MED/SURG Final NCLEX Questions with Solutions All Correct 2024 Updated Graded A+., Exams of Nursing

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MED/SURG Final NCLEX Questions with

Solutions All Correct 2024 Updated Graded

A+.

A student nurse is preparing blood for an A Positive patient who needs to receive a blood transfusion. The nurse intervenes after which statement? A. " Since you are A positive, you are considered a "universal recipient", therefore you can receive any type of blood. B. "A positive blood types can receive A+, A-, O+ and O-" C. "Testing your blood type helps us determine what type of blood you need. Not all blood types are the same and can cause a reaction" D. "Only certain people who meet a certain criteria can donate blood, but if you have any types of symptoms during transfusion, let a health care staff member know" - Solution A. " Since you are A positive, you are considered a "universal recipient", therefore you can receive any type of blood. A patient has a folic acid deficiency. The nurse tells the patient to order foods rich in Folic Acid. What foods are best for the patient to look for when ordering food? A. Leafy Green Vegetables B. Citrus Fruits C.Chicken D.Dried Beans E. Hard Candy - Solution A. Leafy Green Vegetables B. Citrus Fruits D. Dried Beans

1. A patient who was recently diagnosed with Gastroesophageal Reflux Disease (GERD) was just educated on the importance of nutrition and what foods to avoid. What statement made by the patient, indicates the need for further teaching?

a. " I will avoid foods like French fries and citrus juices to decrease my chances of acid reflux and heart burn" b. "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I have enough energy for the day" c. " I need to find another dessert I can eat each night before bed, because the chocolate ice cream I eat every night will exacerbate my Gastroesophageal Reflux" d. " I need to drink more room temperature water to make sure my body has help when properly digesting my meals" - Solution B. "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I have enough energy for the day" A 76-year old man with chronic anemia arrives at the Emergency department with increased fatigue and heart palpitations even at rest. The nurse would expect the patients' laboratory test findings to include: (Select all that apply) a. Hemoglobin (Hgb) of 6.8 g/dL b. Hematocrit (Hct) value of 32% c. An Red Blood Cell count of 4,500,000/L d. A ferritin level of 8.2 ng/mL e. A White Blood Cell count of 6.5 x 109/L - Solution A, B, D a: hemoglobin (Hgb) of 6.8 g/dL b: hematocrit (Hct) value of 32% d: a ferritin level of 8.2 ng/mL A student nurse is explaining the risk factors for metabolic syndrome which statement by the student would require correction from the nurse? A. Waist circumference of 41 for a male B. Body mass index of 30 or higher C. Triglycerides level of 130 D. Blood Glucose of 168 - Solution C. Triglycerides level of 130 A 68 year-old male suffering from chronic diarrhea is found to have a serum phosphate level of 0.9 mg/dL. After reviewing this lab value the nurse can expect the patient to exhibit which of the following symptoms? (Select all that apply)

A. Confusion B. Numbness/tingling in extremities C. Muscle weakness D. Cardiac dysrhythmias E. Dry mucous membranes - Solution A. Confusion C. Muscle weakness D. Cardiac dysrhythmias The physician orders an arterial blood gas who is hyperventilating. The nurse can anticipate that the blood gas results will most likely reveal that the patient is in: A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis - Solution D. Respiratory alkalosis Thalassemia is a group of diseases that causes an inadequate amount of normal hemoglobin to be produced in the body. Thalassemia minor is usually asymptomatic and requires no treatments. There is no cure for thalassemia major, however, there are therapies available to help manage the disease. These include: A. Blood transfusions B. Subcutaneous or IV deferoxamine C. Iron supplements D. Zinc supplements E. Splenectomy - Solution A. Blood transfusions B. Subcutaneous or IV deferoxamine D. Zinc supplements E. Splenectomy A patient diagnosed with Stage II bladder cancer has just received a segmental cystectomy. What will the nurse correct the patient on for postoperative instructions for discharge?: A. "I will drink only small amounts of water for the first week." B. "I will call the doctor if my urine is bright red for the first few days after surgery." C. "After a week, my urine could have dark red flakes, and that's normal."

