Practice NCLEX questions from Lewis textbook

insufficient sleep is associated with (SATA): a. increased BMI b. increased insulin resistance c. impaired cognitive functioning d. improved immune responsiveness e. increased daytime body temperature

a, b, c (chapter 7)

the most effective method of administering a chemotherapy agent that is a vesicant is to a. give it orally b. give it intraarterially c. use an ommaya reservoir d. use a central venous access device

d (chapter 15)

the nurse counsels the patient receiving radiation therapy or chemotherapy that a. effective birth control methods should be used for the rest of the patient's life b. after successful treatment, patients can expect a return to their previous level of function c. the cycle of fatigue-depression-fatigue that may occur during treatment may be reduced by restricting activity d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions

d (chapter 15)

the nurse is caring for a 59-year-old woman who had surgery 1 day ago to remove an ovarian cancer mass. the patient is awaiting the pathology report. she is tearful and says that she is scared to die. the most effective nursing intervention at this point is to use this opportunity to a. motivate change in an unhealthy lifestyle b. teach her about the 7 warning signs of cancer c. discuss health y stress relief and coping practices d. let her communicate about the meaning if this experience

d (chapter 15)

a patient with a T4 spinal cord injury has neurogenic shock due to sympathetic nervous system dysfunction, what would the nurse recognize as a characteristic of this condition? a. tachycardia b. hypotension c. increased cardiac output d. peripheral vasoconstriction

b (chapter 60)

the most common early symptoms of spinal cord tumor is a. urinary incontience b. back pain that worsens with activity c. paralysis below the level of involvement d. impaired sensation of pain, temperature, and light tough

b (chapter 60)

an 80-year-old female patient is receiving palliative care for heart failure. the primary purpose(s) of her receiving palliative care is (are) to (SATA): a. improve her quality of life b. assess her coping ability with disease c. have time to teach patient and family about disease d. focus on reducing the severity of disease symptoms e. provide care that the family is unwilling or unable to give

A, D (chapter 9)

in caring for a patient after a spinal fusion, the nurse would report which finding to the health care provider? a. the patient has a single episode of emesis b. the patient is unable to move the lower extremities c. the patient is nauseated and has not voided in 4 hours d. the patient reports of pain at the bone graft donor site

b (chapter 63)

the nurse would suspect cocaine toxicity in the patient who is experiencing a. agitation, dysrhythmias, and seizures b. blurred vision, restlessness, and irritability c. diarrhea, nausea and vomiting, and confusion d. slow, shallow respirations; bradycardia and hypotension

a (chapter 10)

a 70-year-old male patient has multiple myeloma. his wife called to report that he sleeps most of the day, is confused when awake, and reports nausea and constipation. which complication of cancer is this most likely caused by? a. hypercalcemia b. tumor lysis syndrome c. spinal cord compression d. superior vena cava syndrome

a (chapter 15)

a patient with breast cancer has a lumpectomy with sentinel lymph node biopsy that is positive for cancer. you explain that, of the other tests done to determine the risk for cancer recurrence or spread, the results that support the more favorable prognosis are (SATA): a. well-differentiated tumor b. estrogen receptor-positive tumor c. over expression of HER-2 cell marker d. involvement of two of four axillary modes e. aneuploidy status from cell proliferation studies

a, d (chapter 51)

which factors would place a patient at a higher risk for prostate cancer (SATA) a. older than 65 years b. asian or native american c. long-term use of an indwelling urinary catheter d. father diagnosed and treated for early-stage prostate cancer e. previous history of undescended testicle or testicular cancer

a, d (chapter 54)

in assessing a patient for testicular cancer, the nurse understands that the manifestations of this disease often include: a. urinary frequency b. painless mass in the scrotal area c. erectile dysfunction with retrograde ejaculation d. rapid onset of dysuria with scrotal swelling and fever

b (chapter 54)

determination of whether an event is a stressor is based on a person's a. tolerance b. perception c. adaptation d. stubbornness

b (chapter 6)

an example of distraction to provide pain relief is: a. TENS b. music c. exercise d. biofeedback

b (chapter 8)

which of the following conditions cannot be treated by a Chiropractor?

fractured hip (on the test)

which of the following hydrotherapy treatments decreases inflammation and stimulates blood flow and lymphatic drainage?

