NCLEX-PN REVIEW QUESTIONS WITH COMPLETE SOLUTIONS RATED A+

The nurse is taking the health history of a patient being treated for Emphysema and Chronic Bronchitis. After being told the patient has been smoking cigarettes for 30 years, the nurse expects to note which assessment finding? 1. Increase in Forced Vital Capacity (FVC) 2. A narrowed chest cavity 3. Clubbed fingers 4. An increased risk of cardiac failure - ANSWER 3. Clubbed fingers - CORRECT Clubbed fingers are a sign of a long-term, or chronic, decrease in oxygen levels. The nurse is taking the health history of a 70-year-old patient being treated for a Duodenal Ulcer. After being told the patient is complaining of epigastric pain, the nurse expects to note which assessment finding? 1. Melena 2. Nausea 3. Hernia 4. Hyperthermia - ANSWER 1. Melena - CORRECT Melena is the finding that there are traces of blood in the stool which presents as black, tarry feces. This is a common manifestation of Duodenal Ulcers, since the Duodenum is further down the gastric anatomy. A nurse is providing discharge teaching for a patient with severe Gastroesophogeal Reflux Disease. Which of these statements by the patient indicates a need for more teaching? 1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion." 2. "I'm going to make sure to remain upright after meals and elevate my head when I sleep" 3. "I won't be drinking tea or coffee or eating chocolate any more." 4. "I'm going to start trying to lose some weight." - ANSWER 1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion." CORRECT - Large meals increase the volume and pressure in the stomach and delay gastric emptying. It's recommended instead to eat 4-6 small meals a day. The nurse in the Emergency Room is treating a patient suspected to have a Peptic Ulcer. On assessing lab results, the nurse finds that the patient's blood pressure is 95/60, pulse is 110 beats per minute, and the patient reports epigastric pain. What is the PRIORITY intervention? 1. Start a large-bore IV in the patient's arm 2. Ask the patient for a stool sample 3. Prepare to insert an NG Tube 4. Administer intramuscular morphine sulphate as ordered - ANSWER 1. Start a large-bore IV in the patient's arm CORRECT - The nurse should suspect that the patient is haemorrhaging and will need need a fluid replacement therapy, which requires a large bore IV. A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical and should be reported to the physician immediately? 1. Hemoglobin 11 g/dl 2. Platelet of 150,000 3. INR of 2.5 4. Potassium of 2.7 mEq/L - ANSWER 4. Potassium of 2.7 mEq/L CORRECT - A potassium imbalance for a patient with a history of dysrhythmia can be life-threatening and can lead to cardiac distress. While receiving normal saline infusions to treat a GI bleed, the nurse notes that the patient's lower legs have become edematous and auscultates crackles in the lungs. What should the nurse do first? 1. Stop the saline infusion immediately 2. Notify Physician 3. Elevate the patient's legs 4. Continue the infusion, since these are normal findings - ANSWER 1. Stop the saline infusion immediately CORRECT - the patient has a fluid volume overload as a result of overly rapid fluid replacement. The nurse should stop the infusion and notify the physician. The nurse is working in a support group for clients with HIV. Which point is most important for the nurse to stress? 1. They must inform household members of their condition 2. They must take their medications exactly as prescribed 3. They must abstain from substance use 4. They must avoid large crowds - ANSWER 2. They must take their medications exactly as prescribed CORRECT - Antiretrovirals must be taken exactly as prescribed to prevent drug-resistant strains. Even missed doses can reduce the effectiveness of future treatment. A nurse finds a 30-year-old woman experiencing anaphylaxis from a bee sting. Emergency personnel have been called. The nurse notes the woman is breathing but short of breath. Which of the following interventions should the nurse do first? 1. Initiate cardiopulmonary resuscitation 2. Check for a pulse 3. Ask the woman if she carries an emergency medical kit 4. Stay with the woman until help comes - ANSWER 3. Ask the woman if she carries an emergency medical kit CORRECT - Many patients who have a known history of anaphylaxis carry epi-pens in their pockets or belongings. This is the best way to stop a hypersensitivity reaction before it becomes life-threatening. A man is prescribed lithium to treat bipolar disorder. The nurse is most concerned about lithium toxicity when he notices which of these assessment findings? 1. The patient states he had a manic episode a week ago 2. The patient states he has been having diarrhea every day 3. The patient has a rashy pruritis on his arms and legs 4. The patient presents as severely depressed 5. The patient's lithium level is 1.3 mcg/L - ANSWER 2. The patient states he has been having diarrhea every day Correct - Persistent diarrhea can lead to dehydration, which can increase the risk of lithium toxicity.