Saturday, May 25, 2013

NCLEX questions

1. A nurse is reviewing a patient's medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct. 
A: Coumadin 
B: Finasteride 
C: Celebrex 
D: Catapress 
E: Habitrol 
F: Clofazimine
(A) and (B) are both contraindicated with pregnancy.
A nurse is reviewing a patient's PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct. 
A: Cipro 
B: Sulfonamide 
C: Noroxin 
D: Bactrim 
E: Accutane 
F: Nitrodur
(F) All of the others have can cause photosensitivity reactions.
A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient's medication does not cause urine discoloration? 
A: Sulfasalazine 
B: Levodopa 
C: Phenolphthalein 
D: Aspirin
(D) All of the others can cause urine discoloration.
You are responsible for reviewing the nursing unit's refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator's contents? 
A: Corgard 
B: Humulin (injection) 
C: Urokinase 
D: Epogen (injection)
(A) Corgard could be removed from the refigerator.
A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb? 
A: IgA 
B: IgD 
C: IgE 
D: IgG
(D) IgG is the only immunoglobulin that can cross the placental barrier.
A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take? 
A: Immediately see a social worker 
B: Start prophylactic AZT treatment 
C: Start prophylactic Pentamide treatment 
D: Seek counseling
(B) AZT treatment is the most critical innervention.
A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? 
A: Atherosclerosis 
B: Diabetic nephropathy 
C: Autonomic neuropathy 
D: Somatic neuropathy
(C) Autonomic neuropathy can cause inability to urinate.
You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect? 
A: Multiple sclerosis 
B: Anorexia nervosa 
C: Bulimia 
D: Systemic sclerosis
(B) All of the clinical signs and systems point to a condition of anorexia nervosa.
A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect? 
A: Diverticulosis 
B: Hypercalcaemia 
C: Hypocalcaemia 
D: Irritable bowel syndrome
(B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.
Rho gam is most often used to treat____ mothers that have a ____ infant. 
A: RH positive, RH positive 
B: RH positive, RH negative 
C: RH negative, RH positive 
D: RH negative, RH negative
(C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.
A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU? 
A: A Guthrie test can check the necessary lab values. 
B: The urine has a high concentration of phenylpyruvic acid 
C: Mental deficits are often present with PKU. 
D: The effects of PKU are reversible.
(D) The effects of PKU stay with the infant throughout their life.
A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient? 
A: Onset of pulmonary edema 
B: Metabolic alkalosis 
C: Respiratory alkalosis 
D: Parkinson's disease type symptoms
(D) Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.
A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is? 
A: Let others know about the patient's deficits 
B: Communicate with your supervisor your concerns about the patient's deficits. 
C: Continuously update the patient on the social environment. 
D: Provide a secure environment for the patient.
(D) This patient's safety is your primary concern.
A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient? 
A: Deep breathing techniques to increase O2 levels. 
B: Cough regularly and deeply to clear airway passages. 
C: Cough following bronchodilator utilization 
D: Decrease CO2 levels by increase oxygen take output during meals.
(C) The bronchodilator will allow a more productive cough.
A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present? 
A: Slow pulse rate 
B: Weight gain 
C: Decreased systolic pressure 
D: Irregular WBC lab values
(B) Weight gain is associated with CHF and congenital heart deficits.
A mother has recently been informed that her child has Down's syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down's syndrome? 
A: Simian crease 
B: Brachycephaly 
C: Oily skin 
D: Hypotonicity
(C) The skin would be dry and not oily.
A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered? 
A: Streptokinase 
B: Atropine 
C: Acetaminophen 
D: Coumadin
(A) Streptokinase is a clot busting drug and the best choice in this situation.
A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain folic acids?" 
A: Green vegetables and liver 
B: Yellow vegetables and red meat 
C: Carrots 
D: Milk
(A) Green vegetables and liver are a great source of folic acid.
A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?
A: S. pneumonia 
B: H. influenza 
C: N. meningitis 
D: Cl. difficile
(D) Cl. difficile has not been linked to meningitis.
