NCLEX Leadership Questions: 300. Exam With Verified Answers.Latest Update.Guaranteed Succe, Exams of Nursing

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NCLEX Leadership Questions: 300. Exam With Verified

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**1. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: A. 2 to 5 g of a simple carbohydrate. B. 10 to 15 g of a simple carbohydrate. C. 18 to 20 g of a simple carbohydrate. D. 25 to 30 g of a simple carbohydrate.

2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add?**

A. Related to bone demineralization resulting in pathologic fractures

B. Related to exhaustion secondary to an accelerated metabolic rate

C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces

D. Related to tetany secondary to a decreased serum calcium level

3. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to:

A. Encourage the client to ask questions about personal sexuality.

B. Provide time for privacy.

C. Provide support for the spouse or significant other.

D. Suggest referral to a sex counselor or other appropriate professional.

4. during a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? A. At least once a week

B. At least three times a week

C. At least five times a week

D. Every day

5. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

A. Increased appetite and weight loss

B. Puffiness of the face and hands

C. Nervousness and tremors

D. Thyroid gland swelling

6. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?

A. Dysuria

B. Leg cramps

C. Tachycardia

D. Blurred vision

7. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, Nurse Richard would suspect which of the following disorders? A. Diabetes mellitus

B. Diabetes insipidus

C. Hypoparathyroidism

D. Hyperparathyroidism

8. When caring for a male client with diabetes insipidus, Nurse Juliet expects to administer: A. vasopressin (Pitressin Synthetic).

B. furosemide (Lasix).

C. regular insulin.

D. 10% dextrose.

9. The nurse is aware that the following is the most common cause of hyperaldosteronism?

A. Excessive sodium intake

B. A pituitary adenoma

C. Deficient potassium intake

D. An adrenal adenoma

10. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:

A. “The test needs to be repeated following a 12-hour fast.”

B. a blood glucose level of 130 mg/dl.

C. bradycardia.

D. a blood pressure of 176/88 mm Hg.

16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

A. Infusing I.V. fluids rapidly as ordered

B. Encouraging increased oral intake

C. Restricting fluids

D. Administering glucose-containing I.V. fluids as ordered

17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, Nurse Noah expects to assess: A. Trousseau’s sign.

B. Homans’ sign.

C. Hegar’s sign.

D. Goodell’s sign.

18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

A. Fluid intake is less than 2,500 ml/day.

B. Urine output measures more than 200 ml/hour.

C. Blood pressure is 90/50 mm Hg.

D. The heart rate is 126 beats/minute.

19. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client’s hyperglycemia?

A. Acromegaly

B. Type 1 diabetes mellitus

C. Hypothyroidism

D. Deficient growth hormone

20. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

A. Increasing saturated fat intake and fasting in the afternoon.

B. Increasing intake of vitamins B and D and taking iron supplements.

C. Eating a candy bar if lightheadedness occurs.

D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

21. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, Nurse Libby prepares to take emergency action to prevent the potential complication of: A. Thyroid storm.

B. Cretinism.

C. myxedema coma.

D. Hashimoto’s thyroiditis.

22. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

A. prefers to take insulin orally.

B. has type 2 diabetes.

C. has type 1 diabetes.

D. is pregnant and has type 2 diabetes.

23. When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description? A. sulfisoxazole (Gantrisin)

B. mexiletine (Mexitil)

C. prednisone (Orasone)

D. lithium carbonate (Lithobid)

24. After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do? A. Initiate insulin therapy.

B. Switch the client to a different oral antidiabetic agent.

C. Prescribe an additional oral antidiabetic agent.

D. Restrict carbohydrate intake to less than 30% of the total caloric intake.

25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement?

B. It interacts with plasma membrane receptors to inhibit enzymatic actions.

C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein,

fat, and carbohydrate metabolism.

D. It regulates the threshold for water reabsorption in the kidneys.

31. Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the doses:

A. Onset to be at 2 p.m. and its peak to be at 3 p.m.

B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m.C. Onset to be at 2:30 p.m. and its peak to

be at 4 p.m. D. Onset to be at 4 p.m. and its peak to be at 6 p.m.

