ADVANCED COMPREHENSIVE NCLEX-RN PRACTICE EXAM #1

ADVANCED COMPREHENSIVE NCLEX-RN PRACTICE EXAM #1 1.During a community health assessment at a local school’s parent-teacher conference, the nurse encounters several parents and caregivers. Based on their shared histories and lifestyles, the nurse determines the risk factors for hypertension among them. Which of the following individuals is at the HIGHEST risk for developing hypertension? A. A 45-year-old African-American attorney with a family history of hypertension, who has a sedentary lifestyle, consumes a diet high in sodium, and recently had a significant weight gain. B. A 60-year-old Asian-American shop owner with a BMI of 28, who has well-managed type 2 diabetes, takes medications for high cholesterol, and engages in regular physical activity. C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is a non-smoker but reports high levels of work-related stress and consumes excessive amounts of caffeine. D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy BMI, participates in a moderate-intensity exercise program, and recently started taking oral contraceptives. E. A 50-year-old Middle Eastern engineer with a BMI of 26, who has a family history of cardiovascular diseases, does not engage in any form of exercise, and has recently been diagnosed with obstructive sleep apnea. F. A 52-year-old Native American artist with a family history of kidney disease, who smokes a pack of cigarettes daily, drinks alcohol excessively, and reports infrequent physical activity. G. A 43-year-old European baker who has a BMI of 30, often deals with job-related stress, consumes a diet rich in pastries and sweets, and has a sedentary lifestyle due to long work hours. 2. A 15-year-old female with a history of depression is brought to the emergency department. Nurse’s Notes: 1115: A 15-year-old female with a history of depression and recent relationship troubles with her close friends is brought to the emergency department by her concerned parents after they found an empty bottle of maximum-strength acetaminophen in her room. Upon questioning, the patient tearfully admits to ingesting 15 tablets of the medication 45 minutes ago. She is visibly anxious and frequently looks at the marks on her wrists, which seem to be superficial scratches. Vital signs as of 1115: Blood pressure: 120/70 Heart rate: 88 bpm Respiratory rate: 18 bpm Oxygen saturation: 98% on room air As the nurse prepares to address the situation, several orders from the primary care provider come in. Which of the following orders should the nurse prioritize and carry out first? A. Perform gastric lavage B. Administer acetylcysteine (Mucomyst) orally C. Start an IV with Dextrose 5% and 0.33% normal saline D. Have the patient drink activated charcoal mixed with water E. Conduct a psychiatric evaluation. F. Apply wrist restraints to prevent further self-harm. 3. A 68-year-old male with a history of hypertension and diabetes has undergone a cardiac catheterization to evaluate potential coronary artery disease. He has a known allergy to iodine-based contrast agents, which required premedication with corticosteroids and antihistamines. The procedure was successful, but the patient experienced brief hypotension during the administration of the contrast material. The patient has been transferred to the cardiac step-down unit for observation, and the nurse is aware of the potential complications that can arise in the initial 24 hours post-procedure. Which complication should the nurse monitor closely during this period? A. Persistent angina despite being at rest and receiving nitroglycerin B. Thrombus formation leading to decreased peripheral pulses and cyanosis