NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured succ, Exams of Nursing

Download NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured succ and more Exams Nursing in PDF only on Docsity! NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Correct Incorrect 1. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid: A.Using oil- or cream-based soaps B.Flossing between the teeth C.The intake of salt NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success ween the teeth sed and has bone marrow suppres eth because platelets are decreas ed soap is allowed for leukemia prevent dry skin, which predispose t of salt in the patientʼs food is allo ectric razor is Option D: The use of an el NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.Using an electric razor Home Care Plans Exams Incorrect Correct Answer: B. Flossing bet Study Notes Career The client who is immune-suppres sion should be taught not to floss his te Option A: Oil or cream- bas patients because these will skin injury. Option C: A healthy amoun cCoourmsaprya.croem cours s from NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: A. Apply the new tie before removing the old one. Leaving the old ties in place while securing the clean ties prevents inadvertent dislodging of the tracheostomy tube. Option B: Having a helper is good, but the helper might not prevent the client from coughing out the tracheotomy. Option C: Hold the tracheostomy with the nondominant hand while removing the old tie is not the best way to prevent the client from coughing out the tracheotomy. Option D: Asking the doctor to suture the tracheostomy in place is unnecessary. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 3. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to: A.Turning the client to the left side B.Milking the tube to ensure patency C.Slowing the intravenous infusion NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.Notifying the physician Incorrect Correct Answer: D. Notifying the physician The output of 300 mL is indicative of hemorrhage and should be reported immediately. Option A: Turning the client to the left side does nothing to help the client. Options B and C: Milking the tube is done only with an order and will not help in this situation, and slowing the intravenous infusion is not an appropriate action. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success of Fallot. Option D: Atropine prevents or abolishes bradycardia. 5. The nurse is educating the ladyʼs club in a self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence. On the diagram below, select where the Tail of Spence is. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A B NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C D Incorrect Correct Answer: A. The Tail of Spence is located in the upper outer quadrant of the breast. Option B: Option B is the areola, a dark area of skin surrounding the nipple. 6. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 7. The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to: A.Determine lung maturity B.Measure the fetal activity NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Show the effect of contractions on fetal heart rate D.Measure the wellbeing of the fetus Incorrect Correct Answer: B. Measure the fetal activity A nonstress test determines periodic movement of the fetus. Options A: Fetal lung maturity testing determines the maturity of the lungs. Options C and D: Fetal heart rate monitoring measures the heart rate and rhythm of the baby (fetus) and its well being. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 8. The nurse is evaluating the client who was admitted 8 hours ago for induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse? NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Correct Answer: C. Turn off the Pitocin infusion The monitor indicates variable decelerations caused by cord NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success compression. If Pitocin is infusing, the nurse should turn off the Pitocin. Option A: Instructing the client to push is incorrect because pushing could increase the decelerations and because the client is 8cm dilated, making answer A incorrect. Options B and D: Performing a vaginal exam should be done after turning off the Pitocin, and placing the client in a semi-Fowlerʼs position is not appropriate for this situation. 9. The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as: NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A.Atrial flutter B.A sinus rhythm NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.Clear the air from the syringe before injections Incorrect Correct Answer: B. Be injected into the abdomen Option A: Lovenox injections should be given in the abdomen, not in the deltoid muscle. Options C and D: The client should not aspirate after, but before, the injection or clear the air from the syringe before injection. 11. The nurse has a preop order to administer valium (Diazepam) 10mg and phenergan (Promethazine) 25mg. The correct method of administering these medications NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success is to: A.Administer the medications together in one syringe B.Administer the medication separately C.Administer the Valium, wait 5 minutes, and then inject the Phenergan NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D. the order because they cannot be given at the same time Incorrect Correct Answer: B. Administer the medication separately Medications should not be mixed in one syringe unless indicated by the physician. Option A: Valium is not given in the same syringe with other medications. Option C: It is not necessary to wait to inject the second medication. Valium is an antianxiety medication, and Phenergan is used as an antiemetic. Option D: These medications can be given to the same client. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A.Placing the client in seclusion B.Emptying the Foley catheter of the preeclamptic client C.Feeding the client with dementia D.Ambulating the client with a fractured hip NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: C. Feeding the client with dementia Of these clients, the one who should be assigned to the care of the nursing assistant is feeding the client with dementia. Option A: Only a physicianʼs order can place the client in seclusion. Option B: The nurse should empty the Foley catheter of the preeclamptic client because the client is unstable. Option D: A nurse or physical therapist should ambulate the client with a fractured hip. 14. The client has recently returned from having a thyroidectomy. The nurse should keep which of the NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success following at the bedside? A.A tracheostomy set B.A padded tongue blade C.An endotracheal tube D.An airway NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: D. Birds Histoplasmosis is a fungus carried by birds. Options A, B, C: Histoplasmosis is not transmitted to humans by cats, dogs, or turtles. 