D. "I have a follow-up appointment for a cystoscopy in a few weeks." - Solution A. "I will drink only small amounts of water for the first week." A patient with upper gastrointestinal cancer has been diagnosed with cancer cachexia which of the following would the nurse expect to see? A. Weight gain B. Skeletal muscle atrophy C. Increase immune function D. Improvement in metabolic abnormalities - Solution B. Skeletal muscle atrophy A female patient has just been diagnosed with external hemorrhoids and asks the nurse what could have contributed to her diagnoses, which of the following will the nurse mention as probable risk factors? A. Pregnancy B. Normal Body Mass Index C. Prolonged constipation D. Straining in an effort to defecate E. Heavy lifting F. Standing or sitting for a long period of time - Solution A. Pregnancy B. Normal Body Mass Index C. Prolonged constipation D. Straining in an effort to defecate E. Heavy lifting F. Standing or sitting for a long period of time The most common cause of cobalamin deficiency is pernicious anemia. Which of the following patients may develop a cobalamin deficiency? (Select all that apply) A. A 36-year-old morbidity obese patient that recently had the Roux-en-Y Gastric Bypass (RYGB) Surgery B. A 45-year-old male construction working who has a history of smoking two packs of cigarettes a day C. A 23-year-old female nurse apprentice who is having a routine colonoscopy D. A 50-year-old male yoga instructor who is on a strict vegetarian diet

E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a Pepcid ulcer for the past three years - Solution A. A 36-year-old morbidity obese patient that recently had the Roux-en-Y Gastric Bypass (RYGB) Surgery B. A 45-year-old male construction working who has a history of smoking two packs of cigarettes a day D. A 50-year-old male yoga instructor who is on a strict vegetarian diet E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a Pepcid ulcer for the past three years A 25 year old female patient is diagnosed with viral hepatitis. The provider prescribes Ribavirin, before administering the nucleoside what test will the nurse give to the patient? a). Liver function test b). Pregnancy test c). Occult blood test d). Urinalysis - Solution b). Pregnancy test A Roux-en-Y Gastric Bypass (RYGB) Surgical patient is suffering from an early case of iron deficiency. Which of the following group of clinical manifestations will the patient present? A. No Symptoms B. Anorexia, Abdominal Pain, Paresthesia of the hands and feet, Nausea, Red and Beefy Tongue C. Pallor, Glossitis, Headache, and Burning Sensation of the Tongue D. Fever, Swelling, Tachypnea, Hypertension, Tenderness, Nausea, Vomiting - Solution A. No Symptoms A 67-year-old male has just been admitted into the Emergency Department late into the night. He is severely confused, agitated, and complains of severe chest pain. His wife is present with him and is very concerned about her husband. After receiving some blood tests, he is diagnosed with primary polycythemia vera. The nurse begins to provide education about how to manage his polycythemia. Which of the following would the nurse need to RE-EDUCATE based on patient response? (select all that apply) A. "If I would have received blood tests earlier, I could have prevented myself from getting diagnosed with polycythemia."

B. "I will need to get multiple phlebotomies done in order to keep my hematocrit level less than 45%." C. "I will begin to start taking my low dose aspirin every morning." D. "During each of my phlebotomy appointments, I will lose 700mL of my blood." E. "If my feet and hands begin to turn bright red, I - Solution A. "If I would have received blood tests earlier, I could have prevented myself from getting diagnosed with polycythemia." D. "During each of my phlebotomy appointments, I will lose 700mL of my blood." E. "If my feet and hands begin to turn bright red, I will need to contact my physician immediately." A 27-year-old female patient presents to the ICU after a severe thoracic burn injury. She presents with the following vitals: BP of 90/67, HR of 135, temperature of 100.1, and respiratory rate of 24. She is unconscious, unresponsive, and has purpura present on both lower calves. It's suspected this patient is experiencing DIC as a result of hypovolemic shock. Which of the orders should the nurse QUESTION from the physician? A. IV bolus of NS 0.9% B. Administer STAT order of RBC's C. 500 units of IV heparin D. Administer STAT oral anticoagulants - Solution D. Administer STAT oral anticoagulants A patient diagnosed with systemic lupus erythematosus presents to the healthcare provider for a routine checkup. A urinalysis is completed and has noted proteinuria and hematuria. Which of the following diagnostic studies could be performed to confirm a diagnosis of chronic glomerulonephritis? (select all that apply) A. MRI B. Ultrasound C. Renal Biopsy D. CT Scan E. EKG - Solution B. Ultrasound C. Renal Biopsy D. CT Scan

