NCLEX-RN Practice Quiz Test Bank #10 (75
Questions)
1. 1. Question
The nurse should visit which of the following clients first?
o A. The client with diabetes with a blood glucose of 95mg/dL
o B. The client with hypertension being maintained on Lisinopril
o C. The client with chest pain and a history of angina
o D. The client with Raynaud’s disease
Incorrect
Correct Answer: C. The client with chest pain and a history of
angina
The client with chest pain should be seen first because this could
indicate a myocardial infarction. Despite many advances in treatment,
acute MI still carries a mortality rate of 5-30%; the majority of deaths
occur prior to arrival to the hospital. In addition, within the first year
after an MI, there is an additional mortality rate of 5% to 12%. The
overall prognosis depends on the extent of heart muscle damage and
ejection fraction.
Option A: The client in answer A has blood glucose within
normal limits. The diagnosis of T1DM is usually through a
characteristic history supported by elevated serum glucose levels
(fasting glucose greater than 126 mg/dL, random glucose over
200 mg/dL, or hemoglobin A1C (HbA1c exceeding 6.5%) with or
without antibodies to glutamic acid decarboxylase (GAD) and
insulin.
Option B: The client in this option is maintained on blood
pressure medication. Pharmacological therapy consists of
angiotensin-converting enzyme inhibitors (ACEi), angiotensin
receptor blockers (ARBs), diuretics (usually thiazides), calcium
channel blockers (CCBs), and beta-blockers (BBs), which are
instituted taking into account age, race, and comorbidities such
as presence of renal dysfunction, LV dysfunction, heart failure,
and cerebrovascular disease. JNC-8, ACC, and ESC/ ESH have
, their separate recommendations for pharmacological
management.
Option D: The client in answer D is in no distress. In Raynaud
phenomenon, blood-flow restriction occurs during cold
temperatures and emotional stress. Specifically, in Raynaud
phenomenon, there is vasoconstriction of the digital arteries and
cutaneous arterioles.
2. 2. Question
A client with cystic fibrosis is taking pancreatic enzymes. The nurse
should administer this medication:
A. Once per day in the morning
B. Three times per day with meals
C. Once per day at bedtime
D. Four times per day
Incorrect
Correct Answer: B. Three times per day with meals
Pancreatic enzymes should be given with meals for optimal effects.
These enzymes assist the body in digesting needed nutrients. Chronic,
supportive therapy for patients with CF includes regular pancreatic
enzymes, fat-soluble vitamins (A, D, E, K), mucolytics, bronchodilators,
antibiotics, and anti-inflammatory agents.
Option A: A new class of medications known as CFTR modulator
therapies is designed to correct the dysfunction by improving
production, intracellular processing, or function of the CFTR
protein caused by the mutated gene. Each medication is targeted
at a specific dysfunction caused by a specific gene mutation.
Option C: Individuals with CF are encouraged to consume a high-
fat diet with supplemental fat-soluble vitamins to compensate for
malabsorption. Additionally, patients living with CF are
encouraged to consume a high-calorie diet to maintain a healthy
weight and combat chronic inflammation and frequent infections
that are commonly encountered.
Option D: According to the Cystic Fibrosis Foundation, women
should consume 2500 to 3000 calories a day, while men should
consume 3000 to 3700 calories a day. Those living in hot
, climates or who participate in activities that cause sweating are
encouraged to consume additional sodium in their diet.
3. 3. Question
Cataracts result in the opacity of the crystalline lens. Which of the
following best explains the functions of the lens?
A. The lens controls stimulation of the retina.
B. The lens orchestrates eye movement.
C. The lens focuses light rays on the retina.
D. The lens magnifies small objects.
Incorrect
Correct Answer: C. The lens focuses light rays on the retina.
The lens allows light to pass through the pupil and focus light on the
retina. The lens is a curved structure in the eye that bends light and
focuses it for the retina to help you see images clearly. The crystalline
lens, a clear disk behind the iris, is flexible and changes shape to help
you see objects at varying distances.
Option A: Retinal tissue is stimulated by light but also responds
to mechanical disturbances. Flashing lights usually are caused by
separation of the posterior vitreous. As the vitreous gel separates
from the retina, it stimulates the retinal tissue mechanically,
resulting in the release of phosphenes and the sensation of light.
Option B: Because only a small portion of the retina, the fovea,
is actually employed for distinct vision, it is vitally important that
the motor apparatus governing the direction of gaze be
extremely precise in its operation, and rapid.
