Identifying and Managing Common Medical Conditions, Exams of Nursing

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NCLEX-PN

QUESTIONS

ANSWERS

Question 1:

A 40-year-old patient is being admitted for a third instance of alcohol dependency treatment in nine months. The healthcare team recommends rehabilitation. What is the primary reason for this recommendation? A. It is the only effective means to manage alcohol intake. B. It aids in forming a new social circle. C. It provides insight into the physiological effects of alcohol. D. It assists the patient in recognizing the link between their issues and alcohol use. Answer: D Rationale: Rehabilitative treatment focuses on helping the individual understand how their problems are connected with their alcohol consumption. It does not solely aim to manage intake, find new friends, or solely educate about the effects of alcohol.

Question 2:

A 42-year-old patient with a shingles diagnosis visits the clinic. Which of the following symptoms can confirm this condition? (Select all that apply.) A. Severe pain around the chest area B. Nodular red skin lesions on the chest C. Elevated body temperature D. General malaise E. Diarrhea Answer: A, B, C, D Rationale: Shingles, or herpes zoster, manifests as unilateral pain and distinct red lesions. Additionally, fever and malaise are common, while diarrhea is not typically associated with shingles.

Question 5:

If a client inquires about the rhythm method of family planning, how should the nurse describe it? A. The use of chemical barriers to prevent sperm survival B. Hormonal methods to prevent ovulation C. Physical barriers to prevent sperm entry D. Understanding the fertile window to identify safe sexual activity times Answer: D Rationale: The rhythm method involves tracking basal body temperature and mucus changes to determine fertile periods, enabling awareness of when to avoid intercourse.

Question 6:

When a client asks whether they should leave their spouse, and the nurse replies by restating the client's uncertainty, which therapeutic technique is being utilized? A. Repetition of what the client said B. Offering a new perspective C. Reflecting the client's feelings back to them D. Providing general encouragement Answer: C Rationale: Reflecting involves acknowledging the client's feelings to facilitate exploration, while the other options do not accurately describe the technique used.

Question 7:

A patient presents with symptoms including headache, malaise, chills, fever, and stiff neck, showing signs of confusion and a petechial rash. What does a positive Brudzinski's sign indicate?

A. Increased intracranial pressure B. Presence of cerebral edema C. Low cerebrospinal fluid pressure D. Meningeal irritation Answer: D Rationale: A positive Brudzinski’s sign is indicative of meningeal irritation often seen in cases of meningitis.

Question 8:

A client with chronic undifferentiated schizophrenia will receive monthly fluphenazine decanoate injections due to noncompliance with oral medications. What critical teaching point should the nurse emphasize before discharge? A. Requesting droperidol for any extrapyramidal symptoms B. Adopting a sitting position before standing to prevent hypotension C. Informing the physician if symptoms don’t subside within one week D. Anticipating transient tardive dyskinesia symptoms Answer: B Rationale: It is crucial to educate the patient about managing common side effects like orthostatic hypotension. Other options provide misleading or less relevant information.

Question 9:

When a nurse performs vital sign checks and bowel sound assessments for a patient with a bowel obstruction due to colon cancer, which nursing process step is being conducted? A. Planning B. Data collection C. Evaluating D. Implementation Answer: B

B. Respiratory rate C. Blood pressure D. Temperature Answer: C Rationale: Blood pressure should be closely monitored since hypotension is a common side effect of nitroglycerin.

Question 13:

A client is set for an excretory urography. When should the nurse apply lidocaine-prilocaine cream for anesthesia? A. 7:30 a.m. B. 6:30 a.m. C. 9:00 a.m. D. 9:30 a.m. Answer: A Rationale: The cream requires approximately two hours to be effective; thus it should be applied early.

Question 14:

A client prepares for surgery with general anesthesia but expresses eagerness for breakfast the next day. What nursing diagnosis might this indicate? A. Lack of understanding of dietary restrictions related to anesthesia B. Anxiety related to surgical procedures C. Potential for impaired skin integrity due to surgery D. Ineffective coping mechanisms regarding surgical stress Answer: A Rationale: The client’s statement reveals a lack of knowledge about food restrictions prior to anesthesia.