A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC's last in my body? The correct response is. 
A: The life span of RBC is 45 days. 
B: The life span of RBC is 60 days. 
C: The life span of RBC is 90 days. 
D: The life span of RBC is 120 days.
(D) RBC's last for 120 days in the body.
A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient? 
A: Following surgery 
B: Upon admit 
C: Within 48 hours of discharge 
D: Preoperative discussion
(B) Discharge education begins upon admit.
A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in? 
A: Trust vs. mistrust 
B: Initiative vs. guilt 
C: Autonomy vs. shame 
D: Intimacy vs. isolation
(B) Initiative vs. guilt- 3-6 years old
A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in? 
A: Trust vs. mistrust 
B: Initiative vs. guilt 
C: Autonomy vs. shame 
D: Intimacy vs. isolation
(A) Trust vs. Mistrust- 12-18 months old
A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in? 
A: Trust vs. mistrust 
B: Initiative vs. guilt 
C: Autonomy vs. shame 
D: Intimacy vs. isolation
(D) Intimacy vs. isolation- 18-35 years old
A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal? 
A: 11 year old male - 90 b.p.m, 22 resp/min. , 100/70 mm Hg 
B: 13 year old female - 105 b.p.m., 22 resp/min., 105/60 mm Hg 
C: 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg 
D: 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg
(B) HR and Respirations are slightly increased. BP is down.
When you are taking a patient's history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking? 
A: Elavil 
B: Calcitonin 
C: Pergolide 
D: Verapamil
(A) Elavil is a tricyclic antidepressant.
Which of the following conditions would a nurse not administer erythromycin? 
A: Campylobacterial infection 
B: Legionnaire's disease 
C: Pneumonia 
D: Multiple Sclerosis
(D) Erythromycin is used to treat conditions A-C.
A patient's chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute? 
A: Decreased HR 
B: Paresthesias 
C: Muscle weakness of the extremities 
D: Migranes
(D) Answer choices A-C were symptoms of acute hyperkalemia.
A patient's chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute? 
A: Vomiting 
B: Extreme Thirst 
C: Weight gain 
D: Acetone breath smell
(C) Weight loss would be expected.
A patient's chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute? 
A: Increased appetite 
B: Vomiting 
C: Fever 
D: Poor tolerance of light
(A) Loss of appetite would be expected.
A nurse if reviewing a patient's chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition? 
A: Yersinia pestis 
B: Helicobacter pyroli 
C: Vibrio cholera 
D: Hemophilus aegyptius
(D) Choice A is linked to Plague, Choice B is linked to peptic ulcers, Choice C is linked to Cholera.
A nurse if reviewing a patient's chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition? 
A: Borrelia burgdorferi
B: Streptococcus pyrogens 
C: Bacilus anthracis 
D: Enterococcus faecalis
(A) Choice B is linked to Rheumatic fever, Choice C is linked to Anthrax, Choice D is linked to Endocarditis.
A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed? 
A: FBC (full blood count) 
B: ECG (electrocardiogram) 
C: Thyroid function tests 
D: CT scan
(D) A CT scan would be performed for further investigation of the hemiparesis.
A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed? 
A: FBC (full blood count) 
B: ECG (electrocardiogram) 
C: Thyroid function tests 
D: CT scan
(C) Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function.
A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first? 
A: Blood sugar check 
B: CT scan 
C: Blood cultures 
D: Arterial blood gases
(C) Blood cultures would be performed to investigate the fever and rash symptoms.
A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first? 
A: Blood sugar check 
B: CT scan 
C: Blood cultures 
D: Arterial blood gases
(A) With a history of diabetes, the first response should be to check blood sugar levels.
A mother is inquiring about her child's ability to potty train. Which of the following factors is the most important aspect of toilet training? 
A: The age of the child
B: The child ability to understand instruction. 
C: The overall mental and physical abilities of the child. 
D: Frequent attempts with positive reinforcement.
(C) Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.
A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent? 
A: This too shall pass.
