NCLEX RN ACTUAL EXAM TEST BANK, REAL QUESTIONS & ANSWERS NCLEX
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QUESTION 1 jg
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
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A. Positive inotropes
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B. Vasodilators
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C. Diuretics
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D. Antidysrhythmics
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Answer: A jg
Explanation:
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(A) Positive inotropic agents should not be administered owing to their action of increasing myocardial
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contractility. Increased ventricular contractility would increase outflow tract obstruction in the client with
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hypertrophic cardiomyopathy. (B) Vasodilators are not typicallyprescribed but are not contraindicated. (C)
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Diuretics are used with caution to avoid causing hypovolemi
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A. (D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.
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QUESTION 2 jg
Signs and symptoms of an allergyattack include which of the following?
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A. Wheezing on inspiration
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B. Increased respiratoryrate
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C. Circumoral cyanosis
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D. Prolonged expiration
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Answer: D jg
Explanation:
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(A) Wheezing occurs during expiration when air movement is impaired because of constricted edematous bronchial
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lumin
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A. (B) Respirations are difficult, but the rate is frequently normal. (C) The circumoral area is usually pale. Cyanosis
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is not an early sign of hypoxi
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A. (D) Expiration is prolonged because the alveoli are greatlydistended and air trapping occurs.
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QUESTION 3 jg
A client confides to the nurse that he tasted poison in his evening meal. This would be an example of what type of
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hallucination?
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A. Auditoryjg
B. Gustatory
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C. Olfactory
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D. Visceraljg
Answer: B jg
Explanation:
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(A) Auditory hallucinations involve sensory perceptions of hearing. (B) Gustatory hallucinations involve
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sensoryperceptions of taste. (C) Olfactoryhallucinations involve sensory perceptions of smell. (D) Visceral
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hallucinations involve sensory perceptions of sensation jg jg jg jg jg
,QUESTION
4 Which of the following findings would be abnormal in a postpartal woman?
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A. Chills shortlyafter delivery jg jg jg
B. Pulse rate of 60 bpm in morning on first postdeliveryday
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C. Urinaryoutput of 3000 mLon the second day after delivery jg jg jg jg jg jg jg jg jg jg
D. An oral temperature of 101F (38.3C) on the third day after delivery
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Answer: D jg
Explanation:
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(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous
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response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. (B) The pulse rate
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during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt
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to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. (C)
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Urinary output increases during the early postpartal period (12–24 hours) owing to diuresis. The kidneys must
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eliminate an estimated 2000–3000 mL of extracellular fluid associated with a normal pregnancy. (D) A
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temperature of 100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However,
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anytemperature greater than 100.4F needs further investigation to identify any infectious process.
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QUESTION 5 jg
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching of the
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parents, the nurse states that:
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A. Sustained temperature elevation over 103F is generally related to febrile seizures
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B. Febrile seizures do not usuallyrecur jg jg jg jg jg
C. There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
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D. Febrile seizures are associated with diseases of the central nervous system
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Answer: C jg
Explanation:
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(A) The temperature elevation related to febrile seizures generally exceeds 101F, and seizures occur during the
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temperature rise rather than after a prolonged elevation. (B) Febrile seizures may recur and are more likely to do
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so when the first seizure occurs in the 1st year of life. (C) There is little risk of neurological deficit, mental
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retardation, or altered behavior secondary to febrile seizures. (D) Febrile seizures are associated with disease
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of the central nervous system.
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QUESTION 6 jg
A client diagnosed with bipolar disorder continues to be hyperactive and to lose weight. Which of the following
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nutritional interventions would be most therapeutic for him at this time?
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A. Small, frequent feedings of foods that can be carried
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B. Tube feedings with nutritional supplements
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C. Allowing him to eat when and what he wants jg jg jg jg jg jg jg jg
D. Giving him a quiet place where he can sit down to eat meals
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Answer: A jg
Explanation:
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(A) The manic client is unable to sit still long enough to eat an adequate meal. Small, frequent feedings with
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,finger foods allow him to eat during periods of activity. (B) This type of therapyshould be implemented when
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other methods have been exhausted. (C) The manic client should not be in control of his treatment plan. This
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type of client mayforget to eat. (D) The manic client is unable to sit down to eat full meals.
