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NCLEX-RN 515 NURSING REVIEW
EXAM
Exam A
QUESTION 1
To appropriately monitor therapy and client progress, the nurse should be
aware that increased myocardial work and O2 demand will occur with which
of the following?
A. Positive inotropic therapy
B. Negative chronotropic therapy
C. Increase in balance of myocardial O2 supply and demand
D. Afterload reduction therapy
Correct Answer: A Section: Questions Set A Explanation
Explanation/Reference:
Explanation:
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(A) Inotropic therapy will increase contractility, which will increase myocardial
O2 demand. (B) Decreased heart rate to the point of bradycardia will increase
coronary artery filling time. This should be used cautiously because
tachycardia may be a compensatory mechanism to increase cardiac output.
(C) The goal in the care of the MI client with angina is to maintain a balance
between myocardial O2 supply and demand. (D) Decrease in systemic
vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside,
or intra-aortic balloon pump therapy, would decrease myocardial work and O2
demand.
QUESTION 2
A client who has sustained a basilar skull fracture exhibits blood-tinged
drainage from his nose. After establishing a clear airway, administering
supplemental O2, and establishing IV access, the next nursing intervention
would be to:
A. Pass a nasogastric tube through the left nostril
B. Place a 4 X 4 gauze in the nares to impede the flow
C. Gently suction the nasal drainage to protect the airway
D. Perform a halo test and glucose level on the drainage
Correct Answer: D Section: Questions Set A Explanation
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Explanation/Reference:
Explanation:
(A) Basilar skull fracture may cause dural lacerations, which result in CSF
leaking from the ears or nose. Insertion of a tube could lead to CSF going into
the brain tissue or sinuses. (B) Tamponading flow could worsen the problem
and increase ICP. (C) Suction could increase brain damage and dislocate
tissue. (D) Testing the fluid from the nares would determine the presence of
CSF. Elevation of the head, notification of the medical staff, and prophylactic
antibiotics are appropriate therapy.
QUESTION 3
Which of the following medications requires close observation for
bronchospasm in the client with chronic obstructive pulmonary disease or
asthma?
A. Verapamil (Isoptin)
B. Amrinone (Inocor)
C. Epinephrine (Adrenalin)
D. Propranolol (Inderal)
Correct Answer: D
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Section: Questions Set A Explanation
Explanation/Reference:
Explanation:
(A) Verapamil has the respiratory side effect of nasal or chest congestion,
dyspnea, shortness of breath (SOB), and wheezing. (B) Amrinone has the
effect of increased contractility and dilation of the vascular smooth muscle. It
has no noted respiratory side effects. (C) Epinephrine has the effect of
bronchodilation through β stimulation. (D) Propranolol, esmolol, and labetalol
are all β- blocking agents, which can increase airway resistance and cause
bronchospasms.
QUESTION 4
Priapism may be a sign of:
A. Altered neurological function
B. Imminent death
C. Urinary incontinence
D. Reproductive dysfunction
Correct Answer: A Section: Questions Set A Explanation
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NCLEX-RN 515 NURSING REVIEW
EXAM
Exam A
QUESTION 1
To appropriately monitor therapy and client progress, the nurse should be
aware that increased myocardial work and O2 demand will occur with which
of the following?
A. Positive inotropic therapy
B. Negative chronotropic therapy
C. Increase in balance of myocardial O2 supply and demand
D. Afterload reduction therapy
Correct Answer: A Section: Questions Set A Explanation
Explanation/Reference:
Explanation:
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,https://www.stuvia.com/user/bringgoodiehttps://www.stuvia.com/user/bringgoodie2https://www.stuvia.com/user/bringgoodie
https://www.stuvia.com/user/bringgoodiehttps://www.stuvia.com/user/bringgoodie2https://www.stuvia.com/user/bringgoodie
https://www.stuvia.com/user/bringgoodiehttps://www.stuvia.com/user/bringgoodie2https://www.stuvia.com/user/bringgoodie
(A) Inotropic therapy will increase contractility, which will increase myocardial
O2 demand. (B) Decreased heart rate to the point of bradycardia will increase
coronary artery filling time. This should be used cautiously because
tachycardia may be a compensatory mechanism to increase cardiac output.
(C) The goal in the care of the MI client with angina is to maintain a balance
between myocardial O2 supply and demand. (D) Decrease in systemic
vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside,
or intra-aortic balloon pump therapy, would decrease myocardial work and O2
demand.
QUESTION 2
A client who has sustained a basilar skull fracture exhibits blood-tinged
drainage from his nose. After establishing a clear airway, administering
supplemental O2, and establishing IV access, the next nursing intervention
would be to:
A. Pass a nasogastric tube through the left nostril
B. Place a 4 X 4 gauze in the nares to impede the flow
C. Gently suction the nasal drainage to protect the airway
D. Perform a halo test and glucose level on the drainage
Correct Answer: D Section: Questions Set A Explanation
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https://www.stuvia.com/user/bringgoodiehttps://www.stuvia.com/user/bringgoodie3https://www.stuvia.com/user/bringgoodie
Explanation/Reference:
Explanation:
(A) Basilar skull fracture may cause dural lacerations, which result in CSF
leaking from the ears or nose. Insertion of a tube could lead to CSF going into
the brain tissue or sinuses. (B) Tamponading flow could worsen the problem
and increase ICP. (C) Suction could increase brain damage and dislocate
tissue. (D) Testing the fluid from the nares would determine the presence of
CSF. Elevation of the head, notification of the medical staff, and prophylactic
antibiotics are appropriate therapy.
QUESTION 3
Which of the following medications requires close observation for
bronchospasm in the client with chronic obstructive pulmonary disease or
asthma?
A. Verapamil (Isoptin)
B. Amrinone (Inocor)
C. Epinephrine (Adrenalin)
D. Propranolol (Inderal)
Correct Answer: D
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https://www.stuvia.com/user/bringgoodiehttps://www.stuvia.com/user/bringgoodie4https://www.stuvia.com/user/bringgoodie
Section: Questions Set A Explanation
Explanation/Reference:
Explanation:
(A) Verapamil has the respiratory side effect of nasal or chest congestion,
dyspnea, shortness of breath (SOB), and wheezing. (B) Amrinone has the
effect of increased contractility and dilation of the vascular smooth muscle. It
has no noted respiratory side effects. (C) Epinephrine has the effect of
bronchodilation through β stimulation. (D) Propranolol, esmolol, and labetalol
are all β- blocking agents, which can increase airway resistance and cause
bronchospasms.
QUESTION 4
Priapism may be a sign of:
A. Altered neurological function
B. Imminent death
C. Urinary incontinence
D. Reproductive dysfunction
Correct Answer: A Section: Questions Set A Explanation
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