B: Take the child immediately to the ER 
C: Contact the Poison Control Center quickly
D: Give the child syrup of ipecac
(C) The poison control center will have an exact plan of action for this child.
A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate? 
A: Gluteus maximus 
B: Gluteus minimus 
C: Vastus lateralis 
D: Vastus medialis
(C) Vastus lateralis is the most appropriate location.
A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do? 
A: Contact the provider 
B: Ask the child to write their name on paper. 
C: Ask a co-worker about the identification of the child. 
D: Ask the father who is in the room the child's name.
(D) In this case you are able to determine the name of the child by the father's statement, moreover you should not withhold the medication from the child following identification.
A nurse is observing a child's motor, sensory and speech development. The child is 7 months old. Which of the following tasks would generally not be observed? 
A: Child recognizes tone of voice. 
B: Child exhibits fear of strangers. 
C: Child pulls to stand and occasionally bounces. 
D: Child plays patty-cake and imitates.
(D) These skills generally develop between 10-15 months.
A nurse is observing a child's motor, sensory and speech development. The child is 5 months old. Which of the following tasks would generally not be observed? 
A: Child sits with support. 
B: Child laughs out loud. 
C: Child shifts weight side to side in prone. 
D: Child transfers objects between hands.
(D) Transferring objects between hands is a 8-9 month skill.
A nurse is caring for an adult that has recently been diagnosed with renal failure. Which of the following clinical signs would most likely not be present? 
A: Hypotension 
B: Heart failure 
C: Dizziness 
D: Memory loss
(A) Hypertension is often related renal failure.
A nurse is caring for an adult that has recently been diagnosed with hypokalemia. Which of the following clinical signs would most likely not be present? 
A: Leg cramps 
B: Respiratory distress
C: Confusion 
D: Flaccid paralysis
(D) Flaccid paralysis is an indication of Hyperkalemia.
A nurse is caring for an adult that has recently been diagnosed with metabolic acidosis. Which of the following clinical signs would most likely not be present? 
A: Weakness 
B: Dysrhythmias 
C: Dry skin 
D: Malaise
(B) Dysrhythmias are associated with metabolic alkalosis.
A nurse is caring for an adult that has recently been diagnosed with metabolic alkalosis. Which of the following clinical signs would most likely not be present? 
A: Vomiting 
B: Diarrhea 
C: Agitation 
D: Hyperventilation
(D) Hyperventilation occurs with metabolic acidosis. Hypoventilation occurs with metabolic alkalosis.
A nurse is caring for an adult that has recently been diagnosed with respiratory acidosis. Which of the following clinical signs would most likely not be present? 
A: CO2 Retention 
B: Dyspnea 
C: Headaches 
D: Tachypnea
(D) Tachypnea is associated with respiratory alkalosis.
A nurse is caring for an adult that has recently been diagnosed with respiratory alkalosis. Which of the following clinical signs would most likely not be present? 
A: Anxiety attacks 
B: Dizziness 
C: Hyperventilation cyanosis 
D: Blurred vision
(C) Hyperventilation cyanosis is associated with respiratory acidosis.
A nurse is reviewing a patient's medication list. The drug Pentoxifylline is present on the list. Which of the following conditions is commonly treated with this medication? 
A: COPD B: CAD 
C: PVD 
D: MS
(C) This drug is a hemorheological agent that helps blood viscosity.
A patient has been on long-term management for CHF. Which of the following drugs is considered a loop dieuretic that could be used to treat CHF symptoms? 
A: Ciprofloxacin 
B: Lepirudin 
C: Naproxen 
D: Bumex
(D) Bumex is considered a loop dieuretic.
A patient has recently been diagnosed with polio and has questions about the diagnosis. Which of the following systems is most affected by polio? 
A: PNS 
B: CNS 
C: Urinary system 
D: Cardiac system
(B) Polio is caused by a virus that attacks the CNS.
A nurse is educating a patient about right-sided heart deficits. Which of the following clinical signs is not associated with right-sided heart deficits? 
A: Orthopnea 
B: Dependent edema 
C: Ascites 
D: Nocturia
(A) Orthopnea is a left- sided heart failure clinical symptom.