hot and cold contrast therapies (on the test)

a patient admitted for scheduled surgery has a positive brief screening test result for an alcohol use disorder. which initial action is most appropriate a. notify HCP b. complete a detailed alcohol use assessment c. initiate a referral to a speciality treatment center d. provide patient teaching on postoperative health risks

b (chapter 10)

a patient has recently been diagnosed with early stages off breast cancer. what is most appropriate for the nurse to focus on a. maintaining the patient's hope b. preparing a will and advance directives c. discussing replacement child care for the patient's children d. discussing the patient's past experiences with her grandmother's cancer

a (chapter 15)

a patient with stage I colorectal cancer is scheduled for surgery. patient teaching for this patient would include an explanation that: a. chemotherapy will begin after the patient recovers from the surgery b. with chemotherapy and radiation can be used as palliative treatments c. follow-up colonoscopies will be needed to ensure that the cancer does not recur d. a wound, ostomy, and continence nurse will visit the patine tot identify the site for the ostomy

a (chapter 42)

the most appropriate therapy for a patient with acute diarrhea caused by a viral infection is to a. increase fluid intake b. administer an antibiotic c. administer an anti motility drug d. quarantine the patine to prevent the spread of the virus

a (chapter 42)

To prevent capsular formation after breast reconstruction with implants, teach the patient to a. gently massage the area around the implant b. bind the breasts tightly with elastic bandages c. exercise the arm on the affected side to promote drainage d. avoid strenuous exercise until the implant has healed

a (chapter 51)

when discussing risk factors for breast cancer with a group of women, you emphasize that the greatest known risk factor for breast cancer is a. being a woman over the age of 60 b. experiencing menstruation for 30 years or more c. using hormone therapy for 5 years for menopausal symptoms d. having a paternal grandmother with postmenopausal breast cancer

a (chapter 51)

a patient scheduled for a radical prostatectomy for prostate cancer expresses the fear that he will have erectile dysfunction. in responding to this patient, the nurse should keep in mind that a. PD5 inhibitors are not recommended in prostatectomy patients b. erectile dysfunction can occur even with a nerve-sparing procedure c. the most common complication of this surgery is bowel incontinence d. the provider will place a penile implant during surgery to treat any dysfunction

a (chapter 54)

the nurse recognizes that a patient with newly diagnosed breast cancer is using an emotion-focused coping process when she a. joins a support group for women with breast cancer b. considers the pros and cons of the various treatment options c. delays treatment until her family can take a weekend trip together d. tells the nurse that she has a good prognosis because the tumor is small

a (chapter 6)

during rehab, a patient with spinal cord injury begins to ambulate with long leg braces, which level of injury does the nurse associate with this degree of recovery? a. L1-2 b. T6-7 c. T1-2 d. C7-8

a (chapter 60)

an overweight patient with sleep apnea would like to avoid using a nasal CPAP device. to help him reach this goal, the nurse suggests that the patient a. lose excess weight b. take a nap during the day c. eat a high protein snack at bedtime d. use mild sedatives or alcohol at bedtime

a (chapter 7)

which persons are at high risk for chronic low back pain (SATA) a. a 63-year old man who is a long-distance truck driver b. a 30-year old nurse who works on an orthopedic unit and smokes c. a 55-year old construction worker who is 6 ft 2 inches and weights 250lbs d. a 44-year old female chef with prior compression fracture of the spine e. a 28 year old female yoga instructor who is 5ft 6 in and weights 130 lbs

a, b, c, d (chapter 63)

The children caregivers of an older patient whose death is imminent have not left the bedside for the past 36 hours. In the nurse's assessment of the family, what findings indicate the potential for an abnormal grief reaction to occur (select all that apply)? a. Family cannot express their feelings to one another. b. Dying patient is becoming more restless and agitated. c. A family member is going through a difficult divorce. d. Family talks with and reassures the patient at frequent intervals. e. Siblings who were estranged from each other have now reunited.

