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MEDSURG NCLEX Final Exam Questions with Complete Answers 2024-2025, Exams of Nursing

A comprehensive set of multiple-choice questions and answers covering various medical-surgical topics relevant to the nclex exam. It includes questions on topics such as oncology, cirrhosis, urinary tract infections, constipation, pancreatitis, radiation and chemotherapy, gastroesophageal reflux disease, thrombocytopenia, acid-base balance, hemodialysis, arteriovenous fistula, gout, urinary calculi, diabetic ketoacidosis, e-coli poisoning, acute poststreptococcal glomerulonephritis, and acute kidney injury. Designed to help students prepare for the nclex exam by providing them with a comprehensive review of key concepts and clinical scenarios.

Typology: Exams

2023/2024

Available from 11/07/2024

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MEDSURG NCLEX FINAL EXAM

QUESTIONS WITH COMPLETE

ANSWERS 2024-2025 UPDATED GRADED

A+.

A patient has been receiving chemotherapy and radiation for a diagnosis of non-Hodgkin's lymphoma. In your morning assessment you notice the patient has new onset facial edema, distention of head and neck veins, and dyspnea. Which oncologic emergency would be suspected? a. Hypercalcemia b. Spinal Cord Compression c. Superior Vena Cava Syndrome (SVCS) d. Tumor Lysis Syndrome (TLS) - Exact answer c. Superior Vena Cava Syndrome (SVCS) When providing education to a patient newly diagnosed with cirrhosis, what information should be included? (select all that apply) a. Inform the patient that cirrhosis is an acute condition that can be alleviated with the correct drug regimen b. Avoid aspirin and NSAIDs to prevent hemorrhage c. Limit alcohol consumption to one drink per week d. Teach symptoms of complications and when to seek medical attention e. Avoid hepatotoxic over-the-counter (OTC) drugs - Exact answer b. Avoid aspirin and NSAIDs to prevent hemorrhage d. Teach symptoms of complications and when to seek medical attention e. Avoid hepatotoxic over-the-counter (OTC) drugs A nurse is teaching a patient about prevention of a second UTI. Which of the statements made by the patient requires further intervention? a. "I will stop taking my antibiotic once the symptoms are gone." b. "I should consider drinking unsweetened cranberry juice in my diet."

c. "I will urinate regularly approximately every 3-4 hours" d. "I will remember to drink fluids adequately." - Exact answer a. "I will stop taking my antibiotic once the symptoms are gone." A nursing student is teaching a patient about management of constipation. The nursing instructor would intervene if the student made which statement? (Select all that apply) a. The use of laxatives and enemas will help free up blockage. b. Eat foods with high fiber like raw vegetables and beans c. Drink about 3 quarts of fluid including coffee and energy drinks. d. Establish a regular time to defecate. e. Exercise about 3 times a week. - Exact answer a. The use of laxatives and enemas will help free up blockage. c. Drink about 3 quarts of fluid including coffee and energy drinks. A nurse is reviewing lab values for a patient admitted to the hospital for acute pancreatitis, what lab values would the nurse expect to see? (Select all that apply.) a.) Elevated Serum Amylase b.) Decreased Phosphorus c.) Decreased Calcium d.) Elevated Serum Lipase - Exact answer a.) Elevated Serum Amylase c.) Decreased Calcium d.) Elevated Serum Lipase The nurse knows, which of the following patients is most at risk of having another flair up of their chronic pancreatitis? a.) A 72-year-old female, who enjoys eating fried foods regularly and states she prefers to eat late dinners just before bedtime. b.) A 23-year-old male, who was hospitalized with spleen injury after a MVA, who states he drinks several times a week with his friends, and takes NSAIDs to treat abdominal pain from his accident. c.) A 56-year-old male, who prefers drinking milk instead of water with meals, and states his diet consists of mostly legumes and fish.