Option D: The lens works much like a camera lens, bending and
focusing light to produce a clear image. The crystalline lens is a
convex lens that creates an inverted image focused on the retina.
The brain flips the image back to normal to create what you see
around you. In a process called accommodation, the elasticity of
the crystalline lens allows you to focus on images at far distances
and near with minimal disruption.
4. 4. Question
A client who has glaucoma is to have miotic eye drops instilled in both
eyes. The nurse knows that the purpose of the medication is to:
, A. Anesthetize the cornea
B. Dilate the pupils
C. Constrict the pupils
D. Paralyze the muscles of accommodation
Incorrect
Correct Answer: C. Constrict the pupils
Miotic eye drops constrict the pupil and allow aqueous humor to drain
out of the Canal of Schlemm. Pilocarpine is a muscarinic acetylcholine
agonist that is effective in the treatment and management of acute
angle-closure glaucoma and radiation-induced xerostomia. Although
not a first-line treatment for glaucoma, it is useful as an adjunct
medication in the form of ophthalmic drops.
Option A: The cornea and conjunctiva can be anesthetized by
drops of any of the local anesthetics. Bupivacaine, for example, is
effective as an eyedrop. Bupivacaine is a potent local anesthetic
with unique characteristics from the amide group of local
anesthetics, first discovered in 1957. Local anesthetics are used
in regional anesthesia, epidural anesthesia, spinal anesthesia,
and local infiltration. Local anesthetics generally block the
generation of an action potential in nerve cells by increasing the
threshold for electrical excitation.
Option B: The eye doctor may dilate the pupils with a special
medication called a mydriatic, so they can see the inside of the
eye during a slit lamp test. Typically, mydriasis reverses within 4
to 8 hours. However, it may take 24 hours for the mydriatic effect
to wear off in some individuals. Weaker strength may cause
mydriasis with little cycloplegia.
Option D: Scopolamine ophthalmic is an anticholinergic agent
that blocks constriction of sphincter muscle of iris and ciliary
body muscle, which, in turn, results in mydriasis (dilation) and
cycloplegia (paralysis of accommodation). Scopolamine
competitively inhibits G-protein coupled post-ganglionic
muscarinic receptors for acetylcholine and acts as a nonselective
muscarinic antagonist, producing both peripheral antimuscarinic
properties and central sedative, antiemetic, and amnestic effects.
5. 5. Question
Questions)
1. 1. Question
The nurse should visit which of the following clients first?
o A. The client with diabetes with a blood glucose of 95mg/dL
o B. The client with hypertension being maintained on Lisinopril
o C. The client with chest pain and a history of angina
o D. The client with Raynaud’s disease
Incorrect
Correct Answer: C. The client with chest pain and a history of
angina
The client with chest pain should be seen first because this could
indicate a myocardial infarction. Despite many advances in treatment,
acute MI still carries a mortality rate of 5-30%; the majority of deaths
occur prior to arrival to the hospital. In addition, within the first year
after an MI, there is an additional mortality rate of 5% to 12%. The
overall prognosis depends on the extent of heart muscle damage and
ejection fraction.
Option A: The client in answer A has blood glucose within
normal limits. The diagnosis of T1DM is usually through a
characteristic history supported by elevated serum glucose levels
(fasting glucose greater than 126 mg/dL, random glucose over
200 mg/dL, or hemoglobin A1C (HbA1c exceeding 6.5%) with or
without antibodies to glutamic acid decarboxylase (GAD) and
insulin.
Option B: The client in this option is maintained on blood
pressure medication. Pharmacological therapy consists of
angiotensin-converting enzyme inhibitors (ACEi), angiotensin
receptor blockers (ARBs), diuretics (usually thiazides), calcium
channel blockers (CCBs), and beta-blockers (BBs), which are
instituted taking into account age, race, and comorbidities such
as presence of renal dysfunction, LV dysfunction, heart failure,
and cerebrovascular disease. JNC-8, ACC, and ESC/ ESH have
, their separate recommendations for pharmacological
management.
Option D: The client in answer D is in no distress. In Raynaud
phenomenon, blood-flow restriction occurs during cold
temperatures and emotional stress. Specifically, in Raynaud
phenomenon, there is vasoconstriction of the digital arteries and
cutaneous arterioles.
2. 2. Question
A client with cystic fibrosis is taking pancreatic enzymes. The nurse
should administer this medication:
A. Once per day in the morning
B. Three times per day with meals
C. Once per day at bedtime
D. Four times per day
Incorrect
Correct Answer: B. Three times per day with meals
Pancreatic enzymes should be given with meals for optimal effects.