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QUESTION 7 jg
A client with bipolar disorder taking lithium tells the nurse that he has ringing in his ears, blurred vision, and
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diarrhe
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A. The nurse notices a slight tremor in his left hand and a slurring pattern to his speech. Which of the following
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actions by the nurse is appropriate?
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A. Administer a stat dose of lithium as necessary.
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B. Recognize this as an expected response to lithium.
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C. Request an order for a stat blood lithium level.
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D. Give an oral dose of lithium antidote.
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Answer: C jg
Explanation:
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(A) These symptoms are indicative of lithium toxicity. A stat dose of lithium could be fatal.
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(B) These are toxic effects of lithium therapy. (C) The client is exhibiting symptoms of lithium toxicity, which
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may be validated by lab studies. (D) There is no known lithium antidote.
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QUESTION 8 jg
A diagnosis of hepatitis C is confirmed bya male client‘s physician. The nurse should be knowledgeable of the
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differences between hepatitis A, B, and C. Which of the following are characteristics of hepatitis C?
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A. The potential for chronic liver disease is minimal.
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B. The onset of symptoms is abrupt.
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C. The incubation period is 2–26 weeks.
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D. There is an effective vaccine for hepatitis B, but not for hepatitis C.
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Answer: C jg
Explanation:
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(A) Hepatitis C and B may result in chronic liver disease. Hepatitis A has a low potential for chronic liver
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disease. (B) Hepatitis C and B have insidious onsets. Hepatitis A has an abrupt onset. (C) Incubation periods are
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as follows: hepatitis C is 2–26 weeks, hepatitis B is 6–20 weeks, and hepatitis A is 2–6 weeks. (D) Only
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hepatitis B has an effective vaccine.
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QUESTION 9 jg
Hypoxia is the primary problem related to near-drowning victims. The first organ that sustains irreversible
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damage after submersion in water is the:
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A. Kidney (urinarysystem) jg jg
B. Brain (nervous system) jg jg
C. Heart (circulatorysystem) jg jg
D. Lungs (respiratorysystem) jg jg
Answer: B jg
Explanation:
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A+
, (A) The kidney can survive after 30 minutes of water submersion. (B) The cerebral neurons sustain irreversible
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damage after 4–6 minutes of water submersion. (C) The heart can survive up to 30 minutes of water submersion.
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(D) The lungs can survive up to 30 minutes of water submersion.
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QUESTION 10 jg
Which of the following activities would be most appropriate during occupational therapyfor a client with
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bipolar disorder?
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A. Playing cards with other clients jg jg jg jg
B. Working crossword puzzles jg jg
C. Playing tennis with a staff member jg jg jg jg jg
D. Sewing beads on a leather belt jg jg jg jg jg
Answer: C jg
Explanation:
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(A) This activity is too competitive, and the manic client might become abusive toward the other clients. (B)
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During mania, the client‘s attention span is too short to accomplish this task. (C) This activityuses gross motor
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skills, eases tension, and expands excess energy. A staff member is better equipped to interact therapeutically
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with clients. (D) This activity requires the use of fine motor skills and is very tedious.
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QUESTION 11 jg
A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. For the last 2
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months, his familydescribes him as being ―on the move,‖ sleeping
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3–4 hours nightly, spending lots of money, and losing approximately 10 lb. During the initial
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assessment with the client, the nurse would expect him to exhibit which of the following?
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A. Short, polite responses to interview questions
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B. Introspection related to his present situation jg jg jg jg jg
C. Exaggerated self-importance jg
D. Feelings of helplessness and hopelessness jg jg jg jg
Answer: C jg
Explanation:
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(A) During the manic phase of bipolar disorder, clients have short attention spans and may be abusive toward
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authority figures. (B) Introspection requires focusing and concentration; clients with mania experience flight of
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ideas, which prevents concentration.
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(C) Grandiosity and an inflated sense of self-worth are characteristic of this disorder. (D) Feelings of
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helplessness and hopelessness are symptoms of the depressive stage of bipolar disorder.
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QUESTION 12 jg
Diabetes during pregnancy requires tight metabolic control of glucose levels to prevent perinatal mortality.