d.) A 28-year-old female, with poly cystic ovarian syndrome and a BMI of 31, who states she binges on sweets when she is feeling stressed from work and school. - Exact answer b.) A 23-year-old male, who was hospitalized with spleen injury after a MVA, who states he drinks several times a week with his friends, and takes NSAIDs to treat abdominal pain from his accident. Which of the following are considered nursing interventions for patients going through radiation or chemotherapy? (Select all that apply) a.) Monitor BUN and creatinine levels b.) Teach patient to avoid large crowds c.) Encourage patient to get at least 60 min of direct sunlight per day d.) Monitor platelet counts e.) High fiber diet to prevent constipation - Exact answer a.) Monitor BUN and creatinine levels b.) Teach patient to avoid large crowds d.) Monitor platelet counts Lifestyle modifications are crucial for the management and prevention of gastroesophageal reflux disease (GERD). Which of the following is a strategy for good management to teach a patient who was recently diagnosed? a.) Eat a small meal close to bedtime to ease the onset of GERD b.) Avoid alcohol and caffeinated beverages c.) Avoid taking sucralfate (Carafate) d.) If a PPI is being taken, it is best to take it right before bedtime - Exact answer b.) Avoid alcohol and caffeinated beverages The nurse is doing discharge teaching for a patient with a new diagnosis of thrombocytopenia. Which statement, if made by the patient, would indicate that the patient understands the teaching? (SELECT ALL THAT APPLY) a. "I can't wait to get back to my weights class at the gym!" b "I will talk with my Dr. before my pedicure appointment next week." c. "I will stop taking my herbal supplements and over the counter medications until I speak with my Dr."

d. "I will replace my toothbrush with one with medium bristles." e. "I will contact my Dr. if I get a headache, or my vision changes." - Exact answer b "I will talk with my Dr. before my pedicure appointment next week." c. "I will stop taking my herbal supplements and over the counter medications until I speak with my Dr." e. "I will contact my Dr. if I get a headache, or my vision changes." A patient's arterial blood gas (ABG) results are: PH; 7.31, PaCO2; 54 mmHg, HCO3; 25 mEq/L. What kind of acid-base imbalance is this? a. Metabolic acidosis, uncompensated b. Respiratory alkalosis, compensated c. Respiratory acidosis, uncompensated d. Metabolic alkalosis, uncompensated e. Respiratory acidosis, compensated - Exact answer c. Respiratory acidosis, uncompensated A 65-year-old patient is receiving hemodialysis. They are on Norco for post- surgical pain, and Benazepril for hypertension. The patient starts to unexpectedly blead out from his surgical incision. What would you do and why? (Select all that apply) a.) Give Vitamin K to help the blood clot b.) Give protamine sulfate to stem the excessive bleeding c.) Stop hemodialysis to focus on the bleeding d.) Put pressure on the surgical site to slow the bleeding - Exact answer b.) Give protamine sulfate to stem the excessive bleeding c.) Stop hemodialysis to focus on the bleeding A student nurse is explaining the probable sites for an arteriovenous fistula to the patient. Which statement does the preceptor know suggests understanding of placement on the part of the student nurse? a.) Brachial and antecubital area b.) Cephalic or basilic vein with radial artery c.) Femoral vein

d.) Internal jugular - Exact answer b.) Cephalic or basilic vein with radial artery When providing education about diet for a patient who has had a history of gout and urinary calculi, the nurse should tell the patient to avoid or limit which of the following food selections (SELECT ALL THAT APPLY) a. Liver b. Corn c. Mussels d. Salmon e. Tomatoes - Exact answer a. Liver c. Mussels d. Salmon A 12-year-old patient presents with poor skin turgor, dry mucus membranes, tachycardia, orthostatic hypotension, lethargy, weakness, and has rapid deep respirations with a sweet fruity odor. The nurse suspects this patient is suffering from a. Hyperosmolar hyperglycemic syndrome b. Diabetic Ketoacidosis c. Insulin excess d. Dehydration - Exact answer b. Diabetic Ketoacidosis A 43 year old woman is diagnosed with gastroesophageal reflux disease (GERD). What guidelines can the nurse provide to her for managing her symptoms? SELECT ALL THAT APPLY. a.) Lie down after eating to relieve pressure b.) Having peppermint or tea after eating can soothe any discomfort c.) Avoid late night snacking d.) Eating small, more frequent meals is better than eating a few large meals per day e.) Drinking fluids between meals and not with meals can help prevent reflux - Exact answer c.) Avoid late night snacking

d.) Eating small, more frequent meals is better than eating a few large meals per day e.) Drinking fluids between meals and not with meals can help prevent reflux A 26 year old male presents to the Emergency Department with 2 days of bloody stools, abdominal cramping, and watery diarrhea. He is diagnosed with e-coli poisoning. When explaining what he ate the past few days, which items might you suspect as the e-coli carrying culprit? a.) A bowl of oatmeal with brown sugar and raisins b.) Vegetable soup c.) A chocolate brownie d.) A cheeseburger and fries - Exact answer d.) A cheeseburger and fries A patient comes into the hospital and based on the complete history and physical examination he/she is diagnosed with Acute Poststreptococcal Glomerulonephritis. What are the clinical manifestations that the health care provider is going to see? (Select all that apply) a.) Proteinuria b.) Hematuria with smoky appearance c.) Hyperlipidemia d.) Periorbital edema e.) Flu-like symptoms - Exact answer a.) Proteinuria b.) Hematuria with smoky appearance d.) Periorbital edema After a patient comes into the hospital for an AKI and you notice that he/she is experiencing severe dehydration, and oliguria. The patient does not encompass any damage to the kidney tissue but is experiencing decreased circulating blood volume, which stage of AKI would this patient be in? a.) Acute tubular necrosis b.) Intrarenal