A patient newly diagnosed with diabetes asks their nurse about how to slow the development of diabetic retinopathy. Which of the following should the nurse suggest to the patient? (Select all that apply) a. "Keep blood glucose levels within recommended range." b. "Eat a low protein diet to preserve kidney function." c. "Monitor blood pressure and keep it within recommended range." d. "Make regular visits to your health care provider." e. "Laser photocoagulation treatment may help slow progression of diabetic retinopathy." f. "Your daily aspirin regimen will help slow the development of diabetic retinopathy." - Solution a. "Keep blood glucose levels within recommended range." b. "Eat a low protein diet to preserve kidney function." c. "Monitor blood pressure and keep it within recommended range." d. "Make regular visits to your health care provider." e. "Laser photocoagulation treatment may help slow progression of diabetic retinopathy." A patient with acute urinary retention is seeking interventions to help with elimination of urine. Which of the following statements is NOT correct by the patient, following education by the nurse? A. "I will drink a large amount of fluid in a short period of time" B. "Taking a warm bath can help me urinate" C. "If I do not have successful urination using these interventions I should seek immediate care" D. "I will have a cup of coffee every morning" - Solution A. "I will drink a large amount of fluid in a short period of time" A new nurse has a patient receiving parenteral nutrition. Which actions by the nurse would be of concern? SELECT ALL THAT APPLY. A. The nurse checks the patient's blood glucose level and notices it's on the higher end of normal. She injects insulin into the parenteral nutrition bag to prevent hyperglycemia. B. The parenteral nutrition bag has run out and the new one has yet to be sent up from pharmacy. The nurse runs 10% dextrose solution.

C. The floor is running low on pumps. The nurse sets the parenteral nutrition bag up by drip rate. D. A new bag of parenteral nutrition has arrived early but the old bag has yet to finish. The nurse sets up the new bag and wastes what is left of the old bag. E. The nurse checks label and ingredients before hanging the new bag. - Solution A. The nurse checks the patient's blood glucose level and notices it's on the higher end of normal. She injects insulin into the parenteral nutrition bag to prevent hyperglycemia. C. The floor is running low on pumps. The nurse sets the parenteral nutrition bag up by drip rate. A patient with chronic hyperkalemia has a basic metabolic panel that came back with an abnormality of potassium of 7.5 mEq/L. While working alongside a nursing student giving care to the patient after this finding, the nurse will intervene if the nursing student does which action: (Select all that apply) A. Allows the patient to enjoy a meal brought by a family member with salmon, sweet potato fries, and a spinach salad B. Administers loop diuretics C. Administers Kayexalate orally D. Gives Veltassa at 0900 with other 0900 medications E. Continuously monitors ECG - Solution B. Administers loop diuretics D. Gives Veltassa at 0900 with other 0900 medications A nurse has a 25-year-old patient, diagnosed with anorexia, started on enteral nutrition through a nasogastric tube. Which observation by the nurse would warrant immediate action? A. High blood glucose level B. Slight redness around the nostril C. Gastric residual volume 400mL D. Patient's head of bed at 30 degrees - Solution A. High blood glucose level A patient with gastric cancer has undergone a total gastrectomy. You are caring for the patient postoperatively. Which statement if made by the patient determines need for further patient education?

A. "I will have the NG tube removed as soon as my gut peristalsis returns" B. "I may experience weight loss" C. "I will need to take vitamins to help with my nutritional intake" D. "I should expect a large quantity of secretions in my NG tube canister" - Solution D. The NG tube does not drain a large quantity of secretions because removal of the stomach has eliminated the reservoir capacity (p. 921). (Lewis et al., pg. 921). The nurse comes in on shift change and needs to see all the patients who have the greatest risk of getting esophageal cancer because of how fast it spreads to the liver and lungs via lymph system. What patients should the nurse be most concerned about? Select all that apply A. 58-year old who has a history of tachycardia and obesity but manages her diet and does morning yoga. B. 69-year old male who has some polyps in his stomach and a history of stomach cancer. C. 73-year old female who works with cement dust and has history of achalasia. D. 80-year old male who is an Alaska Native. He sits at home and complains of his food not passing down to the stomach. E. 20-year-old male who has an abrupt sore throat. His mom smokes but he has never tried alcohol. He lives a healthy lifestyle but is worried about second hand smoke. - Solution B. 69-year old male who has some polyps in his stomach and a history of stomach cancer. C. 73-year old female who works with cement dust and has history of achalasia. D. 80-year old male who is an Alaska Native. He sits at home and complains of his food not passing down to the stomach. A patient develops acute gastroenteritis as a result of norovirus. Which of the following symptoms do you expect the patient to have? (Select all that apply) A. Occult blood in stool B. Nausea and vomiting C. Diarrhea and abdominal cramps D. Headache E. Fever - Solution B. Nausea and vomiting C. Diarrhea and abdominal cramps