Question 15:

What is the expected location for an anesthesiologist to inject an anesthetic agent for an epidural block? A. Subarachnoid space B. Area between the subarachnoid and dura mater C. Space between the dura mater and ligamentum flavum D. Ligamentum flavum Answer: C Rationale: For an epidural block, the anesthetic is administered into the epidural space, located between the dura and the ligamentum flavum.

Question 16:

For a patient on total parenteral nutrition (TPN) who needs a 24-hour urine test, when should urine collection begin? A. At the time of the first morning void B. After a known voiding that clears the bladder C. With the first morning urine D. Using the last evening’s void as the final specimen Answer: B Rationale: Collection starts after an initial void to ensure an empty bladder for accurate results.

Question 17:

A patient with an L1-L2 spinal cord injury asks the nurse about walking again. What is an appropriate nursing response? A. "With a positive outlook, anything is possible." B. "What leads you to believe you can't walk again?" C. "What has been discussed with your physician regarding your mobility?" D. "It’s likely you won’t walk again, but we can’t say for certain."

A patient with chronic obstructive pulmonary disease receiving mechanical ventilation requests treatment cessation. What is true regarding the patient’s rights? A. The nurse guides decisions based on assessment and family communication. B. The nurse should advocate for ongoing treatment acceptance. C. The health care team must adhere to the pre-established treatment plan. D. The patient reserves the right to decline treatment at any time. Answer: D Rationale: Patients have inherent rights to make decisions about their care, including the choice to refuse treatment.

Question 21:

A patient in chronic renal failure has a serum potassium level of 6.8 mEq/L. Which assessment should the nurse prioritize? A. Blood pressure B. Respiratory rate C. Temperature D. Cardiac rhythm Answer: D Rationale: It is crucial to assess the patient's cardiac rhythm as elevated serum potassium can lead to serious cardiac arrhythmias. Blood pressure and respiratory rate may be assessed afterward, as they are secondary to the cardiac risks.

Question 22:

A client with advanced AIDS is showing severe symptoms due to a Cryptosporidium infection. What should the nurse focus on in planning their care? A. Pain management B. Fluid replacement

C. Antiretroviral therapy D. High-calorie nutrition Answer: B Rationale: The priority is fluid replacement due to the profuse diarrhea caused by Cryptosporidium, which can lead to severe dehydration. Pain management and nutritional needs are important but secondary at this point.

Question 23:

A client with hyperemesis gravidarum is on a clear liquid diet. What should the nurse offer this client? A. Milk and ice pops B. Decaffeinated coffee and scrambled eggs C. Tea and gelatin D. Apple juice and oatmeal Answer: C Rationale: A clear liquid diet includes clear fluids such as teas and gelatin. Milk, eggs, and oatmeal are not part of a clear liquid diet.

Question 24:

A patient with moderate pregnancy-induced hypertension may face which risk if given regional anesthesia for labor? A. Hypotension B. Hypertension C. Seizures D. Renal toxicity Answer: A Rationale: Regional anesthesia may induce hypotension in patients with pregnancy-induced hypertension, compromising uteroplacental perfusion and oxygenation for both mother and fetus.

D. Schizophrenia Answer: A Rationale: The client's history of trauma and current symptomatic experiences align with PTSD.

Question 28:

A 21-year-old patient admitted with bacterial meningitis should be kept in which type of room? A. A private room down the hall B. An isolation room close to nursing staff C. A semi-private room with a viral meningitis patient D. A shared room with a former bacterial meningitis patient Answer: B Rationale: Patients with bacterial meningitis need to be isolated to prevent the spread of infection, and proximity to nursing staff is essential for observation.

Question 29:

A diabetic patient with sinusitis and mild fever may experience changes in insulin needs. What is likely? A. No change B. Decreased insulin need C. Increased insulin need D. Fluctuating insulin need Answer: C Rationale: Illness and infection typically increase insulin requirements in patients with diabetes due to stress responses in the body.

Question 30:

A caregiver of a patient with Alzheimer's disease states, "Dad seems to be progressing. He could soon move back home." What does this indicate? A. Difficulty adjusting to caregiving B. Recognition of the disease's seriousness C. Denial of the patient's condition D. Successful adjustment to family dynamics Answer: C Rationale: This statement suggests denial of the realities of Alzheimer's disease, which typically leads to progressive decline rather than improvement.