c.) Prerenal d.) Postrenal - Exact answer c.) Prerenal A nurse is educating a female patient about to be discharged from the hospital after being treated for a urinary tract infection (UTI). The nurse recognizes the patient correctly understands the education material when they make the following statements, EXCEPT? (SELECT ALL THAT APPLY) a.) I should urinate approximately every 3-4 hours throughout the day b.) I should take bubble bathes as a way to get everything clean down there c.) I should be emptying my bladder before and after sexual intercourse d.) I should be wiping from front to back after urinating e.) I should stop taking my antibiotics once the symptoms of my urinary tract infection (UTI) are gone - Exact answer b.) I should take bubble bathes as a way to get everything clean down there e.) I should stop taking my antibiotics once the symptoms of my urinary tract infection (UTI) are gone A patient is presenting to the emergency department with confirmed anaphylactic shock after eating peanuts. Which order by the doctor would the nurse question in regard to the treatment of this patient? a.) Epinephrine IM b.) Albuterol c.) Nitroglycerin d.) Diphenhydramine - Exact answer c.) Nitroglycerin A patient is admitted to the hospital with a ventricular septal rupture. He is experiencing tachycardia, tachypnea, crackles, and a narrowing pulse pressure. The patient is suspected to be in cardiogenic shock. The nurse would question which medication ordered? a) Nitroglycerin b) Dobutamine c) Furosemide d) Norepinephrine e) Dopamine - Exact answer d) Norepinephrine

The nurse is providing discharge teaching to a patient who has a new diagnosis of Type 1 Diabetes Mellitus. The nurse understands teaching has been effective when the patient makes which statements? a) I have an autoimmune disorder b) I will be able to control my disease with diet and exercise only c) My AIC goal is less than 7% d) I will only require a once daily injection of Lantus e) I will carry cookies with me incase my blood glucose drops below 70 - Exact answer a) I have an autoimmune disorder c) My AIC goal is less than 7% A student nurse is providing health promotion activities to a patient and caregiver to prevent the recurrence of a Urinary Tract Infection. Which statement by the student would require correction from the nurse? a.) When providing appropriate hygiene wipe from back to front after urinating b.) Maintain adequate fluid intake c.) Report to the HCP symptoms or signs of recurrent UTI d.) Consider drinking unsweetened cranberry juice or taking cranberry extract tablets 300-400 mg/day - Exact answer a.) When providing appropriate hygiene wipe from back to front after urinating What clinical manifestations would you expect to find in a patient diagnosed with Irritable Bowel Disease presenting with hypomagnesemia? (Select all that apply) a.) Trousseau's sign b.) Diminished deep tendon reflexes c.) Vertigo d.) Muscle cramps e.) Urinary retention f.) Confusion - Exact answer a.) Trousseau's sign c.) Vertigo d.) Muscle cramps

f.) Confusion A patient's morning lab has hemoglobin level of 5 g/dL, the integumentary changes the nurse will notice in this patient include the following? (Select all that apply). a. Pallor b. Jaundice c. Anorexia d. Pruritus e. Increased pulse pressure - Exact answer a. Pallor b. Jaundice d. Pruritus A client diagnosed with chronic kidney has the following ABG results; pH 7.26, PaCO2 30 mm Hg, HCO3 16 mEq/L, PaO2 90 mm Hg, and O saturation of 96%. As the nurse, you will interpret these results as a.) Respiratory Acidosis b.) Metabolic Acidosis c.) Respiratory Alkalosis d.) Metabolic Alkalosis - Exact answer b.) Metabolic Acidosis A critically ill patient is diagnosed with severe hypokalemia. Appropriate treatment modalities for the management of severe hypokalemia include (select all that apply) a.) Set up continuous electrocardiogram monitoring b.) Administer a bolus of intravenous potassium chloride c.) Frequently assess the intravenous site for phlebitis and infiltration d.) Monitor urine output - Exact answer a.) Set up continuous electrocardiogram monitoring c.) Frequently assess the intravenous site for phlebitis and infiltration d.) Monitor urine output