a, c (chapter 9)

you are a community health nurse planning a program on breast cancer screening guidelines for women in the neighborhood. which recommendations would you include? (SATA) a. women over age 55 may have biennial screening b. screening should end when the women reaches age 65 c. women aged 45 to 54 years should be screened annually d. regular screening mammography should start at age 45 years e. clinical breast examinations can be used if the woman has average risk

a, c, d (chapter 51)

while caring for a patient who is experiencing alcohol withdrawal, the nurse should (SATA): a. monitor neurologic status on a routine basis b. provide a quiet, non stimulating, dimly lit environment c. pad the side rails and place suction equipment at the bedside d. orient the patient to environment and person with each contact e. give anti seizure drugs and sedatives to relieve withdrawal symptoms

a, c, d, e (chapter 10)

substance use problems in older adults are usually related to a. use of drugs and alcohol as a social activity b. continuing the use of illegal drugs started during middle age c. misuse of prescribed and OTC medications and alcohol d. a pattern of binge drinking for weeks or months with periods of sobriety

c (chapter 10)

the most appropriate nursing intervention for a patient who is being treated for an acute exacerbation of chronic obstructive pulmonary disease who is not interested in quitting smoking is to a. accept the patient's decision and not intervene until the patient expresses desire to quit b. ask the patient to identify the risks and benefits of quitting and what barriers to quitting are present c. realize that some smokers never quit, and trying to assist them increases the patient's frustration d. motivate the patient to quit by describing how continued smoking will worsen breathing problems

b (chapter 10)

when admitting a patient, the nurse must assess the patient for substance use based on the knowledge that long-term use of addictive substances lead to a. the development of coexisting psychiatric illnesses b. a higher risk for complications from underlying health problems c. potentiation of effects of similar drugs taken when there person is drug free d. increased availability of dopamine, resulting in decreased sleep requirements

b (chapter 10)

the nurse explains to the patient undergoing brachytherapy of the cervix that she a. must undergo simulation to locate the treatment area b. requires the use of radioactive precautions during nursing care c. may have desquamation of the skin on the abdomen and upper legs d. requires shielding of the ovaries during treatment to prevent ovarian damage

b (chapter 15)

to prevent fever and shivering during na infusion of rituximab (Rituxan), the nurse should premeditate the patient with a. aspirin b. acetaminophen c. sodium bicarbonate d. meperidine (Demerol)

b (chapter 15)

the nurse uses knowledge of the effects of stress on the immune system by encouraging patients to a. sleep for 10-12 hours per day b. avoid exposure to upper respiratory tract infections c. receive regular immunizations when they are stressed d. use emotion-focused rather than problem focused coping strategies

b (chapter 6)

while caring for a patient with a history of narcolepsy with cataplexy, the nurse can delegate which activity to the UAP a. teaching about the timing of medications b. walking the patient to and from the bathroom c. developing a plan of care with a family member d. planning an appropriate diet that avoids caffeine-containing foods

b (chapter 7)

a patient is receiving a PCA infusion after surgery to repair a hip fracture. she is sleeping soundly but awakens when the nurse speaks to her in a normal tone of voice. her respirations are 8 breaths/min. the most appropriate nursing acton in this situation is to: a. stop the PCA infusion b. obtain an oxygen saturation level c. continue to closely monitor the patient d. administer naloxone and contact the provider

b (chapter 8)

pain is best described as: a. a creation of a person's imagination b. an unpleasant, subjective experience c. a maladaptive response to a stimulus d. a neurologic event resulting form activation of nociceptors

b (chapter 8)

a 67-year old woman was recently diagnosed with inoperable pancreatic cancer. before the diagnosis, she was very active In her neighborhood association. her husband is concerned because his wife is staying at home and missing her usual community activities. which common EOL psychologic manifestation is she most likely demonstrating? a. peacefulness b. decreased socialization c. decreased decision making d. anxiety about unfurnished business

b (chapter 9)

the home health nurse visits a 40-year-old patient with metastatic breast cancer who is receiving palliative care. the patient has pain at a level of 7 (0-10 point scale). in prioritizing activities for the visit, what should the nurse do first? a. auscultate for breath sounds b. give as needed pain medication c. check pressure points for skin breakdown d. ask family about patients food and fluid intake

b (chapter 9)

while caring for his dying wife, the husband states that his wife is a devout Roman Catholic but he is a baptist. who is considered the most reliable source for spiritual preferences concerning EOL care for his dying wife? a. a priest b. dying wife c. hospice staff d. husband or dying wife

b (chapter 9)