E. Fever Tina is a 70-year-old female from Austin, Texas who works at her favorite restaurant, Kentucky Fried Chicken (KFC) part time. During her annual physical, she claims to only smoke one pack of cigarettes per week and drinks a glass of wine with dinner. She stated that she became a vegetarian for her New Year's resolution one year ago. She was diagnosed with lymphoma 3 years ago and has recently stopped with treatments. Her favorite snacks are nuts and seeds. What are her risk factors for developing Diverticulitis, which is "inflammation of one or more diverticula, resulting in perforation into the peritoneum?" Select all that apply: A. Being over the age of 55 years' old B. Smoking 1 pack per week C. Drinking 1 glass of wine daily D. Being a vegetarian E. Having lymphoma F. Consumption of nuts and seeds - Solution B. Smoking 1 pack per week E. Having lymphoma When providing discharge instructions to a patient newly diagnosed with sickle cell disease, it is important to mention that they should seek early medical attention for upper respiratory infections or else they may experience which of the following symptoms? A. Shock, hypoxia, and body pain. B. Sore throat, fever, and swollen lymph nodes. C. Hyponatremia, hyperkalemia, and dehydration. D. Fever, chills, nausea, and swollen lymph nodes. - Solution A. Shock, hypoxia, and body pain. A 35-year old female patient comes into the clinic with a new diagnosis of Addison's disease. After providing education to the patient about this disease, the nurse knows further teaching is required when the patient states which of the following? A. "I will need to increase my hydrocortisone dosage during a stressful event such as surgery or if I contract an infection." B. "Once my hormone levels stabilize my doctor can start lowering my dose and eventually I'll be able to stop taking hormone therapy."

C. "I'm glad to know I can have a normal life expectancy as long as I follow my medication regimen." D. "It's best to take my mineralocorticoids in the morning." - Solution B. "Once my hormone levels stabilize my doctor can start lowering my dose and eventually I'll be able to stop taking hormone therapy." A nurse is assessing a 25-year old female patient who underwent subtotal thyroidectomy 4 hours ago for any signs of complications. The nurse knows immediate action is needed if the patient exhibits which of the following symptoms (Select all that apply)? a. Neck swelling b. Irregular breathing c. Hoarseness d. Frequent swallowing e. Blood on the dressings - Solution a. Neck swelling b. Irregular breathing d. Frequent swallowing e. Blood on the dressings A patient comes into the emergency room that appears anxious, has decreased urine out, tachypnea, absent bowel sounds, and cool, clammy skin. What could be potential causes of these symptoms? Select All That Apply A. Ruptured spleen B. Burn injuries C. Food additives D. Bowel obstruction E. GI bleeding - Solution A. Ruptured spleen B. Burn injuries D. Bowel obstruction E. GI bleeding All of the following patients must be closely monitored following a kidney transplantation due to an increased risk of complications EXCEPT: A. A patient who is morbidly obese. B. A patient with cardiovascular disease. C. A patient with hepatitis C.

D. A patient who smokes. - Solution C. A patient with hepatitis C. A male patient who has been receiving prolonged high-dose antibiotics has developed pearly, bluish white "milk-curd" membranous lesions on the inside of his mouth. The nurse anticipates a diagnosis of which of the following? A. Oral candidiasis B. Vincent's infection C. Herpes D. Gingivitis - Solution A. Oral candidiasis A patient is preparing to take a capsule endoscopy for suspected Crohn's disease. The nurse is doing pre-op teaching with the patient. Which statement would the nurse need to correct if stated by the patient? a. "I will not eat food the evening before the pill." b. "I understand that I can have water two hours after I swallow the pill" c. "I will have to wait at least a day before coming back to get this pill out of me." d. "If I have a narrowed bowel, I may need to use a patency pill before this procedure." - Solution c. "I will have to wait at least a day before coming back to get this pill out of me." A patient is presenting with a heart rate of 45 beats per minute, a capillary return greater than two seconds, and cool skin temperature. The nurse suspects neurogenic shock. Which medications does the nurse prepare to administer? (Select all that apply) a. Phenylephrine b. Atropine c. Furosemide d. Clindamycin e. Epinephrine - Solution a. Phenylephrine b. Atropine A young male patient has been admitted for blood testing to assess the extent of renal impairment after a diagnosis of acute poststreptococcal glomerulonephritis. As the nurse, which of the following clinical

manifestations would you expect to find upon assessment of this patient? Select all that apply. A. Rust colored urine B. Low blood pressure C. Flank pain D. Proteinuria E. Swelling around the eyes - Solution A. Rust colored urine C. Flank pain D. Proteinuria E. Swelling around the eyes A patient with systemic inflammatory response syndrome (SIRS) continues to progress to MODS, which of the following symptoms can the nurse expect first to show signs of dysfunction. A. Severe dyspnea and tachypnea B. Bradycardia and widening pulse pressure C. Prolonged confusion and slow changes in neurologic status D. Hypoglycemia E. Decreased bleeding time and increased platelet count - Solution A. Severe dyspnea and tachypnea A 39-year-old pregnant female patient presents symptoms of dysuria, urgency, and frequency, which additional symptoms, diagnostic studies, and treatments would be associated with acute pyelonephritis versus cystitis? A. Flank pain, chills, and fever B. Antibiotics for 3 days C. Urine cultures D. Sensitivity guided antibiotic therapy E. Symptoms generally improve after 1-2 days of therapy - Solution A. Flank pain, chills, and fever C. Urine cultures D. Sensitivity guided antibiotic therapy The patient is experiencing the following symptoms: shakiness, palpitations, nervousness, diaphoresis, anxiety, hunger, pallor, difficulty