During an hourly neurological assessment of a patient suffering from neurogenic shock, which of the following signs or symptoms would the nurse find most concerning? a.) Delirium b.) Restlessness c.) Decreased responsiveness to stimuli d.) Pupils nonreactive and dilated - Exact answer d.) Pupils nonreactive and dilated You are caring for a patient diagnosed with Acute Kidney injury. In educating the patient about this disease, you describe the different types of AKI as prerenal, intrarenal, and postrenal. Which of the following are potential causes of prerenal AKI? Select all that apply. a) Severe dehydration b) Heart failure c) Damage to kidney tissue d) Decreased cardiac output e) Nephrotoxins - Exact answer a) Severe dehydration b) Heart failure d) Decreased cardiac output A patient is diagnosed with Grave's disease. They are scheduled to have a complete thyroidectomy. What post-op complication should the nurse educate the patient on that involves an excessive amount of thyroid hormone being released into circulation and is considered a medical emergency if left untreated? a) Thyroid Storm b) Exophthalmos c) Goiter d) Hyperthyroidism e) Decreased basal metabolic rate - Exact answer a) Thyroid Storm A patient diagnosed with chronic kidney disease questions the nurse on his possibility of a kidney transplant. The nurse knows that which of the

following factors would cause the patient to be unable to receive a kidney transplant (select all that apply): A. Unmanaged Bipolar II disorder B. Being over age 70 C. Having no familial relatives with a viable kidney to donate D. Disseminated lung cancer E. Being HIV positive F. Chronic respiratory failure - Exact answer A. Unmanaged Bipolar II disorder D. Disseminated lung cancer F. Chronic respiratory failure A student nurse is discussing risk factors for renal cell carcinoma with an experienced nurse. The experienced nurse should intervene if the student describes which of the following as a risk factor for developing this type of cancer? A. Smoking one pack of cigarettes per day B. A blood pressure of 110/ C. A body mass index of 31 kg/m D. Workplace exposure to asbestos and gasoline - Exact answer B. A blood pressure of 110/ Which statement(s) is/are correct about Acute Kidney Injury (AKI)? Select all that apply. a) The most common intrarenal cause is acute tubular necrosis. b) The onset is gradual and often over many years. c) Prerenal and postrenal AKI usually resolves quickly with treatment. d) The RIFLE classification is used to describe the stages of AKI. e) Diagnostic criteria of AKI are acute reduction in urine output and /or elevation in serum creatinine. - Exact answer a) The most common intrarenal cause is acute tubular necrosis. c) Prerenal and postrenal AKI usually resolves quickly with treatment. d) The RIFLE classification is used to describe the stages of AKI.

e) Diagnostic criteria of AKI are acute reduction in urine output and /or elevation in serum creatinine. What is Inflammatory bowel disease (IBD)? a) Inflammation of the mucosa of the stomach and small intestine with sudden diarrhea, nausea, vomiting, fever, and abdominal cramping. b) Disorder characterized by chronic abdominal pain or discomfort and alteration of bowel patterns between diarrhea and constipation. c) Chronic symptom of mucosal damage caused by reflux of stomach acid into the lower esophagus. d) Chronic inflammation of the GI tract characterized by periods of remission interspersed with periods of exacerbation. e) Syndrome defined by difficult or infrequent stools; hard, dry stools that are difficult to pass; or a feeling of incomplete evacuation. - Exact answer d) Chronic inflammation of the GI tract characterized by periods of remission interspersed with periods of exacerbation. After providing education to a patient with Chronic Kidney Disease (CKD) receiving bi-weekly Peritoneal Dialysis, which of the following statements indicates that dietary coaching has been effective? a. "I can drink as much water as I want as long as my weight and blood pressure are controlled." b. "My daily protein intake should be 2.1 g/kg of my ideal body weight." c. "My nutritional energy sources should come primarily from carbohydrate and fat sources." d. "I will not require supplements to balance my nutritional needs if I'm receiving erythropoietin." - Exact answer a. "I can drink as much water as I want as long as my weight and blood pressure are controlled." Which of the following are risk factors for developing Chronic Kidney Disease? (Select all that apply) a. Diabetes Mellitus b. Hypertension c. Minority population status d. Burns - Exact answer a. Diabetes Mellitus

