NCLEX RN EXAM QUESTIONS & ANSWERS UPDATE
1. Question
A patient is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nurse checking the patient’s lab resultswould expect
which of the following changes in laboratory findings?
o A. Elevated serum calcium
o B. Low serum parathyroid hormone (PTH)
o C. Elevated serum vitamin D
o D. Low urine calcium
,
,client should include complex carbohydrates in hisdiet,
including grains.
o Option B: A high protein diet is recommended for theclient
with Addison’s disease. The adrenal fatigue dietaims to
stabilize blood sugar and balance cortisol levels by limiting
sugar while increasing the intake of protein, healthy fats,
veggies, and whole grains. Healthy fats and high-quality
proteins slow the blood sugar rollercoaster and promote
stable blood sugar levels throughout the day.
o Option C: Adequate caloric intake is recommended.
Refined carbohydrates quickly break down into sugarafter
you ingest them, which causes a spike in blood sugar
followed by a steep decline. The diet discourages foods
that are inflammatory or hard todigest and may contribute
to gut health issues. Theadrenal fatigue diet is more about
eating more foodsthat make the client feel good and nourish
the body versus restricting.
• 3. Question
A patient with a history of diabetes mellitus is in the second postoperative day
following cholecystectomy. She has complained of nausea and isn’t able to
eat solid foods. The nurseenters the room to find the patient confused and
shaky. Which ofthe following is the most likely explanation for the patient’s
symptoms?
o A. Anesthesia reaction
o B. Hyperglycemia
o C. Hypoglycemia
o D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic patient who is unable to eat is likely to be suffering
from hypoglycemia. The actual treatment recommendations for a given
patient should be individualized, based on diabetes classification, usual
diabetes regimen, state of
, glycemic control, nature and extent of surgical procedure, andavailable
expertise.
o Option A: An anesthesia reaction would not occur on the
second postoperative day. Anesthesia and surgery cause a
stereotypical metabolic stress response that could overwhelm
homeostatic mechanisms in patients with pre-existing
abnormalities of glucose metabolism.The invariant features
of the metabolic stress response include release of the
catabolic hormones epinephrine, norepinephrine, cortisol,
glucagons, and growth hormone and inhibition of insulin
secretion andaction.
o Option B: Confusion is a late sign of hyperglycemia.
Shakiness is not one of its symptoms. The management
approach in these categories of patients always includes
insulin therapy in combination with dextrose and potassium
infusion. Major surgery is defined as one requiring general
anesthesia of ?1 h. Ata minimum, blood glucose should be
monitored beforeand immediately after surgery in all patients.
Those undergoing extensive procedures should have hourly
glucose monitoring during and immediately following
surgery.
o Option D: Symptoms of DKA include excessive thirst,
frequent urination, abdominal pain, fruity-scented breath,
confusion, and shortness of breath. However, shakiness is not
a sign of DKA. The stress of surgery itself results in
metabolic perturbations that alter glucose homeostasis, and
persistent hyperglycemia isa risk factor for endothelial
dysfunction, postoperativesepsis, impaired wound healing,
and cerebral ischemia. The stress response itself may
precipitate diabetic crises (diabetic ketoacidosis [DKA].
• 4. Question
A nurse assigned to the emergency department evaluates a patient who
underwent fiberoptic colonoscopy 18 hours previously. The patient reports
increasing abdominal pain, fever,and chills. Which of the following
conditions poses
the most immediate concern?
1. Question
A patient is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nurse checking the patient’s lab resultswould expect
which of the following changes in laboratory findings?
o A. Elevated serum calcium
o B. Low serum parathyroid hormone (PTH)
o C. Elevated serum vitamin D
o D. Low urine calcium
,
,client should include complex carbohydrates in hisdiet,
including grains.
o Option B: A high protein diet is recommended for theclient
with Addison’s disease. The adrenal fatigue dietaims to
stabilize blood sugar and balance cortisol levels by limiting
sugar while increasing the intake of protein, healthy fats,
veggies, and whole grains. Healthy fats and high-quality
proteins slow the blood sugar rollercoaster and promote
stable blood sugar levels throughout the day.
o Option C: Adequate caloric intake is recommended.
Refined carbohydrates quickly break down into sugarafter
you ingest them, which causes a spike in blood sugar
followed by a steep decline. The diet discourages foods
that are inflammatory or hard todigest and may contribute
to gut health issues. Theadrenal fatigue diet is more about
eating more foodsthat make the client feel good and nourish
the body versus restricting.
• 3. Question
A patient with a history of diabetes mellitus is in the second postoperative day
following cholecystectomy. She has complained of nausea and isn’t able to
eat solid foods. The nurseenters the room to find the patient confused and
shaky. Which ofthe following is the most likely explanation for the patient’s
symptoms?
o A. Anesthesia reaction
o B. Hyperglycemia
o C. Hypoglycemia
o D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic patient who is unable to eat is likely to be suffering
from hypoglycemia. The actual treatment recommendations for a given
patient should be individualized, based on diabetes classification, usual
diabetes regimen, state of
, glycemic control, nature and extent of surgical procedure, andavailable
expertise.
o Option A: An anesthesia reaction would not occur on the
second postoperative day. Anesthesia and surgery cause a
stereotypical metabolic stress response that could overwhelm
homeostatic mechanisms in patients with pre-existing
abnormalities of glucose metabolism.The invariant features
of the metabolic stress response include release of the
catabolic hormones epinephrine, norepinephrine, cortisol,
glucagons, and growth hormone and inhibition of insulin
secretion andaction.
o Option B: Confusion is a late sign of hyperglycemia.
Shakiness is not one of its symptoms. The management
approach in these categories of patients always includes
insulin therapy in combination with dextrose and potassium
infusion. Major surgery is defined as one requiring general
anesthesia of ?1 h. Ata minimum, blood glucose should be
monitored beforeand immediately after surgery in all patients.
Those undergoing extensive procedures should have hourly
glucose monitoring during and immediately following
surgery.
o Option D: Symptoms of DKA include excessive thirst,
frequent urination, abdominal pain, fruity-scented breath,
confusion, and shortness of breath. However, shakiness is not
a sign of DKA. The stress of surgery itself results in
metabolic perturbations that alter glucose homeostasis, and
persistent hyperglycemia isa risk factor for endothelial
dysfunction, postoperativesepsis, impaired wound healing,
and cerebral ischemia. The stress response itself may
precipitate diabetic crises (diabetic ketoacidosis [DKA].
• 4. Question
A nurse assigned to the emergency department evaluates a patient who
underwent fiberoptic colonoscopy 18 hours previously. The patient reports
increasing abdominal pain, fever,and chills. Which of the following
conditions poses
the most immediate concern?