speaking, visual disturbances, stupor, and confusion. As a nurse, you anticipate which treatment to be prescribed? (multiple choice). a. A consult with the psychologist. The patient is experiencing an anxiety attack. b. Fluids, careful observation, and possible sedation. Patient is experiencing alcohol intoxication. c. An order to check the blood glucose and immediately administer insulin intravenously if the reading is greater than 250 mg/dL. The patient is experiencing diabetic ketoacidosis. d. An order to check the blood glucose and give 4-6 ounces of fruit juice if the reading is less than 70 mg/dL. The patient is experiencing hypoglycemia. - Solution d. An order to check the blood glucose and give 4-6 ounces of fruit juice if the reading is less than 70 mg/dL. The patient is experiencing hypoglycemia. The nurse identifies which of the following patients as the highest risk for developing cirrhosis? A. A 58-year-old African American male with Hepatitis C who also has a 40-year history of alcohol and drug abuse. B. A 23-year-old female who drinks a few glasses of wine each night with dinner. C. A 41-year-old male with a BMI of 46 who takes 1,000 mg of acetaminophen daily to control headaches. D. A 70-year-old female with malabsorption syndrome who also has a history of alcoholism, but has been sober for 30 years. - Solution A. A 58- year-old African American male with Hepatitis C who also has a 40-year history of alcohol and drug abuse. A patient's test results reveal an Impaired Fasting Glucose (IFG) of 120mg/dL. The patient states they are feeling fine, and have no symptoms of Diabetes Mellitus. What is the nurse's teaching priority (Lewis et al, 2017, pages 1122-1124)? A. Your test results are indicative of Insulin Resistance, which is a condition in which body tissues do not respond to the action of insulin. This results in hyperinsulinemia and hyperglycemia.

B. Your test results are indicative of Metabolic Syndrome, which is characterized by five components: elevated glucose levels, abdominal obesity, elevated BP, high levels of triglycerides, and decreased HDLs. C. Your test results are indicative of Prediabetes. It is important to exercise, eat healthy, and maintain a healthy weight to reduce the damage to your heart and blood vessels to prevent Diabetes. D. Your test results are indicative of Gestational Diabetes. There is a 63% chan - Solution C. Your test results are indicative of Prediabetes. It is important to exercise, eat healthy, and maintain a healthy weight to reduce the damage to your heart and blood vessels to prevent Diabetes. A nurse considers providing IV replacement fluids for a patient in hypovolemic shock. Which of the fluids listed below does the nurse consider to maintain the patient's fluid volume? (Select all that apply) A. 5% Dextrose in water B. 5% Albumin C. 25% Albumin D. 0.9% Normal Saline E. Lactated Ringers - Solution B. 5% Albumin D. 0.9% Normal Saline E. Lactated Ringers Aplastic anemia is a disease in which the patient has peripheral blood pancytopenia. This indicates a decrease in (select all that apply): A. RBC B. Platelets C. Hypocellular bone marrow D. WBC E. Plasma - Solution A. RBC B. Platelets C. Hypocellular bone marrow D. WBC On assessment, a patient presents with hypotension, is tachycardic, tachypneic, and has crackles when auscultation his lungs. What type of shock is the patient having?

a. Septic Shock b. Hypovolemic Shock c. Cardiogenic Shock d. Neurological Shock - Solution c. Cardiogenic Shock You are discussing the diagnostic procedures that have been ordered by the physician with a client who is suspected of having acromegaly. Which of the following statements by the client would indicate that they understand the current plan? (Select all that apply) a. My scheduled MRI will be able to identify if I have a mass growing on my pituitary gland. b. I will need to get a complete eye exam. c. The biopsy of the thyroid will identify if the abnormal growth of my face, feet, and hands is a result of a mass there. d. The physician has ordered blood work to evaluate my plasma insulin-like growth factor. e. There will be an oral glucose tolerance test to check my growth hormone response. - Solution a. My scheduled MRI will be able to identify if I have a mass growing on my pituitary gland. b. I will need to get a complete eye exam d. The physician has ordered blood work to evaluate my plasma insulin-like growth factor. e. There will be an oral glucose tolerance test to check my growth hormone response. Systematic Inflammatory Response Syndrome (SIRS), also referred to as sepsis, has many different clinical manifestations. The nurse recognizes the following as manifestations that meet the criteria of SIRS (select all that apply). a). PCO2 of 40 mm Hg b). WBC of 16, c). Ejection Fraction of 40% d). Systolic blood pressure of 110 - Solution b). WBC of 16, c). Ejection Fraction of 40%