b. Hypertension c. Minority population status A male patient has undergone a hemopoietic stem cell transplant for acute lymphoblastic leukemia (ALL) a couple months ago. From the patient's most recent lab draw, which lab values would be most concerning to the nurse? -Select all that applies a. Sodium level of 136 b. Hematocrit of 25% c. Hemoglobin of 8.2 g/dL d. Platelet count of 350,000/μL e. Red blood cell count of 5.0〖×10〗^6/μL - Exact answer b. Hematocrit of 25% c. Hemoglobin of 8.2 g/dL A nurse is administering parenteral nutrition to their patient. What action by the nurse would require the charge nurse to intervene? a) The nurse verifies the parenteral nutrition rate and dose before administration. b) The nurse realizes the feeding is behind schedule and speeds it up. c) The feeding finishes sooner than expected so the nurse starts a 10% dextrose solution. d) The nurse attaches feeding tubing to the patient's peripherally inserted central catheter - Exact answer b) The nurse realizes the feeding is behind schedule and speeds it up. When educating the patient, caregiver, and family about incontinent urinary diversion surgery, the nurse understands it is important to include (SELECT ALL THAT APPLY) a. small bowel obstruction is a potential complication after pelvic surgery. b. an assessment of the patient's ability and readiness to learn before beginning. c. observations of mucus in the urine from an ileal conduit should be reported to the healthcare provider as soon as possible.

d. the skin around the stoma must be cared for meticulously to prevent dermatitis and yeast infections. e. in this procedure, a patient does not leak involuntarily; there will be no need for an external collecting device. - Exact answer a. small bowel obstruction is a potential complication after pelvic surgery. b. an assessment of the patient's ability and readiness to learn before beginning. d. the skin around the stoma must be cared for meticulously to prevent dermatitis and yeast infections. When assessing a patient with the diagnosis of Grave's disease, the nurse anticipates the following manifestations EXCEPT a. exophthalmos b. thick, brittle nails c. laboratory results showing low thyroid stimulating hormone (TSH) and elevated thyroxine (T4) d. intolerance to heat - Exact answer b. thick, brittle nails A client comes into the clinic complaining of dysuria, frequent urination, urgency, and cloudy urine. For which client would it be expected for the health care provider to order 3 days of trimethropim/sulfamethoxazole (Bactrim)? a. A 22 year old female who tends to drink 4-5 alcoholic beverages on Friday nights. b. A 24 year old male who exercises regularly. c. A 30 year old female with type 2 diabetes. d. A 70 year old male patient who lives in a nursing home and has a foley catheter. e. A 45 year old female who is complaining of costovertebral angle (CVA) tenderness. - Exact answer a. A 22 year old female who tends to drink 4- alcoholic beverages on Friday nights. The nurse is caring for a patient who had strep throat 8 days ago and is now complaining of flank pain, periorbital edema and said their urine is a rusty color. What lab findings will the nurse expect to see?

a. Proteinuria b. RBCs c. WBs d. Casts e. Glucose - Exact answer a. Proteinuria b. RBCs d. Casts A 59-year-old male is admitted to the ER with a distended abdomen thought to be ascites. Ascites is a common manifestation of cirrhosis. What are three mechanisms that lead to ascites? (Select all that apply) a. Hyperaldosteronism b. Inflammation of the sphincter of Oddi associated with cholelithiasis c. Portal hypertension d. Hypoalbuminemia e. Pancreatic abscess - Exact answer a. Hyperaldosteronism c. Portal hypertension d. Hypoalbuminemia Central Venous Access Devices (CVADs) have several potential complications. Careful monitoring and assessment may assist in early identification of potential complications. What is a manifestation of a pneumothorax, if it would occur? a. Sluggish infusion or aspiration b. Dysrhythmias c. Systemic: fever, chills, malaise d. Decreased or absent breath sounds - Exact answer d. Decreased or absent breath sounds A 54-year-old female patient has a suspected infection. Which of the following findings support a diagnosis of sepsis? Select all that apply a) Temperature of 101.3°F b) RBC count 6.2 x 1012/L

c) Lactate 3 mmol/L d) Heart Rate 110 beats/min e) Respiratory Rate 10/min - Exact answer a) Temperature of 101.3°F c) Lactate 3 mmol/L d) Heart Rate 110 beats/min The insulin regiment that most closely mimics endogenous insulin production is the basal-bolus regimen. Which of the following types of insulin is used as a basal insulin to maintain blood glucose levels in between meals and overnight? a) Lispro (Humalog) b) Aspart (Novolog) c) Regular (Humulin R) d) Glulisine (Apidra) e) Glargine (Lantus) - Exact answer e) Glargine (Lantus) A patient undergoing hemodialysis begins to experience complications. Which of the following are known complications associated with hemodialysis? Select all that apply. a. Hypertension b. Muscle cramps c. Loss of blood d. Hepatitis - Exact answer b. Muscle cramps c. Loss of blood d. Hepatitis Which of the following is true of hypovolemic shock? a. blood products are not initiated as volume replacement until volume loss is greater than 40% b. the size of the vascular compartment increases while the fluid volume decreases c. relative hypovolemia is seen in burn patients