Question 31:

Before administering pain medication to a client, what key information should the nurse gather? (Select all that apply.) A. Time of last medication B. Client's pain level (scale of 1-10) C. Type of medication previously taken D. Client's reaction to previous dose E. Client's height and weight F. Effectiveness of the prior dose Answer: A, B, C, D, F Rationale: Gathering these details is essential for safe and effective pain management. Current height and weight are less critical at this point.

Question 32:

In a pizza parlor, a patron expresses frustration with service, and later, a waiter retaliates by spitting on his pizza. This behavior exemplifies which disorder? A. Obsessive-compulsive disorder B. Narcissistic personality disorder C. Passive-aggressive behavior

A postpartum patient requires education about breastfeeding. What should the nurse instruct to avoid breast engorgement? A. Use an electric breast pump. B. Apply warm compresses. C. Breast-feed every 1.5 to 3 hours. D. Wear a bra 24/7. Answer: C Rationale: Frequent breastfeeding helps empty the breasts and prevents engorgement by stimulating circulation.

Question 36:

A school-age child with leukemia is admitted for care. What information should the nurse focus on discussing with the parents regarding advance directives? A. Positive outlook on prognosis B. Available chemotherapy options C. Comfort care alternatives D. Bone marrow transplant details Answer: C Rationale: Focus should be on palliative and comfort care as the prognosis may not be favorable.

Question 37:

A toddler with a dislocated shoulder and humerus fracture exhibits which behavior that might indicate abuse? A. Attempts to sit up on the stretcher B. Attempts to move away from the nurse C. Failing to answer questions D. Not crying when moved Answer: D

Rationale: A child who does not express pain upon being moved may indicate distress or fear, common in abuse cases.

Question 38:

What is the priority nursing action for a toddler experiencing a tonic-clonic seizure? A. Restrain the child B. Place an object in the mouth C. Remove hazardous objects nearby D. Check the child's breathing Answer: C Rationale: The priority is to ensure safety by removing potentially harmful objects near the child during a seizure.

Question 39:

An adolescent with type 1 diabetes is undergoing a growth spurt. Which treatment method is most effective? A. Single daily insulin administration B. Several doses of insulin daily C. Reduced fat intake D. Switching to oral antidiabetic medications Answer: B Rationale: Multiple daily insulin doses provide better regulation of blood glucose during growth spurts.

Question 40:

A confused, agitated client arrives at the emergency department with signs of hypoglycemia. Upon recovery, what should the nurse instruct when treating future hypoglycemic episodes?

Question 43:

What finding during peritoneal dialysis signals a significant issue for the patient? A. Serum glucose at 200 mg/dl B. Elevated WBC count at 20,000/mm³ C. Serum potassium level at 3.8 mEq/L D. Hematocrit level at 35% Answer: B Rationale: An increased WBC count suggests the presence of infection, potentially indicating peritonitis.

Question 44:

Damage to which brain area is likely to result in receptive aphasia? A. Parietal lobe B. Occipital lobe C. Temporal lobe D. Frontal lobe Answer: C Rationale: The temporal lobe is crucial for language comprehension, and damage here results in receptive aphasia.

Question 45:

What effect does anxiety have on the genitourinary system? A. Slows glomerular filtration rate B. Increases sodium resorption C. Decreases potassium excretion D. Stimulates or hinders urinary function Answer: D

Rationale: Anxiety can cause urinary urgency or hesitancy, impacting micturition dynamics.

Question 46:

After a small-bowel resection, a client develops wound fever and anemia. What would most suggest necrotizing fasciitis? A. Erythema B. Leukocytosis C. Severe pressure-like pain D. Swelling Answer: C Rationale: Severe, disproportionate pain is characteristic of necrotizing fasciitis.

Question 47:

For a patient with Graves' disease, which nursing intervention promotes comfort? A. Restricting oral fluid intake B. Adding extra blankets C. Reducing high-carbohydrate food consumption D. Keeping room temperature cool Answer: D Rationale: Lowering room temperature helps reduce symptoms of heat intolerance associated with hyperthyroidism.

Question 48:

What factor may trigger a bipolar episode in someone predisposed to the disorder? A. Hypothyroidism