A patient comes to the clinic and is concerned because they shared food with a family member last week that was diagnosed with hepatitis A. What actions can the nurse expect to take? (Select all that apply). A) Test for Hepatitis A antibodies B) Administer HAV vaccine C) Administer Hepatitis A immune globulin (IG) D) Contact precautions E) Educate the patient on the need for annual follow-ups - Solution A) Test for Hepatitis A antibodies B) Administer HAV vaccine C) Administer Hepatitis A immune globulin (IG) The nurse is caring for a patient with newly diagnosed End Stage Renal Disease (ESRD). When the patient asks about what kind of treatment he may receive, the nurse can expect to provide education in which of the following areas (select all that apply)? a. Peritoneal Dialysis (PD) b. High sodium diet c. High potassium diet d. Hemodialysis (HD) e. Exogenous erythropoietin supplement - Solution a. Peritoneal Dialysis (PD) d. Hemodialysis (HD) e. Exogenous erythropoietin supplement One common trait of Gastric and Duodenal ulcers is: A.) Patient may not experience pain. B) Food tends to aggravate symptoms and cause pain. C) Pain usually occurs two hours after a meal. D) Pain will occur for a few weeks then tends to disappear. E) There are no common traits between gastric and duodenal ulcers. - Solution a. Patient may not experience pain. A 74-year-old patient with a history of gastroesophageal reflux disease (GERD) presents to the emergency department with heartburn and dyspnea. The nurse educates the patient about ways to reduce these symptoms to prevent further irritation and exacerbations. Education is

successful if the patient understands the need to avoid which substances? (Select all that apply). A. Coffee B. Chocolate C. Avocados D. Peppermint E. Alcohol - Solution A. Coffee B. Chocolate D. Peppermint E. Alcohol Neutropenia is the reduction of neutrophils in the blood. Which patients are at risk for developing neutropenia? (Select all that apply): A. 61 year old male with Felty syndrome taking lasix or kidney disease B. 35 year old female who is taking ibuprofen for pain related to their tonsillitis C. 72 year old who is getting chemotherapy for liver cancer D. 46 year old who is has diabetes in the hospital for treatment of systemic lupus erythematosus - Solution A. 61 year old male with Felty syndrome taking lasix or kidney disease C. 72 year old who is getting chemotherapy for liver cancer D. 46 year old who is has diabetes in the hospital for treatment of systemic lupus erythematosus A patient who had part of their thyroid removed 2 hours ago now has a serum calcium level of 5.8 mg. What clinical manifestation does the nurse anticipate this patient will exhibit? a) Increased BP b) Coma c) Chvostek's sign d) Depressed reflexes - Solution c) Chvostek's sign A nurse is caring for a patient who has Nephrotic Syndrome. What laboratory findings would the nurse expect to find? Select all that apply. a) Decreased total serum protein b) Elevated serum cholesterol

c) Decreased serum cholesterol d) Decreased serum albumin e) Elevated BUN - Solution a) Decreased total serum protein b) Elevated serum cholesterol d) Decreased serum albumin A female patient comes into her doctor's office after noticing a protrusion coming from her body, below her inguinal ligament. After she is examined by the physician, the woman asks the nurse: "The doctor said that I have a hernia, but my husband had a hernia and it looked nothing like this. How is that possible?" The nurse knows she must explain that the more common type of hernia experienced in females is a: a. Inguinal hernia: a point of weakness in the abdominal wall b. Umbilical hernia: the umbilical opening fails to close after birth c. Incisional hernia: weakness at the site of a previous incision d. Femoral hernia: protrusion through the femoral ring into the femoral canal - Solution d. Femoral hernia: protrusion through the femoral ring into the femoral canal After restrictive gastric banding surgery, a 42-year-old female patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the postoperative plan of care? A. Water and clear liquids given q 2 hours B. Assessment of wound C. Identify health information concerning CPAP devices D. Educate patient on the dietary modifications required - Solution A. Water and clear liquids given q 2 hours B. Assessment of wound D. Educate patient on the dietary modifications required Which of these statements is true about Crohn's disease? Select all that apply: a. Weight loss is common with the disease. b. Usually starts in the rectum, and spreads up the colon c. Involves the entire thickness of the bowel wall