A nurse is reviewing a patient's medication. Which of the following is considered a potassium sparing dieuretic? 
A: Esidrix 
B: Lasix 
C: Aldactone 
D: Edecrin
(C) Aldactone (Spironolactone) is considered a potassium sparing diuretic.
A nurse is reviewing a patient's medication. The patient is taking Digoxin. Which of the following is not an effect of Digoxin? 
A: Depressed HR 
B: Increased CO 
C: Increased venous pressure 
D: Increased contractility of cardiac muscle
(C) Digoxin decreases venous pressure.
A patient has been instructed by the doctor to reduce their intake of Potassium. Which types of foods should not worry about avoiding? 
A: Bananas 
B: Tomatoes 
C: Orange juice 
D: Apples
(D) All the others are high in potassium.
A patient's chart indicates the patient is suffering from Digoxin toxicity. Which of the following clinical signs is not associated with digoxin toxicity? 
A: Ventricular bigeminy 
B: Anorexia 
C: Normal ventricular rhythm 
D: Nausea
(C) Ventricular rhythm may be premature with Digoxin toxicity.
A fourteen year old male has just been admitted to your floor. He has a history of central abdominal pain that has moved to the right iliac fossa region. He also has tenderness over the region and a fever. Which of the following would you most likely suspect? 
A: Appendicitis 
B: Acute pancreatitis 
C: Ulcerative colitis 
D: Cholecystitis
(A) Appendicitis is most likely indicated in this case.
A thirteen-year old male has a tender lump area in his left groin. His abdomen is distended and he has been vomiting for the past 24 hours. Which of the following would you most like suspect? 
A: Ulcerative colitis 
B: Biliary colic 
C: Acute gastroenteritis 
D: Strangulated hernia
(D) A hernia is the most likely indicated in this case.
Which of the following is the key risk factor for development of Parkinson's disease dementia? 
A: History of strokes 
B: Acute headaches history 
C: Edward's syndrome 
D: Use of phenothiazines
(D) Penothiazines are considered a risk factor for Parkinson's disease dementia.
A father notifies your clinic that his son's homeroom teacher has just been diagnosed with meningitis and his son spent the day with the teacher in detention yesterday. Which of the following would be the most likely innervention? 
A: Isolation of the son
B: Treatment of the son with Aciclovir 
C: Treatment of the son with Rifampicin 
D: Reassure the father
(C) Rifampicin would be used in this case.
A patient has recently been diagnosed with hyponatremia. Which of the following is not associated with hyponatremia? 
A: Muscle twitching 
B: Anxiety 
C: Cyanosis 
D: Sticky mucous membranes
(D) Stick mucuous membranes are associated with hypernatremia.
A patient has recently been diagnosed with hypernatremia. Which of the following is not associated with hypernatremia? 
A: Hypotension 
B: Tachycardia 
C: Pitting edema 
D: Weight gain
(A) Hypotension would be associated with hyponatremia.
Which of the following normal blood therapeutic concentrations is abnormal? 
A: Phenobarbital 10-40 mcg/ml 
B: Lithium .6 - 1.2 mEq/L 
C: Digoxin .5 - 1.6 ng/ml 
D: Valproic acid 40 - 100 mcg/ml
(C) The normal ranges for Digoxin is .7 - 1.4 ng/ml.
Which of the following normal blood therapeutic concentrations is abnormal? 
A: Digitoxin 09 - 25 mcg/ml 
B: Vancomycin 05 - 15 mcg/ml 
C: Primidone 02 - 14 mcg/ml 
D: Theophylline 10 - 20 mcg/ml
(C) The normal ranges of Primidone is 04 -12 mcg/ml.
Which of the following normal blood therapeutic concentrations is abnormal? 
A: Phenytoin 10 - 20 mcg/ml 
B: Quinidine 02 - 06 mcg/ml 
C: Haloperidol 05 - 20 ng/ml 
D: Carbamazepine 5 - 25 mcg/ml
(C) The normal ranges of Carbamazepine is 10 - 20 mcg/ml.