the nurse recognizes that a person who has chronic stress could be at higher risk for (SATA): a. osteoporosis b. fibromyalgia c. colds and flu d. high blood pressure e. high serum cholesterol

b, c, d (chapter 6)

which words are most likely to be used to describe neuropathic pain (SATA): a. dull b. itching c. burning d. shooting e. shock-like

b, c, d, e (chapter 8)

appropriate non-opioid analgesics for mild pain include (SATA): a. oxycodone b. ibuprofen (Advil) c. lorazepam (Ativan) d. acetaminophen (Tylenol) e. codeine with acetaminophen (Tylenol #3)

b, d (chapter 8)

which statements are true about rapid eye movement (REM) sleep (SATA): a. the EEG pattern is quiescent b. muscle tone is greatly reduced c. it occurs only once in the night d. it is physiologically similar to NREM sleep e. the most vivid dreaming occurs during this phase

b, e (chapter 7)

The goals of cancer treatment are based on the principle that:a. surgery is the single most effective treatment for cancer. b. initial treatment is always directed toward cure of the cancer. c. a combination of treatment modalities is effective for controlling many cancers. d. although cancer cure is rare, quality of life can be increased with treatment modalities. "

c (chapter 15)

Preoperatively, to meet the psychologic needs of a woman scheduled for a simple mastectomy, you would A. discuss the limitations of breast reconstruction. B. include her significant other in all conversations. C. promote an environment for expression of feelings. D. explain the importance of regular follow-up screening.

c (chapter 51)

Postoperatively, a patient who has had a laser prostatectomy has continuous bladder irrigation with a three-way urinary catheter with a 30-mL balloon. When he complains of bladder spasms with the catheter in place, you should A. deflate the catheter balloon to 10 mL to decrease bulk in the bladder. B. deflate the catheter balloon and then reinflate it to ensure that it is patent. C. explain that this feeling is normal and that he should not try to urinate around the catheter. D. stop the irrigation, assess the patient's vital signs, and notify the HCP of possible obstruction

c (chapter 54)

during a stressful circumstance that is unchangeable, which type of coping strategy is the most effective? a. avoidance b. coping flexibility c. emotion-focused coping d. problem focused coping

c (chapter 6)

the nurse would expect which finding in a patient because of the physiologic effect of stress on the reticular formation a. an episode of diarrhea while awaiting painful dressing changes b. refusal to communicate with nurses while awaiting a cardiac catheterization c. inability to sleep the night before beginning to self-administer insulin injections d. increased blood pressure, decreased urine output, and hyperglycemia after a car accident

c (chapter 6)

a patient undergoing rehab for a C7 spinal cord injury tells the nurse that he must have the flu because he has a bad headache and nausea. the nurse's first priority is to: a. call the health care provider b. check the patient's temperature c. measure the patient's blood pressure d. elevate the head of the bed to 90 degrees

c (chapter 60)

strategies to reduce sleepiness during nighttime working include a. exercising before work b. taking melatonin before working the night shift c. sleeping for at least 2 hours immediately before work time d. walking for 10 minutes every 4 hours during the night shift

c (chapter 7)

a cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes is: a. probably exaggerating his pain b. in need of a referral for surgical treatment of his pain c. best treated by receiving a long-acting and a short-acting opioid d. best treated by regularly scheduled short-acting opioids plus acetaminophen

c (chapter 8)

an important nursing responsibility related to pain is to: a. leave the patient alone to rest b. help the patient appear to not be in pain c. believe what the patient says about the pain d. assume responsibility for eliminating the patient's pain

c (chapter 8)

giving opioids to an actively dying patient who has moderate to severe pain: a. may cause addiction b. will likely be ineffective c. is an appropriate nursing action d. will likely hasten the person's death

c (chapter 8)

unrelieved pain is: a. not expected after major surgery b. expected in a person with cancer c. dangerous and can lead to many physical and Psychological complications d. an annoying sensation, but it is not as important as other physical care needs

c (chapter 8)