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When evaluating the pregnant client, the nurse knows the recommended serum glucose range during pregnancy
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is:
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A. 70 mg/dL and 120 mg/dL
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B. 100 mg/dL and 200 mg/dL jg jg jg jg
C. 40 mg/dL and 130 mg/dL
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D. 90 mg/dL and 200 mg/dL
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A+
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QUESTION 1 jg
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
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A. Positive inotropes
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B. Vasodilators
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C. Diuretics
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D. Antidysrhythmics
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Answer: A jg
Explanation:
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(A) Positive inotropic agents should not be administered owing to their action of increasing myocardial
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contractility. Increased ventricular contractility would increase outflow tract obstruction in the client with
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hypertrophic cardiomyopathy. (B) Vasodilators are not typicallyprescribed but are not contraindicated. (C)
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Diuretics are used with caution to avoid causing hypovolemi
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A. (D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.
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QUESTION 2 jg
Signs and symptoms of an allergyattack include which of the following?
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A. Wheezing on inspiration
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B. Increased respiratoryrate
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C. Circumoral cyanosis
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D. Prolonged expiration
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Answer: D jg
Explanation:
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(A) Wheezing occurs during expiration when air movement is impaired because of constricted edematous bronchial
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lumin
jg
A. (B) Respirations are difficult, but the rate is frequently normal. (C) The circumoral area is usually pale. Cyanosis
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is not an early sign of hypoxi
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A. (D) Expiration is prolonged because the alveoli are greatlydistended and air trapping occurs.
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QUESTION 3 jg
A client confides to the nurse that he tasted poison in his evening meal. This would be an example of what type of
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hallucination?
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A. Auditoryjg
B. Gustatory
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C. Olfactory
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D. Visceraljg
Answer: B jg
Explanation:
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(A) Auditory hallucinations involve sensory perceptions of hearing. (B) Gustatory hallucinations involve
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sensoryperceptions of taste. (C) Olfactoryhallucinations involve sensory perceptions of smell. (D) Visceral
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hallucinations involve sensory perceptions of sensation jg jg jg jg jg
,QUESTION
4 Which of the following findings would be abnormal in a postpartal woman?
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A. Chills shortlyafter delivery jg jg jg
B. Pulse rate of 60 bpm in morning on first postdeliveryday
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C. Urinaryoutput of 3000 mLon the second day after delivery jg jg jg jg jg jg jg jg jg jg
D. An oral temperature of 101F (38.3C) on the third day after delivery
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Answer: D jg
Explanation:
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(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous
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response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. (B) The pulse rate
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during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt
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to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. (C)
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Urinary output increases during the early postpartal period (12–24 hours) owing to diuresis. The kidneys must
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eliminate an estimated 2000–3000 mL of extracellular fluid associated with a normal pregnancy. (D) A
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temperature of 100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However,
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anytemperature greater than 100.4F needs further investigation to identify any infectious process.
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QUESTION 5 jg
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching of the
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parents, the nurse states that:
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A. Sustained temperature elevation over 103F is generally related to febrile seizures
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B. Febrile seizures do not usuallyrecur jg jg jg jg jg
C. There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
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D. Febrile seizures are associated with diseases of the central nervous system
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Answer: C jg
Explanation:
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(A) The temperature elevation related to febrile seizures generally exceeds 101F, and seizures occur during the
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temperature rise rather than after a prolonged elevation. (B) Febrile seizures may recur and are more likely to do
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so when the first seizure occurs in the 1st year of life. (C) There is little risk of neurological deficit, mental
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retardation, or altered behavior secondary to febrile seizures. (D) Febrile seizures are associated with disease
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of the central nervous system.
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QUESTION 6 jg
A client diagnosed with bipolar disorder continues to be hyperactive and to lose weight. Which of the following
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nutritional interventions would be most therapeutic for him at this time?
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A. Small, frequent feedings of foods that can be carried
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B. Tube feedings with nutritional supplements
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C. Allowing him to eat when and what he wants jg jg jg jg jg jg jg jg
D. Giving him a quiet place where he can sit down to eat meals
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Answer: A jg
Explanation:
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(A) The manic client is unable to sit still long enough to eat an adequate meal. Small, frequent feedings with
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,finger foods allow him to eat during periods of activity. (B) This type of therapyshould be implemented when
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other methods have been exhausted. (C) The manic client should not be in control of his treatment plan. This
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type of client mayforget to eat. (D) The manic client is unable to sit down to eat full meals.
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QUESTION 7 jg
A client with bipolar disorder taking lithium tells the nurse that he has ringing in his ears, blurred vision, and
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diarrhe
jg
A. The nurse notices a slight tremor in his left hand and a slurring pattern to his speech. Which of the following
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actions by the nurse is appropriate?
