NCLEX-RN Practice Quiz Test Bank #1 (75 Questions)

NCLEX-RN Practice Quiz Test Bank #1 (75 Questions) NCLEXRN-01-001 Question Tag: hypertension Question Category: Physiological Integrity, Reduction of Risk Potential Which individual is at greatest risk for developing hypertension? • A. 45-year-old African-American attorney • B. 60-year-old Asian-American shop owner • C. 40-year-old Caucasian nurse • D. 55-year-old Hispanic teacher Correct Answer: A: 45-year-old African American attorney • Option A: African-Americans develop high blood pressure at younger ages than other groups in the US. Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension. • Option B: The incidence of hypertension in Asian-Americans does not appear to be significantly higher than the general population, according to limited US data. • Option C: The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African-Americans with greater risks than Caucasians. • Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity. NCLEXRN-01-002 Question Tag: acetaminophen Question Category: Physiological Integrity, Pharmacological and Parenteral Therapies A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first? • A. Gastric lavage • B. Administer acetylcysteine (Mucomyst) orally • C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open • D. Have the patient drink activated charcoal mixed with water Correct Answer: A. Gastric lavage • Option A: Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life-threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion. • Option B: The oral formulation of acetylcysteine is the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetylcysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen to its nontoxic form. When given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally or intravenously. • Option C: Intermittent IV infusion with Dextrose 5% may be considered for late-presenting or chronic ingestion. • Option D: Oral activated charcoal (AC) avidly adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes since it can effectively adsorb it and neutralize the benefits. NCLEXRN-01-003