d. drug therapy for hypovolemic shock is administration of vasopressors and antibiotics - Exact answer c. relative hypovolemia is seen in burn patients Patrick, a 65-year-old man, has been recently diagnosed with Hyperosmolar hyperglycemic syndrome (HHS). What are some common causes that could have led to the diagnosis of this syndrome? (Select all that apply) a.) Urinary tract infection b.) Pneumonia c.) Sepsis d.) Undiagnosed type 1 diabetes e.) Newly diagnosed type 2 diabetes - Exact answer a.) Urinary tract infection b.) Pneumonia c.) Sepsis e.) Newly diagnosed type 2 diabetes Stacey, a 61-year-old woman, states that almost every time she sneezes, coughs or laughs she urinates a little bit and is unable to control it from happening. What type of urinary incontinence is this patient most likely experiencing? a.) Urge Incontinence b.) Stress Incontinence c.) Overflow Incontinence d.) Functional Incontinence - Exact answer b.) Stress Incontinence When providing education to a group of adults targeted by a community outreach program the nurse should include the following information to teach ways to decrease the risk of contracting HIV. (Select all that apply) a.) Kiss individuals only after knowing their HIV status b.) Increase safe sex practices, including always wearing a condom and decrease number of sex partners

c.) Don't share drug equipment including needles, cookers, cotton, rinse water, straws, or pipes d.) Safe sexual activities include "hand jobs" and other mutual masturbation techniques - Exact answer b.) Increase safe sex practices, including always wearing a condom and decrease number of sex partners c.) Don't share drug equipment including needles, cookers, cotton, rinse water, straws, or pipes d.) Safe sexual activities include "hand jobs" and other mutual masturbation techniques When providing education to a patient recently diagnosed with Sickle Cell Disease, what should the nurse instruct the patient about managing symptoms and preventing a crisis? a. Take weekly high-intensity, high-elevation hikes to ensure cardiac health b.) Drink 1L/day of water c.) Begin screening for retinopathy at the age of 10 d.) Seek medical attention two weeks after the onset of infection if condition worsens - Exact answer c.) Begin screening for retinopathy at the age of 10 The nurse would question the order for enteral nutrition in patients with which of the following diagnosis? a. Anorexia b. Chemotherapy patient c. Gastrointestinal Obstruction d. Extensive burns - Exact answer c. Gastrointestinal Obstruction A patient with a diagnosis of Diabetes Insipidus would experience which of the following fluid and electrolyte imbalance symptoms? Select all that apply. a. Polydipsia b. Polyuria c. Serum sodium 132 mg/dL d. Specific gravity of 1. e. Generalized weakness - Exact answer a. Polydipsia b. Polyuria

d. Specific gravity of 1. e. Generalized weakness A 29-year-old anorexic female patient recently started receiving parenteral nutrition via central catheterization. During your re-assessment you notice the patient has developed some general edema, and tells you she is having trouble breathing, feels like her heart is "skipping beats," and is concerned about her lower extremities feeling tingly. What is most likely occurring with your patient? a) Hyperventilation brought on by anxiety related to new procedure b) Relative hypovolemic shock related to systemic vasodilation c) Refeeding syndrome related to electrolyte imbalances and fluid retention d) Hyperphosphatemia related to malnutrition and fluid overload - Exact answer c) Refeeding syndrome related to electrolyte imbalances and fluid retention A patient is admitted to the emergency department with signs and symptoms of shock. Your priority is in assessing airway, breathing, circulation, and monitoring vitals. His blood oxygen saturation (SpO2) is at 86% on room air, blood pressure 89/68, heart rate 130, respirations 22, and temperature 98.9 degrees Fahrenheit. After taking vitals, you continue to monitor your patient for which signs and symptoms that indicate shock progression? -Select all that applies a) Polyuria b) Warm, flushed skin c) Hyperreactive reflexes d) Anuria e) Hypothermia - Exact answer d) Anuria e) Hypothermia A patient is coming back post operatively from a thyroidectomy. The nurse should take all of the following actions EXCEPT: a. Position patient in Semi-Fowlers position b. Asses for hemorrhage every 2 hours

