NCLEX-RN Practice Quiz Test Bank #3 (75 Questions)

NCLEX-RN Practice Quiz Test Bank #3 (75 Questions) NCLEXRN-03-001 Question Category: Pharmacological and Parenteral Therapies Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy? • A. Antihypertensive • B. Beta-adrenergic blockers • C. Calcium channel blockers • D. Nitrates Correct Answer: B. Beta-adrenergic blockers By decreasing the heart rate and contractility, beta-adrenergic blockers improve myocardial filling and cardiac output, which are primary goals in the treatment of cardiomyopathy. • Option A: Antihypertensives aren’t usually indicated because they would decrease cardiac output in clients who are often already hypotensive. Many antihypertensive drugs have their primary action on systemic vascular resistance. Some of these drugs produce vasodilation by interfering with sympathetic adrenergic vascular tone (sympatholytics) or by blocking the formation of angiotensin II or its vascular receptors. • Option C: Calcium channel blockers are sometimes used for the same reasons as beta-adrenergic blockers; however, they aren’t as effective as beta-adrenergic blockers and cause increased hypotension. These channels are responsible for regulating the influx of calcium into muscle cells, which in turn stimulates smooth muscle contraction and cardiac myocyte contraction. In cardiac nodal tissue, L-type calcium channels play an important role in and in phase 0 of the action potentials. • Option D: Nitrates aren’t used because of their dilating effects, which would further compromise the myocardium. Nitrates exert their effects by dilating venous vessels, coronary arteries, and small arterioles; its maximal vasodilation is in the venous vessels. Question Tag: Parkinson’s disease Question Category: Safe and Effective Care Environment, Management of Care A patient with Parkinson’s disease has a nursing diagnosis of Impaired Physical Mobility related to neuromuscular impairment. You observe a nursing assistant performing all of these actions. For which action must you intervene? • A. The NA assists the patient to ambulate to the bathroom and back to bed. • B. The NA reminds the patient not to look at his feet when he is walking. • C. The NA performs the patient’s complete bath and oral care. • D. The NA sets up the patient’s tray and encourages the patient to feed himself. Correct Answer: C. The NA performs the patient’s complete bath and oral care. The nursing assistant should assist the patient with morning care as needed, but the goal is to keep this patient as independent and mobile as possible. • Option A: Assisting the patient to ambulate prevents incidences of fall and injury. • Option B: Reminding the patient not to look at his feet while walking maintains the client’s independence while keeping him safe. • Option D: Encouraging the patient to feed himself is an appropriate goal of maintaining independence. NCLEXRN-03-002 Question Tag: low back pain Question Category: Health Promotion and Maintenance The nurse is preparing to discharge a patient with chronic low back pain. Which statement by the patient indicates that additional teaching is necessary? • A. “I will avoid exercise because the pain gets worse.” • B. “I will use heat or ice to help control the pain.” • C. “I will not wear high-heeled shoes at home or work.” • D. “I will purchase a firm mattress to replace my old one.” Correct Answer: A. “I will avoid exercise because the pain gets worse.” Exercises are used to strengthen the back, relieve pressure on compressed nerves and protect the back from re-injury. Doing exercises to strengthen the lower back can help alleviate and prevent lower back pain. It can also strengthen the core, leg, and arm muscles. According to researchers, exercise also increases blood flow to the lower back area, which may reduce stiffness and speed up the healing process. • Option B: Ice and heat application are appropriate interventions for back pain. Applying ice or a reusable gel pack constricts blood vessels and reduces swelling around the injury. This is particularly useful for conditions, like a sprained ankle, that cause significant swelling. Heat has the opposite effect, increasing blood flow to the area. This relaxes muscle fibers, which can help when the client experiences spasms or stiffness.