d. Involves just the mucosa of the bowel e. Commonly causes toxic megacolon - Solution a. Weight loss is common with the disease. c. Involves the entire thickness of the bowel wall A patient presents themselves to the ED with dehydration, poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. They state they are feeling lethargic and weak, with nausea and abdominal pain. During your assessment, you notice the fruity odor of their breath. What should you expect the physician will order for this patient (select all that apply)? a. 20 gauge IV catheter access b. Intermittent Insulin Drip c. 0.9% NaCl Solution d. NG Tube to continuous suction e. Oxygen via a Nasal Cannula or Non-Rebreather Mask - Solution c. 0.9% NaCl Solution e. Oxygen via a Nasal Cannula or Non-Rebreather Mask Which of the following individuals would most likely develop a hiatal hernia? A. 42-year-old obese male with working in a sedentary office setting. B. 36-year-old overweight female working at a package delivery company. C. 25-year-old female clerk abusing laxatives. D. 45-year-old male high school football coach. - Solution B. 36-year-old overweight female working at a package delivery company. A patient is brought to the ED with suspected opiate overdose. Respirations are shallow with a rate of 8 per minute. What lab values would the nurse expect to see with this patient? a) pH - 7.48, PaCO2 - 26 mm Hg, HCO3 - 26 mEq/L b) pH - 7.49, PaCO2 - 39 mm Hg, HCO3 - 35 mEq/L c) pH - 7.29, PaCO2 - 52 mm Hg, HCO3 - 24 mEq/L d) pH - 7.24, PaCO2 - 39 mm Hg, HCO3 - 17 mEq/L - Solution c) pH - 7.29, PaCO2 - 52 mm Hg, HCO3 - 24 mEq/L An 18 year old female patient presents to the Emergency Department complaining of severe cramping pain and has a history of Crohnes disease.

The nurse knows that typically this cramping pain associated with Crohns disease stems from what location in the body: A. occurs anywhere along GI tract, most frequently the distal illium B. Starts in the rectum an spreads in a continuous pattern up the colon C. Is considered inflammation of the mucosa of the stomach D. Is inflammation and irritation in the esophagus - Solution A. occurs anywhere along GI tract, most frequently the distal illium The nurse is teaching a patient newly diagnosed with ulcerative colitis about characteristics of the disease. The nurse determines further teaching is necessary if the patient makes which of the following statement(s)? Select all that apply. a. "If medication management doesn't work for me, I can be cured if I undergo a total proctocolectomy." b. "I may experience complications in places like my joints, skin, eyes, or bones due to the inflammatory response in my body." c. "This disease usually starts in the upper gastrointestinal tract and moves toward the colon." d. "I will know I am experiencing an exacerbation of the disease when I have constipation and abdominal pain." e. "I have been diagnosed with an autoimmune disease." f. "I will likely develop a fistula or anal abscess as a result of this disease." - Solution c. "This disease usually starts in the upper gastrointestinal tract and moves toward the colon." d. "I will know I am experiencing an exacerbation of the disease when I have constipation and abdominal pain." f. "I will likely develop a fistula or anal abscess as a result of this disease." The nursing student is doing discharge teaching for a patient who was admitted for an acute exacerbation of ulcerative colitis. The nurse intervenes if the student makes which of the following statements? a. "You may experience some systemic effects related to this disease." b. "If you experience hard, tarry stools, you may be suffering another acute exacerbation." c. "It is important to monitor the number and appearance of your stools."

d. "Ensure you are eating enough and getting plenty of rest as fatigue with this illness can be debilitating." - Solution b. "If you experience hard, tarry stools, you may be suffering another acute exacerbation." A 28 year old female patient presents to the emergency room with severe bronchospasm and respiratory distress along with swelling of the lips and tongue. The patient appears to be wheezing and has flushing of the skin. This patient is experiencing shock that could be caused by which of the following (select all that apply) A. foods/ ingestion B. blood or blood products C. environmental agents D. myocardial Infarction E. Sepsis - Solution A. foods/ ingestion B. blood or blood products C. environmental agents A patient with peptic ulcer disease caused by the H. Pylori bacteria is going to be started on a triple drug therapy regimen. What three medications will the patient most likely be prescribed (Select all that apply)? A. Omeprazole B. Amoxicillin C. Clarithromycin D. Furosemide E. Clonazepam - Solution A. Omeprazole B. Amoxicillin C. Clarithromycin Which patient is at the highest risk for developing a Uric Acid Urinary Calculi? A. A 42 year old African American male who works in construction and eats 3 eggs every morning for breakfast B. A 56 year old Jewish male who has a family history of gouty arthritis and lives in Florida C. A 23 year old female who plays collegiate basketball and drinks 4 cups of herbal tea every day