32. A female client with Cushing’s syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem? A. Depression

B. Neuropathy

C. Hypoglycemia

D. Hyperthyroidism

33. Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

A. Tetany

B. Hemorrhage

C. Thyroid storm

D. Laryngeal nerve damage

34. After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

A. Primary hypothyroidism

B. Graves’ disease

C. Thyrotoxicosis

D. Euthyroidism

35. Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

A. Tetanic contractions

B. Neck vein distention

C. Weight loss

D. Polyuria

36. A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:

A. phentolamine (Regitine).

B. methyldopa (Aldomet).

C. mannitol (Osmitrol).

D. felodipine (Plendil).

37. A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands?

A. Adrenal cortex

B. Pancreas

C. Adrenal medulla

D. Parathyroid

38. Nurse Troy is aware that the most appropriate for a client with Addison’s disease?

A. Risk for infection

B. Excessive fluid volume

C. Urinary retention

D. Hypothermia

39. Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client’s need for additional teaching when the client states:

A. “If I have hypoglycemia, I should eat some sugar, not dextrose.”

C. Forcing fluids

D. Restricting potassium

44. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?

A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone

excess

B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing

C. Body image disturbance related to weight gain and edema

D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

45. A male client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder?

A. Serum potassium level

B. Serum sodium level

C. Arterial blood gas (ABG) values

D. Serum osmolarity

46. A male client has just been diagnosed with type 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?

A. “You’ll need more insulin when you exercise or increase your food intake.”

B. “You’ll need less insulin when you exercise or reduce your food intake.”

C. “You’ll need less insulin when you increase your food intake.”

D. “You’ll need more insulin when you exercise or decrease your food intake.”

47. Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

A. Oral anticoagulants

B. Anabolic steroids

C. Beta-adrenergic blockers

D. Thiazide diuretics

48. Which instruction about insulin administration should Nurse Kate give to a client?

A. “Always follow the same order when drawing the different insulins into the syringe.”

B. “Shake the vials before withdrawing the insulin.”

C. “Store unopened vials of insulin in the freezer at temperatures well below freezing.”

D. “Discard the intermediate-acting insulin if it appears cloudy.”

49. Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light- headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

A. I.M. or subcutaneous glucagon.

B. I.V. bolus of dextrose 50%.

C. 15 to 20 g of a fast-acting carbohydrate such as orange juice.

D. 10 U of fast-acting insulin.

50. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?

A. Hypocalcaemia

B. Hypercalcemia

C. Hypokalemia

D. Hyperkalemia

51) Knowing that gluconeogenesis helps to maintain blood levels, a nurse should:

1. Document weight changes because of fatty acid mobilization

2. Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose

tissue insulation

3. Protect the patient from sources of infection because of decreased cellular protein deposits4.

Do all of the above

**52. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except:

1. Hypoglycemia**

2. Hyponatremia

3. Ketonuria

4. Polyphagia

53. The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:

1. 90mg/dl

2. 115mg/dl

2. 1330 and 1930

3. 1530 and 2130

4. 1730 and 2330

59. A bedtime snack is provided for Albert. This is based on the knowledge that intermediateacting insulins are effective for an approximate duration of:

1. 6-8 hours

2. 10-14 hours

3. 16-20 hours

4. 24-28 hours

60. Albert refuses his bedtime snack. This should alert the nurse to assess for:

1. Elevated serum bicarbonate and a decreased blood pH.

2. Signs of hypoglycemia earlier than expected.

3. Symptoms of hyperglycemia during the peak time of NPH insulin.

4. Sugar in the urine

61. A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:

1. 2-4 hours after administration

2. 6-14 hours after administration

3. 16-18 hours after administration

4. 18-24 hours after administration

**62. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:

1. Gives small continuous dose of regular insulin subcutaneously, and the client can self- administer a bolus with an additional dosage from the pump before each meal.**

2. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at

specific intervals.

3. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in

turn releases the insulin into the bloodstream.

4. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly

monitoring blood glucose levels.

63. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

1. Elevated blood glucose level and a low plasma bicarbonate

2. Decreased urine output

3. Increased respirations and an increase in pH

4. Comatose state

64. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to:

1. Administer a sedative

2. Make sure the client knows all the correct medical terms to understand what is happening.

3. Ignore the signs and symptoms of anxiety so that they will soon disappear

4. Convey empathy, trust, and respect toward the client.

65. A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be:

1. High risk for deficient fluid volume

2. Deficient knowledge: disease process and treatment

3. Imbalanced nutrition: less than body requirements

4. Disabled family coping: compromised.

66. A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to:

1. Administer regular insulin intravenously

2. Administer 5% dextrose intravenously

3. Correct the acidosis

4. Apply an electrocardiogram monitor.

67. A nurse performs a physical assessment on a client with type 2 DM. Findings include a fasting blood glucose of 120mg/dl, temperature of 101, pulse of 88, respirations of 22, and a bp of 140/84. Which finding would be of most concern of the nurse?