The family attorney informed a patient's adult children and wife that the patient did not have an advance directive after he suffered a serious stroke. Who is responsible for making the decision about EOL measures when the patient cannot communicate his or her specific wishes? a. Notary and attorney b. physician and family c. wife and adult children d. physician and nursing staff

c (chapter 9)

a nurse has been working full-time with terminally ill patients for 3 years. he has been experiencing irritability and mixed emotions when expressing sadness since 4 of his patients died on the same day. to optimize the quality of his nursing care, he should examine his own a. full-time work schedule b. past feelings towards death c. patterns for dealing with grief d. demands for involvement in patient care

c (chapter 9)

a patient on chemotherapy for 10 weeks started at a weight of 121 lb. she now weighs 118lbs and has no sense of taste. which nursing intervention would be a priority a.dicuss with the provider the need for parenteral nutrition b. teach the patient to eat foods that are fatty, fried, or high in calories c. tell the patient to drink a nutritional supplement beverage three times a day d. have the patient try various spices and seasonings to enhance the flavor of food

d (chapter 15)

a patient with pancreatic cancer is admitted to the hospital for evaluation of treatment options, the patient asks the nurse to explain the Whipple procedure that the surgeon has described. the explanation includes the information that a Whipple procedure includes... a. creating a bypass around the obstruction caused by the tumor by joining the gallbladder to the jejunum b. resection of the entire pancreas and the distal part of the stomach, with anastomosis of the common bile duct and the stomach into the duodenum c. removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum d. removal of the pancreas, duodenum, and the spleen, and attachment of the stomach to the jejunum, which requires oral supplementation of pancreatic digestive enzymes and insulin replacement therapy

c. removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum (chapter 43)

you are caring for a patient with breast cancer following a simple mastectomy. postoperatively, to restore arm function on the affected side, you would a. apply heating pads or blankets to increase circulation b. place daily ice packs to minimize the risk for lymphedema c. teach passive exercises with the affected arm in a dependent position d. emphasize regular exercises for the affected shoulder to increase ROM

d (chapter 51)

you are caring for a young woman who has painful fibrocystic breast changes. management of this patient would include: a. scheduling a biopsy to rule of the presence of breast cancer b. teaching that symptoms will subside if she stops using oral contraceptives c. preparing her for surgical removal of the lumps since they will become larger and more painful d. explaining that restricting coffee and chocolate and supplementing with vitamin E may relieve some discomfort

d (chapter 51)

the nurse is caring for a patient with peripheral neuropathy who is scheduled for EMG studies tomorrow morning. the nurse should a. ensure the patient has an empty bladder b. instruct the patient about the risk for electric shock c. ensure the patient has no metallic jewelry or metal fragments d. teach the patient that pain may be experienced during the study

d (chapter 55)

an appropriate nursing intervention for a hospitalized patient who says she cannot cope with her illness is a. controlling the environment to prevent sensory overload and promote sleep b. encouraging the patient's family to offer emotional support by frequent visiting c. arranging for the patient to phone family and friends to maintain emotional bonds d. asking the patient to describe previous stressful situations and how she managed to resolve them

d (chapter 6)

a patient with suspected disc herniations has acute pain and muscle spasms. the nurse's responsibility is to: a. encourage total bed rest for several days b. teach principles of back strengthening exercises c. stress the importance of straight leg raises to decrease pain d. promote use of hot and cold compresses and pain medications

d (chapter 63)

sleep is best described as a. loosely organized state similar to coma b. quiet state in which there is little brain activity c. state in which a person has reduced sensitivity to pain d. state In which a person lacks conscious awareness of the environment

d (chapter 7)

when teaching the patient with primary insomnia about sleep hygiene the nurse should emphasize a. the importance of daytime naps b. the need for long-term use of hypnotics c. the need to exercise about 1 hour before bedtime d. the importance of avoiding caffeine 6-9 hours before bedtime

d (chapter 7)

a nurse believes that patients with the same type of tissue injure should have the same amount of pain. this statement reflects: a. a belief that will contribute to appropriate pain management b. an accurate statement about pain mechanisms and expected goals of pain therapy c. a belief that will not have any effect on the type of care provided to the people in pain d. a lack of knowledge about pain mechanisms, which is likely to contribute to poor pain management

d (chapter 8)

For the past 5 years, Tom has repeatedly asked his mother to donate his deceased father's belongings to charity, but his mother has refused. She sits in the bedroom closet, crying and talking to her long-dead husband. What type of grief is Tom's mother experiencing? A. Adaptive grief B. Disruptive grief C. Anticipatory grief D. Prolonged grief disorder

d (chapter 9)