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NCLEX-PN
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NSG4800 Comprehensive Predictor ... NCLEX-PN Test prep questions. For ... RN DaVita Final Exam
180 terms Teacher 113 terms 53 terms
Elizabeth_Whitney33 Preview TutorDk Preview nursedocmedicim
A nurse is collecting data on a B, glaucoma is characterized by increased intraocular pressure
58 year old client with blurred (IOP) resulting in compression of the optic nerve. When IOP
vision and reduced visual fields. increases rapidly sudden onset of severe eye pain can occur.
The nurse finds which clinical
manifestation MOST Gradual loss of vision and difficulty adjusting to lights are not
concerning? considered emergency situations. Opaque lenses are
A) Difficulty adjusting to dimmed characteristics of cataracts which is not a medical emergency.
lights
B) Extreme eye pain
C) Gradual loss of peripheral
vision
D) Opaque appearance of lens
The nurse is caring for a patient B, hypoglycemia occurs when blood glucose levels fall below 70
with diabetes mellitus. The client mg/dL. Conscious clients should be given 15 g of a simple
is alert and oriented but appears carbohydrate (ex. 4 oz regular soda) to quickly increase the
shaky and pale. The client's blood glucose level.
capillary blood glucose is 50
mg/dL (2.8 mmol/L). Which of IV dextrose and IM glucagon are given to patient who can not
the following actions should the digest an oral simple carbohydrate. The blood glucose should
nurse take next? be rechecked 15 minutes after administration of a simple
A) Administer 1 mg glucagon IM carbohydrate to check effectiveness.
to the patient
B) Give the patient 4 oz (120 mL
of regular soda.
C) Prepare 50 mL of dextrose
50% in water IV push.
D) Repeat the capillary blood
glucose level to verify accuracy.
,The nurse is reviewing medical A, B, D, E, the most important risk factor for cervical cancer is
histories with several clients persistent human papillomavirus (HPV) infection. Other risks
during a community health factors for cervical cancer include multiple sex partners (>1),
screening event. Which of the smoking tobacco, being infected with other STIs (chlamydia). As
following client statements these all increase the likelihood of HPV infection.
indicate a risk factor for cervical
cancer? SATA Condoms help prevent HPV, and not taking oral birth control is
A) "I have had four sexual associated with a decreased risk of cervical cancer.
partners during my lifetime."
B) "I have smoked cigarettes for
many years."
C) "I never use birth control pills
because my partners wore
condoms."
D) "I received treatment for
chlamydia when I was younger."
E) "I tested positive for human
papillomavirus a few years ago."
See an expert-written answer!
The nurse in the emergency SpO2 88% on RA (hypoxia), lung auscultation reveals bilateral
department is caring for a 66 crackles (pulmonary edema), BP 170/100 (HTN), S3 are heard on
year old client. auscultation (abnormal heart sounds), bilateral lower extremity
GENERAL: The client comes to pitting edema (peripheral edema).
the ED with fatigue, SOB, dry
cough, and exertional dyspnea Smoking and homelessness require follow-up to ensure the
for 1 week; the client is client receives appropriate resources and support, but they do
homeless; medical history not require immediate intervention.
includes chronic heart failure,
uncontrolled hypertension, Decreased O2, crackles, extra heart tones, HTN, peripheral
CAD, and type 2 DM edema require further intervention due to concern of fluid
PULMONARY: VS: RR 22, SpO2 overload and impaired gas exchange characteristics of HF.
88% on RA; the client is
dyspneic but can speak in full
sentences; lung auscultation
reveals bilateral crackles; the
client reports smoking 1 pack of
cigarettes per day for 35 years;
the client was hospitalized with
pneumonia 6 months ago.
CARDIOVASCULAR: VS: T 99 F
(37.2 C), P 90, BP 170/100;
continuous cardiac monitor
shows sinus rhythm with
occasional premature
ventricular contractions; S1, S2,
and S3 are heard on
auscultation; bilateral lower
extremity pitting edema is
noted.
Highlight below the 5 findings
that are MOST concerning.
,The nurse has reviewed the A, B, C, D, E, Decompensated HF is characterized by pulmonary
information from the Laboratory congestion (crackles, decreased O2, fluid overload [peripheral
Results and Diagnostic Results, edema]). In addition clients will have an elevated b-type
the nurse suspects the client is natriuretic peptide and low ejection fraction (<50%).
experiencing acute
decompensated HF. Which of
the following findings are
consistent with this condition?