D. A 82 year old retired female who eats beef soup every day for lunch and has a history of gallstones - Solution B. A 56 year old Jewish male who has a family history of gouty arthritis and lives in Florida Which of the following symptoms would be indicative of a ureterovesical junction (UVJ) urinary stone (Select all that apply)? A. Testicular pain or labial pain B. Dull costovertebral flank pain (renal colic) C. Lower quadrant pain D. All of the above - Solution A. Testicular pain or labial pain C. Lower quadrant pain The nurse is completing patient teaching for how to prep the bowel for a colonoscopy to evaluate for polyps. The nurse knows teaching has been effective when the patient states (select all that apply). a. "I should follow a low residue or clear liquid diet the day before the procedure until the bowel cleansing begins" b. "The probe will be inserted through my skin on my stomach" c. "If I do the bowel prep correctly I have clear or yellow liquid bowel movements" d. "The evening before the procedure I should drink 2 liters of oral polyethylene glycol (PEG) lavage solution" e. "I will know I'm ready for the procedure when I have normal bowel movements" - Solution a. "I should follow a low residue diet the day before the procedure until the bowel cleansing begins" c. "If I do the bowel prep correctly I have clear or yellow liquid bowel movements" d. "The evening before the procedure I should drink 2 liters of oral polyethylene glycol (PEG) lavage solution" Which of the following is NOT used to treat diabetic neuropathy?

a. Amputation b. Blood glucose control c. Topical capsaicin creams d. Antiseizure medications, tricyclic antidepressants, Selective Serotonin Reuptake Inhibitors and Selective Norepinephrine Reuptake Inhibitors. - Solution a. Amputation When performing client education for a patient recently diagnosed with lactase deficiency, the nurse knows that the teaching was effective when the patient repeats the following to her. a) Eliminating dairy foods will not completely resolve my symptoms. b) I can purchase lactase enzyme at the store to assist me in digesting dairy foods. c) Without variation, any dairy food will likely give my system the same reaction. d) Products containing milk products are usually well labeled and easy to spot. - Solution b) I can purchase lactase enzyme at the store to assist me in digesting dairy foods. A 65-year-old male presents to the emergency room with frequent infections, a fever, chronic fatigue and has been losing weight over the past few months. The doctor orders diagnostic tests. Which of the following results of those tests would show that this patient has chronic lymphocytic leukemia? (select all that apply): A. increase of red blood cells B. WBC > 100,00 C. thrombocytopenia D. increase number of lymphocytes in bone marrow E. increase in banded neutrophils and myeloblasts - Solution B. WBC > 100,00 C. thrombocytopenia D. increase number of lymphocytes in bone marrow A 45-year-old male patient diagnosed with CKD (chronic kidney disease) is set to discharge with plans to continue hemodialysis at a dialysis center. Which statement(s), if made by the patient, would indicate to the nurse that the patient has adequate understanding of hemodialysis? (Select all that apply)

a. "I may experience muscle cramps during dialysis treatment." b. "I will drink a protein shake everyday for breakfast." c. "I will need to restrict my fluid intake if my urine output decreases." d. "I should make sure to eat potassium rich foods with each meal." e. "This treatment will require blood transfusions to be effective." - Solution a. "I may experience muscle cramps during dialysis treatment." c. "I will need to restrict my fluid intake if my urine output decreases." A student nurse is explaining the goal of combination antiretroviral (ART) therapy to a patient diagnosed with Human Immunodeficiency Virus. Which of the following should the nurse correct the student nurse on during the education? A. decrease viral load B. cure the disease C. prevent transmission D. raise/maintain CD4 counts - Solution B. cure the disease A busy Registered Nurse (RN) has 5 patients on the medical surgical floor. What tasks involving the care of an intravenous (IV) line may the RN delegate to a Licensed Practical Nurse (LPN)? a) Choose and insert appropriate IV catheters and infusion devices. b) Monitor for clinical manifestations of adverse reactions to IV fluids or medications. c) Adjust IV flow rate for stable patients according to provider orders. d) Prepare IV medications and infusions. e) Evaluate patient for clinical manifestations of fluid overload or hypovolemia and initiate appropriate changes in IV fluids. f) Report swelling or redness at the site, or patient complaints about the IV.

• Solution b) Monitor for clinical manifestations of adverse reactions to IV fluids or medications. c) Adjust IV flow rate for stable patients according to provider orders. f) Report swelling or redness at the site, or patient complaints about the IV. A patient is going to start frequent peritoneal dialysis to treat their chronic kidney disease. Education that needs to be provided to this patient includes: