Avoid excessive amounts of pickled or smoked food." E. "Avoid taking large amounts of NSAIDs."

A. B. D. E.

Which teaching will the nurse include when educating a client who is scheduled to have an esophagogastroduodenoscopy (EGD)? (SATA) A. "Anesthesia will be used for sedation." B. "The procedure takes about 20 to 30 minutes to complete." C. "Informed consent will be needed prior to the procedure." D. "A separate test will be required to obtain any needed biopsies." E. "You will need to refrain from eating for at least 6 to 8 hours before the EGD."

A. B. D. E.

Which teaching will the nurse provide to a community group about early detection of colorectal cancer? (SATA) A. Home testing kits are available with a prescription B. Sigmoidoscopy should be performed every 10 years C. People over 40 years old should be tested for colon cancer D. Bowel preparation is necessary prior to performance of a colonoscopy E. Virtual colonoscopies (CT colonography) can be performed every 5 years

A. D. E.

When obtaining a health history and physical assessment from a 68-year-old male client who has a history of an enlarged prostate, which finding does the nurse consider significant? (SATA) A. Distended bladder B. Absence of a bruit C. Frequency of urination D. Dribbling urine after voiding E. Chemical exposure in the workplace

A. Distended bladder C. Frequency of urination D. Dribbling urine after voiding

Which assessment data would the nurse anticipate in a client with acute pyelonephritis? (SATA) A. Urinary frequency B. Dysuria C. Oliguria D. Heart rate 120 beats/min E. Uremia F. Costovertebral angle tenderness

A. Urinary frequency B. Dysuria D. Heart rate 120 beats/min F. Costovertebral angle tenderness

Which client statement about GERD triggers requires further nursing teaching? (SATA) A. "I will decrease my alcohol intake." B. "Smoking one or two cigarettes a day won't hurt." C. "My plan is to eat six small meals daily." D. "Tomato-based foods should be avoided."' E. "I love soda but I'm going to stop drinking it." F. "Our family eats tacos and burritos several times weekly."

B. F.

Which adverse drug effects will the nurse assess for in a hospitalized client who is prescribed an anticholinergic drug to manage incontinence? (SATA) A. Insomnia B. Blurred vision C. Constipation D. Dry mouth E. Loss of sphincter control F. Increased sweating G. Worsening mental function

B. Blurred vision C. Constipation D. Dry mouth G. Worsening mental function

Which lab finding is indicative of renal function alterations and not dehydration? (SATA) A. BUN 20 mL/dL B. Creatinine 2.3 mL/dL C. Hemoglobin 14 g/dL D. Cystatin-c 105 mg/mL E. BUN/creatinine ratio 10 F. Creatinine clearance 175 mL/min

B. Creatinine 2.3 mL/dL D. Cystatin-c 105 mg/mL F. Creatinine clearance 175 mL/min

The nurse is caring for an 80-year-old female client with recurrent cystitis. Which teaching will the nurse include in the plan of care? (SATA) A. Drink citrus juices daily. B. Encourage fluid intake of 2-3 L of fluid throughout the day. C. Instruct her to always wipe the perineum from front to back after each toilet use. D. Reinforce that she should complete the entire course of antibiotics as prescribed. E. Instruct her to empty her bladder immediately before and after having intercourse.

B. Encourage fluid intake of 2-3 L of fluid throughout the day. C. Instruct her to always wipe the perineum from front to back after each toilet use. D. Reinforce that she should complete the entire course of antibiotics as prescribed. E. Instruct her to empty her bladder immediately before and after having intercourse.

The nurse is admitting a client undergoing a CT scan with contrast. Which finding does the nurse report as a possible immediate hypersensitivity reaction? (SATA) A. Nausea B. Pruritis C. Urticaria D. Laryngeal stridor E. Flushing of the skin

B. Pruritis C. Urticaria D. Laryngeal stridor E. Flushing of the skin

A client is on a 24-hour urine collection. At midpoint during the collection, the client tells the nurse that some of the urine was discarded. What action will the nurse take? (SATA) A. No action is required. B. Reinforce client education. C. Notify the laboratory staff. D. Restart the urine collection. E. Document the discarded urine. F. Notify the health care provider.

B. Reinforce client education C. Notify the laboratory staff E. Document the discarded urine F. Notify the health care provider

Immediately following a colonoscopy, which client behavior will the nurse report to the health care provider? (SATA) A. Passing of flatus B. Blood pressure 128/80 mmHg C. Abdominal guarding D. Change in mental status E. Report of mild abdominal cramping

C. D.

Which assessment finding would require the nurse to take immediate action in a client who is 1 hour post kidney biopsy? (SATA) A. Pink-tinged urine B. Nausea and vomiting C. Increased bowel sounds D. Reports of flank pain E. The patient is ambulating to the bathroom

C. Increased bowel sounds

A nurse is caring for a client with recurrent aphthous stomatitis (RAS) who asks about food choices while healing. Which food will the nurse suggest?

Chocolate pudding

When administering a new GI medication to an older adult patient, the nurse anticipates what?

Close monitoring is needed because toxic levels may develop

The nurse is caring for a patient with a long history of osteoarthritis. Which risk factors will the nurse teach the patient that may contribute to development of GERD?

Frequently takes NSAIDs for pain

The nurse is reviewing the client's laboratory data prior to a nephrostomy tube insertion. Which data requires the nurse to take action?

INR of 2.1

An older patient with poor oral hygiene was admitted after a fall in which he sustained a fractures hip What is the priority nursing intervention?

Implement aspiration precautions

Which nursing interventions is the priority in the care of a patient with a hiatal hernia?

Providing nutrition education

Which client assessment data is essential for the nurse to report to the health care provider before a renal scan is performed?

Reports pregnancy

Which symptom(s) in a client during the first 12 hours after a kidney biopsy indicates to the nurse a possible complication from the procedure?

The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready.

3. When providing care to a client who has undergone a nephrostomy for hydronephrosis, which observation alerts the nurse to a possible complication? (SATA) A. Urine output of 15 mL for the first hour and then diminishing B. A hematocrit value 3% lower than the preoperative value C. Sudden onset of abdominal pain that worsens after abdominal palpation D. Blood pressure of 180/90 mm Hg that persists despite administration of pain medication

all of the above

The nurse is caring for a client diagnosed with peptic ulcer disease (PUD). For which potential complications will the nurse monitor? (SATA) A. Pneumonia B. Peritonitis C. Anemia D. Stroke E. Hypotension F. Cirrhosis

all of the above