SATA
A) Crackles with auscultation
B) Decreased capillary oxygen
saturation
C) Elevated b-type natriuretic
peptide
D) left ventricular ejection
fraction 30%
E) Lower extremity pitting
edema
The nurse should prioritize Dysrhythmias and Acute kidney injury (AKI).
interventions for acute
decompensated heart failure to Dysrhythmias are due to structural changes altering the electrical
reduce the risk of the client activity of the heart. AKI is due to hypo-perfusion (decreased
developing ____________ and perfusion) of vital organs secondary to decreased cardiac
____________. output. Both complications of decompensated HF.
Disseminated intravascular Empyema is pus in the pleural cavity due to bacteria in the lungs,
coagulation HF can cause pleural effusions, but empyema is not an expected
Bacterial endocarditis finding. Bacterial endocarditis can precipitate HF, but this client
Empyema shows no signs of infection. DIC is a life threatening condition
Dysrhythmias from abnormal blood clotting. Caused by sepsis and trauma, HF
Acute kidney injury (AKI) is not a common cause.
For each potential intervention, Expected: Daily weights, IV furosemide, Fluid restriction,
click to specify if the Supplemental oxygen, Antihypertensive medications.
intervention is expected or not Not expected:nebulized albuterol breathing treatments
expected for the care of the
client. Expected interventions for decompensated HF focus on
reducing the cardiac workload and improving oxygenation.
Potential interventions: Daily
weights, IV furosemide, Fluid Nebulized albuterol is a bronchodilator to improve oxygenation
restriction, Supplemental in clients with reactive airway disease (COPD, asthma). They will
oxygen, Antihypertensive not improve oxygenation in clients with pulmonary edema and
medications, nebulized albuterol are NOT expected for treatment of HF.
breathing treatments.
, Carvedilol: Decreases HR and Decreases BP
Enalapril: Decreases BP
Furosemide: Increased urinary output, Decreases BP and
Increases O2 saturation
For the findings below, click to Beta blockers (carvedilol) reduce cardiac workload and
specify if the finding is decrease myocardial oxygen demand by DECREASING BP and
consistent with the expected DECREASING HR
action of the medication
carvedilol, enalapril, or Angiotensin-converting enzyme (ACE) inhibitors (enalapril)
furosemide. May support more reduces circulating aldosterone, promoting vasodilation resulting
than one medication. in DECREASED BP. Aldosterone retains Na and water promoting
vasoconstriction, we want to use ACE inhibitors to prevent the
Decreases HR release of aldosterone.
Increased urinary output
Decreases BP Loop diuretics (furosemide) prevent the reabsorption of Na and
Increases O2 saturation Cl in the kidneys, INCREASING URINE OUTPUT and fluid
excretion. Decreases in fluid volume will DECREASE BP and
reduce pulmonary edema (INCREASE O2 SATURATION)
Management of HF focuses on reducing cardiac workload and
improving cardiac output.
Which of the following findings A, B, C, D
indicate that the client is Improvement in a client with HF includes improvement of fluid
improving as expected? SATA volume status and gas exchange.
A) BP 138/70 mm Hg Unilateral lower extremity edema is concerning for DVT and
B) Clear lung sounds requires immediate follow-up, as it could lead to a life
C) Increased urinary output threatening PE.
D) SpO2 95% on RA
E) Unilateral lower extremity
edema
The nurse is reinforcing B and D
information for a client with Pursed lip-breathing helps decrease SOB by preventing airway
COPD. Which statements by the collapse, promoting CO2 elimination. COPD patients should use
client indicate the this for 5-10 minutes 4 times daily.
understanding of the pursed lip
breathing technique? SATA Step 1) Relax the neck and shoulders
Step 2) Inhale deeply for 2 seconds through the nose with the
A) "I exhale for 2 seconds mouth closed.
through pursed lips." Step 3) Exhale for 4 seconds through pursed lips, as if blowing
B) "I exhale for 4 seconds through a straw. Or twice as long as inhalation.
through pursed lips."
C) "I inhale for 2 seconds
through my mouth."
D) "I inhale for 2 second through
my nose, keeping my mouth
closed."
E) "I inhale for 4 seconds
through my nose, keeping my
mouth closed."