1. Pulse

2. BP

3. Respiration

2. Palpitations

3. Diaphoresis

4. Slurred speech

5. Hyperventilation

73. When a client is in diabetic ketoacidosis, the insulin that would be administered is:

1. Human NPH insulin

2. Human regular insulin

3. Insulin lispro injection

4. Insulin glargine injection

74. The nurse recognizes that additional teaching is necessary when the client who is learning alternative site testing (AST) for glucose monitoring says:

1. “I need to rub my forearm vigorously until warm before testing at this site.”

2. “The fingertip is preferred for glucose monitoring if hyperglycemia is suspected.”

3. “I have to make sure that my current glucose monitor can be used at an alternate site.”

4. “Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels.”

75. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply:

1. Sweating

2. Low PCO

3. Retinopathy

4. Acetone breath

5. Elevated serum bicarbonate

76. All of the following statements about Hashimoto's disease are true accept:

a. Many patients are entirely asymptomatic

b. Not all patients become hypothyroid

c. Most cases of obesity are attributable to Hashimoto's disease

d. Hypothyroidism may be subclinical

77. The most common benign tumor of the pituitary gland is a:

a. Glioma b Prolactinoma

c. Carcinoid tumor

d. Islet cell tumor

78.12. Symptoms of polycystic ovarian syndrome (PCOS) may include all of the following except:

a. Pelvic pain

b. Acne, oily skin, and dandruff

c. Infertility

d. Weight Loss

79. Women with PCOS are at increased risk for all of the following except: a. Pregnancy

b. Diabetes

c. Cardiovascular disease

d. Metabolic syndrome

80. All of the following organs may be affected by multiple endocrine neoplasia type 1 except: a. Parathyroid glands

b. Kidneys

c. Pancreas and Duodenum

d. Pituitary gland

81. What is the treatment for hyperparathyroidism?

a. Synthetic thyroid hormone

b. Desiccated thyroid hormone

c. Surgical removal of the glands

d. Calcium and phosphate

82. The most common causes of death in people with cystic fibrosis is:

a. Dehydration

b. Opportunistic infection

c. Lung cancer

d. Respiratory failure

D. stimulate release of digestive enzymes

89. A client is admitted to the hospital with a medical DX of hyperthyroidism. When taking a history which information would be most significant? A. edema, intolerance to cold, lethargy

b. peri-orbital edema, lethargy mask like face

c. weight loss, intolerance to cold, muscle wasting

d. weight loss, intolerance to heat, exophthalmos

90. Which nursing action is most appropriate for a client in ketoacidosis? a. admin of carbs

b. admin of IV fluids

c. applying cold compress

d. giving glucagon IV

91. The nurse smells a sweet fruity odor on the breath of a client admitted with DM. This odor may be associated with? a. alcohol intoxication

b. insulin shock

c. ketoacidosis

92. A client asks what the purpose of the Hb A1c test is. The nurses best explanation would be that the test measures the average:

a. blood sugar lvl's over a 6-10 week period

b. hemoglobin lvl's over a 6 - 10 week period

c. protein lvl over a 3 month period

d. vanillylmandelic acid lvl's

93. Which of the following would be a nursing priority for a client just DX with Addison's disease?

a. avoiding unnecessary activity

b. encouraging client to wear a med alert tag

c. ensuring the client is adequately hydrated

d. explaining that the client will need lifelong hormone therapy

94. A nurse is caring for a client in the late stage of Ketoacidosis. The nurse notices that the clients’ breath has a characteristic fruity odor. Which of the following substances is responsible for the fruity smell in the breath? a. iodine

b. acetone c.alcohol d. glucose

95. A nurse is caring for a client with Addison's disease. Which of the following nursing considerations should be employed when caring for this client? a. avoid sodium in the clients diet

b. monitor and protect skin integrity

c. document the specific gravity of urine

d. monitor increases in blood pressure

96. A nurse is assigned to care for and monitor any complications in a 40 yr client with chronic diabetes. Which of the following is a macrovascular complication of diabetes? a. neuropathy

b. retinopathy

c. nephropathy

d. Arteriosclerosis

97. A nurse is instructing a 50yr diabetic client about the steps to be followed for self admin of insulin. Which of the following instructions should be included in the client teaching? a. instruct client to avoid injections to the abdomen

b. encourage client to always inject insulin in the same site

c. inform client about the type of syringe to use

d. encourage client to do active exercise after injection

98. A nurse is preparing a diet plan for a 50yr with simple goiter. Which of the following should be included in the client’s diet to decrease the enlargement of the thyroid gland? a. iodine

b. sodium

c. potassium

d. calcium

99. A nurse is caring for a 60yr client affected with hypoparathyroidism. When checking the lab report, the nurse finds the clients’ calcium level was very low. Which of the following vitamins regulates the calcium level in the body? a. A

b. D

c. E

d. K