c. Head support to avoid stress on the sutures d. Have patient preform range of motion and neck exercises immediately - Exact answer d. Have patient preform range of motion and neck exercises immediately A patient who is about to receive Radioactive Iodine Therapy is asking you how It works. SELECT ALL THAT APPLY that you would explain to the patient about this process of Iodine Therapy: a. The Iodine is picked up by the thyroid gland b. It may take up to 3 months for full benefit c. The patient will need to follow radiation precautions for a few weeks after therapy d. The Iodine therapy destroys the overactive thyroid cells over time e. The treatment involves making a small incision on the patient's neck - Exact answer a. The Iodine is picked up by the thyroid gland b. It may take up to 3 months for full benefit c. The patient will need to follow radiation precautions for a few weeks after therapy d. The Iodine therapy destroys the overactive thyroid cells over time A patient has recently been diagnosed with cancer of the bladder. She has become incontinent and is undergoing urinary diversion surgery tomorrow. At the preoperative appointment you are educating the patient on what to expect postoperatively. You know the patient requires further teaching if they make which statement? a. It is normal for my stoma to shrink within the first couple weeks of surgery. b. I will need to limit my fluid intake at home to prevent excess urine from seeping from my stoma. c. I will be fitted for a permanent appliance 7-10 days after my surgery. d. After my surgery I will need to continue using my incentive spirometer to prevent my lungs from collapsing. - Exact answer b. I will need to limit my fluid intake at home to prevent excess urine from seeping from my stoma.

A 42-year-old female has been diagnosed with hyperthyroidism due to Graves disease. A student nurse is educating the patient about the disease, its sign and symptoms and precipitating factors. The registered nurse is confident that student nurse understands this illness when the student nurse makes which following statements? (SELECT ALL THAT APPLY) a. Graves disease is caused by a virus and it affects your thyroid levels but with the proper medication, you can cure this infection. b. One hallmark sign for Graves' disease is exophthalmos c. Clinical manifestations of this illness include warm, smooth, and moist skin d. Clinical manifestations of this illness include thick, cold, and dry skin. e. Without proper treatment this disease can result in hypothyroidism - Exact answer b. One hallmark sign for Graves' disease is exophthalmos c. Clinical manifestations of this illness include warm, smooth, and moist skin e. Without proper treatment this disease can result in hypothyroidism The nurse is caring for a patient who develops septic shock. The nurse knows to take which of the following actions? (Select all that apply). a. Administer large amounts of isotonic crystalloid fluid replacement. b. Start antibiotic therapy and then obtain cultures. c. Maintain glucose levels below 180 mg/dL. d. Perform a cardiac catheterization as soon as possible. e. Monitor vital signs, especially temperature. - Exact answer a. Administer large amounts of isotonic crystalloid fluid replacement. c. Maintain glucose levels below 180 mg/dL. e. Monitor vital signs, especially temperature. A nurse is teaching a patient newly diagnosed with Interstitial cystitis (IS) and Painful Bladder Syndrome (PBS) about his condition. The nurse realizes that further teaching is necessary when the patient states?

a. "I may experience pain and bothersome lower urinary tract symptoms (LUTS) such as frequency and urgency". b. "I will be taking antibiotics to treat interstitial cystitis". c. "If my condition becomes severs, I may urinate as often as 60 times per day". d. "Pain is often temporarily relieved by urination". - Exact answer b. "I will be taking antibiotics to treat interstitial cystitis". A 24-year-old female is admitted to the hospital for sickle cell crisis. She is ready to discharge and the nurse is preparing her discharge education. What should the nurse include in her teaching? (Select all that apply) A. Avoid areas of high elevation B. Use of home oxygen therapy C. Genetic testing for her and her partner D. Maintain adequate fluid intake E. Treat infections promptly - Exact answer A. Avoid areas of high elevation C. Genetic testing for her and her partner D. Maintain adequate fluid intake E. Treat infections promptly A patient diagnosed with an uncomplicated urinary tract infection is given education on how to prevent further infections from occuring. The nurse should intervene if the patient makes which statement? A. "My job is so busy, sometimes I go all day without being able to go to the bathroom." B. "I am sad I can no longer take bubble baths" C. "I will ensure to maintain proper hygiene, especially after a bowel movement." D. "I love cranberry juice! I will buy some on my way home." - Exact answer A. "My job is so busy, sometimes I go all day without being able to go to the bathroom." The nurse is caring for a male patient who is suspected of being in metabolic syndrome. The nurse understands that this puts the patient at

