NCLEX-PN Review Questions and Accurate Answers

The nurse is taking the health history of a patient being treated for sickle cell disease. After being told the patient has severe generalized pain, the nurse expects to note which assessment finding? 1. Severe and persistent diarrhea 2. Intense pain in the toe 3. Yellow-tinged sclera 4. Headache ️️ 3. Yellow-tinged sclera Correct - Jaundice is a common clinical finding of sickle cell disease, caused by bilirubin released from damaged or destroyed RBCs A client with Multiple Sclerosis reports a constant, burning, tingling pain in the shoulders. The nurse anticipates that the physician will order which medication for this type of pain? 1. alprazolam (Xanax) 2. Corticosteroid injection 3. gabapentin (Neurontin) 4. hydrocodone/acetaminophen (Norco) ️️ 3. gabapentin (Neurontin) Correct - Anticonvulsants like gabapentin are often the first line of treatment for nerve pain Which of these clients is likely to receive sublingual morphine? 1. A 75-year-old woman in a hospice program 2. A 40-year-old man who just had throat surgery 3. A 20-year-old woman with trigeminal neuralgia 4. A 60-year-old man who has a painful incision ️️ 1. A 75-year-old woman in a hospice program Correct - Sublingual morphine is often used in hospice because the patients are unable to swallow, and intravenous access can be painful and not conducive to palliative care. In educating clients on ways to manage pain, which topic can be appropriately delegated to a LPN/LVN who will continue under supervision? 1. Acupuncture 2. Guided Imagery 3. Alternating Rest/Activity 4. Over the counter medications ️️ 3. Alternating Rest/Activity Correct - This is within the nursing scope of practice and within the training and education provided to all nurses. It is safe to use and a standard treatment. The nurse assesses a patient suspected of having an asthma attack. Which of the following is a common clinical manifestation of this condition? 1. Audible crackles and orthopnea 2. An audible wheeze and use of accessory muscles 3. Audible crackles and use of accessory muscles 4. Audible wheeze and orthopnea ️️ 2. An audible wheeze and use of accessory muscles Correct - Both of these are associated with asthma. The nurse assesses a patient suspected of having meningitis. Which of the following is a common clinical manifestation of this condition? 1. A high WBC count and decreased level of consciousness 2. A high WBC count and manic activity 3. A low WBC count and manic activity 4. A low WBC count and decreased level of consciousness ️️ 1. A high WBC count and decreased level of consciousness Correct - Meningitis is most often cause by an infectious organism, increasing the WBC count. One defining feature is an increased Intracranial Pressure (ICP) which presents as a decreased level of consciousness. A patient is being treated in the Neurology Unit for Meningitis. Which of these is a priority assessment for the nurse to make? 1. Assess the patient for nuchal rigidity 2. Determine the patient's past exposure to infectious organisms 3. Check the patient's WBC lab values 4. Monitor for increased lethargy and drowsiness ️️ 4. Monitor for increased lethargy and drowsiness Correct - Lethargy and drowsiness indicate a decreased level of consciousness, which is the cardinal sign of increased ICP (Intracranial Pressure), which can be life-threatening. The nurse is caring for clients in the pediatric unit. A 6-year patient is admitted who has 2nd and 3rd degree burns on his arms. The nurse should assign the new patient to which of the following roommates? 1. A 4-year old with sickle-cell disease 2. A 12-year old with chickenpox 3. A 6-year old undergoing chemotherapy 4. A 7-year old with a high temperature ️️ 1. A 4-year old with sickle-cell disease Correct - The nurse should be concerned about the burn patient's vulnerability to infection. Sickle cell disease is not a communicable disease. A patient with Meningitis is being treated with Vancomycin intravenously 3 times per day. The nurse notes that the urine output during the last 8 hours was 200mL. What is the nurse's priority action? 1. Check the patient's last BUN 2. Ask the patient to increase their fluid intake 3. Ask the physician to order a diuretic 4. Notify the physician of this finding ️️ 4. Notify the physician of this finding Correct - Vancomycin is a nephrotoxic drug and can cause impaired renal perfusion, which would cause a decreased urine output. This is a serious adverse effect and should be reported to the physician. A patient is being admitted to the ICU with a severe case of encephalitis. Which of these drugs would the nurse not be expect to be prescribed for this condition? 1. Acyclovir (Zovirax) 2. Mannitol (Osmitrol) 3. Lactated Ringer's 4. Phenytoin (Dilantin) ️️ 3. Lactated Ringer's Correct - Lactated Ringer's solution is often used in fluid replacement therapy, which is not warranted if a patient is at risk for high ICP. .The nurse is treating a patient who has Parkinson's Disease. Which of these practices would not be included in the care plan? 1. Decrease the calorie content of daily meals to avoid weight gain 2. Allow the patient extra time to respond to questions and do ADLs 3. Use thickened liquids and a soft diet 4. Encourage the patient to hold the spoon when eating ️️ 1. Decrease the calorie content of daily meals to avoid weight gain Correct - Calorie content should be increased for patients with Parkinson's Disease because of dysphagia (difficulty swallowing), as well as calories burned due to muscle rigidity.