NCLEX-PN
Save
Students also studied
Flashcard sets Study guides
NSG4800 Comprehensive Predictor ... NCLEX-PN Test prep questions. For ... RN DaVita Final Exam
180 terms Teacher 113 terms 53 terms
Elizabeth_Whitney33 Preview TutorDk Preview nursedocmedicim
A nurse is collecting data on a B, glaucoma is characterized by increased intraocular pressure
58 year old client with blurred (IOP) resulting in compression of the optic nerve. When IOP
vision and reduced visual fields. increases rapidly sudden onset of severe eye pain can occur.
The nurse finds which clinical
manifestation MOST Gradual loss of vision and difficulty adjusting to lights are not
concerning? considered emergency situations. Opaque lenses are
A) Difficulty adjusting to dimmed characteristics of cataracts which is not a medical emergency.
lights
B) Extreme eye pain
C) Gradual loss of peripheral
vision
D) Opaque appearance of lens
The nurse is caring for a patient B, hypoglycemia occurs when blood glucose levels fall below 70
with diabetes mellitus. The client mg/dL. Conscious clients should be given 15 g of a simple
is alert and oriented but appears carbohydrate (ex. 4 oz regular soda) to quickly increase the
shaky and pale. The client's blood glucose level.
capillary blood glucose is 50
mg/dL (2.8 mmol/L). Which of IV dextrose and IM glucagon are given to patient who can not
the following actions should the digest an oral simple carbohydrate. The blood glucose should
nurse take next? be rechecked 15 minutes after administration of a simple
A) Administer 1 mg glucagon IM carbohydrate to check effectiveness.
to the patient
B) Give the patient 4 oz (120 mL
of regular soda.
C) Prepare 50 mL of dextrose
50% in water IV push.
D) Repeat the capillary blood
glucose level to verify accuracy.
,The nurse is reviewing medical A, B, D, E, the most important risk factor for cervical cancer is
histories with several clients persistent human papillomavirus (HPV) infection. Other risks
during a community health factors for cervical cancer include multiple sex partners (>1),
screening event. Which of the smoking tobacco, being infected with other STIs (chlamydia). As
following client statements these all increase the likelihood of HPV infection.
indicate a risk factor for cervical
cancer? SATA Condoms help prevent HPV, and not taking oral birth control is
A) "I have had four sexual associated with a decreased risk of cervical cancer.
partners during my lifetime."
B) "I have smoked cigarettes for
many years."
C) "I never use birth control pills
because my partners wore
condoms."
D) "I received treatment for
chlamydia when I was younger."
E) "I tested positive for human
papillomavirus a few years ago."
See an expert-written answer!
The nurse in the emergency SpO2 88% on RA (hypoxia), lung auscultation reveals bilateral
department is caring for a 66 crackles (pulmonary edema), BP 170/100 (HTN), S3 are heard on
year old client. auscultation (abnormal heart sounds), bilateral lower extremity
GENERAL: The client comes to pitting edema (peripheral edema).
the ED with fatigue, SOB, dry
cough, and exertional dyspnea Smoking and homelessness require follow-up to ensure the
for 1 week; the client is client receives appropriate resources and support, but they do
homeless; medical history not require immediate intervention.
includes chronic heart failure,
uncontrolled hypertension, Decreased O2, crackles, extra heart tones, HTN, peripheral
CAD, and type 2 DM edema require further intervention due to concern of fluid
PULMONARY: VS: RR 22, SpO2 overload and impaired gas exchange characteristics of HF.
88% on RA; the client is
dyspneic but can speak in full
sentences; lung auscultation
reveals bilateral crackles; the
client reports smoking 1 pack of
cigarettes per day for 35 years;
the client was hospitalized with
pneumonia 6 months ago.
CARDIOVASCULAR: VS: T 99 F
(37.2 C), P 90, BP 170/100;
continuous cardiac monitor
shows sinus rhythm with
occasional premature
ventricular contractions; S1, S2,
and S3 are heard on
auscultation; bilateral lower
extremity pitting edema is
noted.
Highlight below the 5 findings
that are MOST concerning.
,The nurse has reviewed the A, B, C, D, E, Decompensated HF is characterized by pulmonary
information from the Laboratory congestion (crackles, decreased O2, fluid overload [peripheral
Results and Diagnostic Results, edema]). In addition clients will have an elevated b-type
the nurse suspects the client is natriuretic peptide and low ejection fraction (<50%).
experiencing acute
decompensated HF. Which of
the following findings are
consistent with this condition?