These enzymes assist the body in digesting needed nutrients. Chronic,
supportive therapy for patients with CF includes regular pancreatic
enzymes, fat-soluble vitamins (A, D, E, K), mucolytics, bronchodilators,
antibiotics, and anti-inflammatory agents.
Option A: A new class of medications known as CFTR modulator
therapies is designed to correct the dysfunction by improving
production, intracellular processing, or function of the CFTR
protein caused by the mutated gene. Each medication is targeted
at a specific dysfunction caused by a specific gene mutation.
Option C: Individuals with CF are encouraged to consume a high-
fat diet with supplemental fat-soluble vitamins to compensate for
malabsorption. Additionally, patients living with CF are
encouraged to consume a high-calorie diet to maintain a healthy
weight and combat chronic inflammation and frequent infections
that are commonly encountered.
Option D: According to the Cystic Fibrosis Foundation, women
should consume 2500 to 3000 calories a day, while men should
consume 3000 to 3700 calories a day. Those living in hot
, climates or who participate in activities that cause sweating are
encouraged to consume additional sodium in their diet.
3. 3. Question
Cataracts result in the opacity of the crystalline lens. Which of the
following best explains the functions of the lens?
A. The lens controls stimulation of the retina.
B. The lens orchestrates eye movement.
C. The lens focuses light rays on the retina.
D. The lens magnifies small objects.
Incorrect
Correct Answer: C. The lens focuses light rays on the retina.
The lens allows light to pass through the pupil and focus light on the
retina. The lens is a curved structure in the eye that bends light and
focuses it for the retina to help you see images clearly. The crystalline
lens, a clear disk behind the iris, is flexible and changes shape to help
you see objects at varying distances.
Option A: Retinal tissue is stimulated by light but also responds
to mechanical disturbances. Flashing lights usually are caused by
separation of the posterior vitreous. As the vitreous gel separates
from the retina, it stimulates the retinal tissue mechanically,
resulting in the release of phosphenes and the sensation of light.
Option B: Because only a small portion of the retina, the fovea,
is actually employed for distinct vision, it is vitally important that
the motor apparatus governing the direction of gaze be
extremely precise in its operation, and rapid.
Option D: The lens works much like a camera lens, bending and
focusing light to produce a clear image. The crystalline lens is a
convex lens that creates an inverted image focused on the retina.
The brain flips the image back to normal to create what you see
around you. In a process called accommodation, the elasticity of
the crystalline lens allows you to focus on images at far distances
and near with minimal disruption.
4. 4. Question
A client who has glaucoma is to have miotic eye drops instilled in both
eyes. The nurse knows that the purpose of the medication is to:
, A. Anesthetize the cornea
B. Dilate the pupils
C. Constrict the pupils
D. Paralyze the muscles of accommodation
Incorrect
Correct Answer: C. Constrict the pupils
Miotic eye drops constrict the pupil and allow aqueous humor to drain
out of the Canal of Schlemm. Pilocarpine is a muscarinic acetylcholine
agonist that is effective in the treatment and management of acute
angle-closure glaucoma and radiation-induced xerostomia. Although
not a first-line treatment for glaucoma, it is useful as an adjunct
medication in the form of ophthalmic drops.
Option A: The cornea and conjunctiva can be anesthetized by
drops of any of the local anesthetics. Bupivacaine, for example, is
effective as an eyedrop. Bupivacaine is a potent local anesthetic
with unique characteristics from the amide group of local
anesthetics, first discovered in 1957. Local anesthetics are used
in regional anesthesia, epidural anesthesia, spinal anesthesia,
and local infiltration. Local anesthetics generally block the
generation of an action potential in nerve cells by increasing the
threshold for electrical excitation.
Option B: The eye doctor may dilate the pupils with a special
medication called a mydriatic, so they can see the inside of the
eye during a slit lamp test. Typically, mydriasis reverses within 4
to 8 hours. However, it may take 24 hours for the mydriatic effect
to wear off in some individuals. Weaker strength may cause
mydriasis with little cycloplegia.
Option D: Scopolamine ophthalmic is an anticholinergic agent
that blocks constriction of sphincter muscle of iris and ciliary
body muscle, which, in turn, results in mydriasis (dilation) and
cycloplegia (paralysis of accommodation). Scopolamine
competitively inhibits G-protein coupled post-ganglionic
muscarinic receptors for acetylcholine and acts as a nonselective
muscarinic antagonist, producing both peripheral antimuscarinic
properties and central sedative, antiemetic, and amnestic effects.
5. 5. Question