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A. Administer a stat dose of lithium as necessary.
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B. Recognize this as an expected response to lithium.
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C. Request an order for a stat blood lithium level.
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D. Give an oral dose of lithium antidote.
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Answer: C jg
Explanation:
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(A) These symptoms are indicative of lithium toxicity. A stat dose of lithium could be fatal.
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(B) These are toxic effects of lithium therapy. (C) The client is exhibiting symptoms of lithium toxicity, which
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may be validated by lab studies. (D) There is no known lithium antidote.
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QUESTION 8 jg
A diagnosis of hepatitis C is confirmed bya male client‘s physician. The nurse should be knowledgeable of the
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differences between hepatitis A, B, and C. Which of the following are characteristics of hepatitis C?
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A. The potential for chronic liver disease is minimal.
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B. The onset of symptoms is abrupt.
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C. The incubation period is 2–26 weeks.
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D. There is an effective vaccine for hepatitis B, but not for hepatitis C.
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Answer: C jg
Explanation:
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(A) Hepatitis C and B may result in chronic liver disease. Hepatitis A has a low potential for chronic liver
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disease. (B) Hepatitis C and B have insidious onsets. Hepatitis A has an abrupt onset. (C) Incubation periods are
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as follows: hepatitis C is 2–26 weeks, hepatitis B is 6–20 weeks, and hepatitis A is 2–6 weeks. (D) Only
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hepatitis B has an effective vaccine.
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QUESTION 9 jg
Hypoxia is the primary problem related to near-drowning victims. The first organ that sustains irreversible
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damage after submersion in water is the:
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A. Kidney (urinarysystem) jg jg
B. Brain (nervous system) jg jg
C. Heart (circulatorysystem) jg jg
D. Lungs (respiratorysystem) jg jg
Answer: B jg
Explanation:
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A+
, (A) The kidney can survive after 30 minutes of water submersion. (B) The cerebral neurons sustain irreversible
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damage after 4–6 minutes of water submersion. (C) The heart can survive up to 30 minutes of water submersion.
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(D) The lungs can survive up to 30 minutes of water submersion.
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QUESTION 10 jg
Which of the following activities would be most appropriate during occupational therapyfor a client with
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bipolar disorder?
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A. Playing cards with other clients jg jg jg jg
B. Working crossword puzzles jg jg
C. Playing tennis with a staff member jg jg jg jg jg
D. Sewing beads on a leather belt jg jg jg jg jg
Answer: C jg
Explanation:
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(A) This activity is too competitive, and the manic client might become abusive toward the other clients. (B)
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During mania, the client‘s attention span is too short to accomplish this task. (C) This activityuses gross motor
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skills, eases tension, and expands excess energy. A staff member is better equipped to interact therapeutically
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with clients. (D) This activity requires the use of fine motor skills and is very tedious.
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QUESTION 11 jg
A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. For the last 2
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months, his familydescribes him as being ―on the move,‖ sleeping
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3–4 hours nightly, spending lots of money, and losing approximately 10 lb. During the initial
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assessment with the client, the nurse would expect him to exhibit which of the following?
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A. Short, polite responses to interview questions
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B. Introspection related to his present situation jg jg jg jg jg
C. Exaggerated self-importance jg
D. Feelings of helplessness and hopelessness jg jg jg jg
Answer: C jg
Explanation:
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(A) During the manic phase of bipolar disorder, clients have short attention spans and may be abusive toward
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authority figures. (B) Introspection requires focusing and concentration; clients with mania experience flight of
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ideas, which prevents concentration.
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(C) Grandiosity and an inflated sense of self-worth are characteristic of this disorder. (D) Feelings of
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helplessness and hopelessness are symptoms of the depressive stage of bipolar disorder.
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QUESTION 12 jg
Diabetes during pregnancy requires tight metabolic control of glucose levels to prevent perinatal mortality.
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When evaluating the pregnant client, the nurse knows the recommended serum glucose range during pregnancy
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is:
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A. 70 mg/dL and 120 mg/dL
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B. 100 mg/dL and 200 mg/dL jg jg jg jg
C. 40 mg/dL and 130 mg/dL
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D. 90 mg/dL and 200 mg/dL
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A+