SATA
A) Crackles with auscultation
B) Decreased capillary oxygen
saturation
C) Elevated b-type natriuretic
peptide
D) left ventricular ejection
fraction 30%
E) Lower extremity pitting
edema
The nurse should prioritize Dysrhythmias and Acute kidney injury (AKI).
interventions for acute
decompensated heart failure to Dysrhythmias are due to structural changes altering the electrical
reduce the risk of the client activity of the heart. AKI is due to hypo-perfusion (decreased
developing ____________ and perfusion) of vital organs secondary to decreased cardiac
____________. output. Both complications of decompensated HF.
Disseminated intravascular Empyema is pus in the pleural cavity due to bacteria in the lungs,
coagulation HF can cause pleural effusions, but empyema is not an expected
Bacterial endocarditis finding. Bacterial endocarditis can precipitate HF, but this client
Empyema shows no signs of infection. DIC is a life threatening condition
Dysrhythmias from abnormal blood clotting. Caused by sepsis and trauma, HF
Acute kidney injury (AKI) is not a common cause.
For each potential intervention, Expected: Daily weights, IV furosemide, Fluid restriction,
click to specify if the Supplemental oxygen, Antihypertensive medications.
intervention is expected or not Not expected:nebulized albuterol breathing treatments
expected for the care of the
client. Expected interventions for decompensated HF focus on
reducing the cardiac workload and improving oxygenation.
Potential interventions: Daily
weights, IV furosemide, Fluid Nebulized albuterol is a bronchodilator to improve oxygenation
restriction, Supplemental in clients with reactive airway disease (COPD, asthma). They will
oxygen, Antihypertensive not improve oxygenation in clients with pulmonary edema and
medications, nebulized albuterol are NOT expected for treatment of HF.
breathing treatments.
, Carvedilol: Decreases HR and Decreases BP
Enalapril: Decreases BP
Furosemide: Increased urinary output, Decreases BP and
Increases O2 saturation
For the findings below, click to Beta blockers (carvedilol) reduce cardiac workload and
specify if the finding is decrease myocardial oxygen demand by DECREASING BP and
consistent with the expected DECREASING HR
action of the medication
carvedilol, enalapril, or Angiotensin-converting enzyme (ACE) inhibitors (enalapril)
furosemide. May support more reduces circulating aldosterone, promoting vasodilation resulting
than one medication. in DECREASED BP. Aldosterone retains Na and water promoting
vasoconstriction, we want to use ACE inhibitors to prevent the
Decreases HR release of aldosterone.
Increased urinary output
Decreases BP Loop diuretics (furosemide) prevent the reabsorption of Na and
Increases O2 saturation Cl in the kidneys, INCREASING URINE OUTPUT and fluid
excretion. Decreases in fluid volume will DECREASE BP and
reduce pulmonary edema (INCREASE O2 SATURATION)
Management of HF focuses on reducing cardiac workload and
improving cardiac output.
Which of the following findings A, B, C, D
indicate that the client is Improvement in a client with HF includes improvement of fluid
improving as expected? SATA volume status and gas exchange.
A) BP 138/70 mm Hg Unilateral lower extremity edema is concerning for DVT and
B) Clear lung sounds requires immediate follow-up, as it could lead to a life
C) Increased urinary output threatening PE.
D) SpO2 95% on RA
E) Unilateral lower extremity
edema
The nurse is reinforcing B and D
information for a client with Pursed lip-breathing helps decrease SOB by preventing airway
COPD. Which statements by the collapse, promoting CO2 elimination. COPD patients should use
client indicate the this for 5-10 minutes 4 times daily.
understanding of the pursed lip
breathing technique? SATA Step 1) Relax the neck and shoulders
Step 2) Inhale deeply for 2 seconds through the nose with the
A) "I exhale for 2 seconds mouth closed.
through pursed lips." Step 3) Exhale for 4 seconds through pursed lips, as if blowing
B) "I exhale for 4 seconds through a straw. Or twice as long as inhalation.
through pursed lips."
C) "I inhale for 2 seconds
through my mouth."
D) "I inhale for 2 second through
my nose, keeping my mouth
closed."
E) "I inhale for 4 seconds
through my nose, keeping my
mouth closed."