greater risk for cardiovascular disease, stroke, and diabetes mellitus. When the nurse inspects the patient's chart, he would expect to see which of the following? a. Waist circumference of 42 in, triglyceride level of 136 mg/dL, fasting blood glucose of 120 mg/dL, and a blood pressure of 122/78. b. Waist circumference of 38 in, triglyceride level of 144 mg/dL, fasting blood glucose of 98mg/dL, and a blood pressure of 125/66. c. Waist circumference of 44 in, triglyceride level of 164 mg/dL, HDL level of 52 mg/dL, and a medication order for hydrochlorothiazide 12.5 mg PO BID. d. Waist circumference of 32 in, triglyceride level of 143 mg/dL, a medication order for atorvastatin 10mg PO QD, and blood pressure of 133/72. - Exact answer c. Waist circumference of 44 in, triglyceride level of 164 mg/dL, HDL level of 52 mg/dL, and a medication order for hydrochlorothiazide 12.5 mg PO BID. The nurse is caring for a patient who is complaining of urinary incontinence since the birth of her child. The nurse is educating the patient about Kegel exercises, and knows that teaching was successful if the patient states which of the following? (Select all that apply). a. "These exercises are meant to strengthen the muscles that support my bladder, rectum, vagina, and uterus." b. "I should do both short and long squeezes 40-50 times each day." c. "I should lay on my stomach and squeeze my buttocks together to perform this exercise." d. "When I do the exercise, I imagine I'm on an elevator full of people and I'm trying to control the passing of gas." - Exact answer a. "These exercises are meant to strengthen the muscles that support my bladder, rectum, vagina, and uterus." b. "I should do both short and long squeezes 40-50 times each day." d. "When I do the exercise, I imagine I'm on an elevator full of people and I'm trying to control the passing of gas." The nurse is taking care of a patient who just arrived into the ED with suspected sepsis. The nurse would know one of the clinical manifestations of septic shock are?

A. Hypoglycemia B. Hyperthermia C. Vasodilation D. Bradypnea - Exact answer C. Vasodilation If a patient is diagnosed with Cardiogenic shock, which drug therapies would the patient be on to treat Cardiogenic shock. Select all that apply: a. Nitrates (nitroglycerin) b. Vasopressors (phenylephrine) c. Diuretics (furosemide) d. Anticholinergics (atropine) e. Inotropes (dobutamine) - Exact answer a. Nitrates (nitroglycerin) c. Diuretics (furosemide) e. Inotropes (dobutamine) The nurse understands that the first manifestation(s) of Polycystic Kidney Disease (PKD) is/are: (Select all that apply) a. Hypertension b. Elevated Triglycerides c. Headaches d. Hematuria e. Pain - Exact answer a. Hypertension c. Headaches d. Hematuria e. Pain Which patient is at most risk for developing Chronic Kidney Disease (CKD)? a. A 54-year-old white male with uncontrolled hypertension. b. An 80-year-old Native American with diabetes and polypharmacy. c. A 64-year-old African American female with obesity and a Hgb A1-c of 6.

d. A 60-year-old Hispanic female with hyperlipidemia and blood pressure of 130/80. - Exact answer b. An 80-year-old Native American with diabetes and polypharmacy. A patient asks the student nurse to explain common symptoms of a lower urinary tract infection. The student nurse would be correct if they gave all the symptoms except which of the following? a. Dysuria b. Suprapubic discomfort c. Flank pain d. Urgency - Exact answer c. Flank pain When hemodialysis is performed, the nurse will want to closely observe the patient for a decrease in blood pressure that will manifest itself in which way(s) (Select all that apply.) a. vision changes b. increases cardiovascular disease c. seizure activity d. nausea/vomiting - Exact answer a. vision changes c. seizure activity d. nausea/vomiting Which statement(s) would be considered correct in regards to the onset, peak, and duration for the following types of insulin? (Select all that apply). a. Rapid acting insulin has an onset of 10-30 minutes, a peak of 30 minutes

  • 3 hours, and a duration of 3-5 hours. b. Short acting insulin has an onset of 1.5-4 hours, a peak of 4-12 hours, and a duration of 12-18 hours c. Intermediate insulin has an onset of 30 minutes-1 hour, a peak of 2-5 hours, and a duration of 5-8 hours d. Long acting insulin has an onset of 0.8-4 hours, no pronounced/less defined peak, and a duration of 16-24 hours e. Inhaled insulin has an onset of 12-15 minutes, a peak of 60 minutes, and a duration of 2.5-3 hours. - Exact answer a. Rapid acting insulin has an onset of 10-30 minutes, a peak of 30 minutes - 3 hours, and a duration of 3-5 hours.