16. Whatʼs the first intervention for a patient experiencing chest pain and a p02 of 89%? A.Administer morphine B.Administer oxygen NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Administer sublingual nitroglycerin D.Obtain an electrocardiogram (ECC) Incorrect Correct Answer: B. Administer oxygen Administering supplemental oxygen to the patient is the first priority. Administer oxygen to increase SpO2 to greater than 90% to help prevent NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success further cardiac damage. Options A and C: Sublingual nitroglycerin and morphine are commonly administered after oxygen. Option D: Obtaining an ECG may occur after administering the oxygen to provide baseline data. 17. Which of the following signs and symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm? A.Abdominal pain B.Absent pedal pulses NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Dilated D.Hypertrophic Incorrect NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Correct Answer: D. Hypertrophic Hypertrophic cardiomyopathy (HCM) is a condition in which there is a severe ventricular hypertrophy and poor diastolic filling. It is an autosomal dominant condition wherein the heart muscles asymmetrically increases in size and mass along the septum. The increase in the thickness of heart muscles reduces the size of the cavities of the ventricles causing them to take a longer time to relax after systole. Cardiac output isnʼt affected by hypertrophic cardiomyopathy because the size of the ventricle remains relatively unchanged. Options A and B: Restrictive cardiomyopathy (RCM) is wherein the walls of the heart are rigid causing a restrictive stretching and filling of blood properly. Restrictive and obliterative cardiomyopathy are the same. Option C: Dilated cardiomyopathy (DCM) is a condition in which the left ventricle is enlarged and weakened causing a decrease in the ability to pump blood (decreased cardiac output). It is the most common type of cardiomyopathy and commonly leads to progressive heart failure. The cause of DCM can be idiopathic or it can result NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success from inflammatory processes like myocarditis, or from cytotoxic agents like alcohol and certain neoplastic drugs. 19. Which of the following interventions should be your first priority when treating a patient experiencing chest pain while walking? A.Have the patient sit down. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.High Fowlerʼs position D.Semi-Fowlerʼs position Incorrect Correct Answer: C. High Fowlerʼs position High Fowlerʼs position facilitates breathing by reducing venous return. Lying flat and side-lying positions worsen breathing and increase the heartʼs workload. Option A: Lying flat in bed would make the patient feel like he is “drowning”. Option C: Side-lying position worsens breathing and increases the heartʼs workload. Option D: Semi-Fowlerʼs may not be enough to NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success improve the patientʼs breathing. 21. A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeksʼ gestation. Sheʼs at risk for which of the following blood dyscrasias? A.Heparin-associated thrombosis and thrombocytopenia (HATT) NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success B.Idiopathic thrombocytopenic purpura (ITP) C.Thrombocytopenia D.Disseminated intravascular coagulation (DIC) Incorrect Correct Answer: D. Disseminated intravascular coagulation (DIC) Abruptio placentae is a cause of DIC because it activates the clotting cascade after hemorrhage. Option A: A patient with abruptio placentae NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success In a trauma situation, the first blood product given is unmatched (O negative) packed red blood cells. Options B and C: Lactated Ringerʼs solution or 0.9% sodium chloride is used to increase volume and blood pressure, but too much of these crystalloids will dilute the blood and wonʼt improve oxygen-carrying capacity. Option D: Fresh frozen plasma often is used to replace clotting factors. 23. Corticosteroids are potent suppressors of the bodyʼs inflammatory response. Which of the following conditions or actions do they suppress? NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A.Cushing syndrome B.Pain receptors C. Immune response D.Neural transmission Incorrect Correct Answer: C. Immune response NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Corticosteroids suppress eosinophils, lymphocytes, and natural killer cells, inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation, stabilizes lysosomal membranes, decreases capillary permeability, and depresses phagocytosis of tissues by white blood cells, thus blocking the release of more inflammatory materials. Option A: Excessive corticosteroid therapy can lead to Cushingʼs syndrome. Option B: Analgesics suppress pain receptors. Option D: Opioids and heroin may suppress neural transmission if taken in unregulated amounts. 24. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A."Hold your cough as much as possible." B."Place the head of your bed flat to help with coughing." C."Restrict fluids to help decrease the amount of sputum." D."Splint your chest wall with a pillow for comfort." NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: D. “Splint your chest wall with a pillow for comfort.” Showing this patient how to splint his chest wall will help decrease discomfort when coughing. Option A: Holding in his coughs will only increase his pain. Option B: Placing the head of the bed flat may increase the frequency of his cough and his work of breathing. Option C: Increasing fluid intake will help thin the secretions, making it easier for him to clear them. 26. A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first? NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A.Take a full medical history. B.Give a bronchodilator by nebulizer. C.Apply a cardiac monitor to the patient. D.Provide emotional support for the patient. Incorrect Correct Answer: B. Give a bronchodilator by nebulizer. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: D. Acute respiratory distress syndrome (ARDS). Severe hypoxia after smoke inhalation typically is related to ARDS. The other choices arenʼt typically associated with smoke inhalation. Option A: Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid. Atelectasis is one of the most common breathing (respiratory) complications after surgery. Option B: Pneumonia is an infection that inflames the air sacs in one or both lungs. Option C: Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 28. Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube? A.You see a lot of drainage from the chest tube. B.Arterial blood gas (ABG) levels are normal. C.The chest X-ray continues to show the lung is 35% deflated. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.The water-seal chamber doesnʼt fluctuate when no suction is applied. Incorrect Correct Answer: D. The water-seal chamber doesnʼt fluctuate when no suction is applied. The chest tube isnʼt removed until the patientʼs lung has adequately re- expanded and is expected to stay that way. One indication of reexpansion is the cessation of fluctuation in the water-seal chamber when suction isnʼt applied. Option A: Drainage should be minimal before the chest tube is removed. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success foot drop and contractures. Option C: A consult with physical therapy is important to prevent foot drop, but you can use high-top sneakers independently. Option D: Sequential compression devices (SCDs) are inflatable sleeves that fit around the legs. The sleeves are attached to a pump that inflates and deflates the sleeves. The pumping action acts like muscles to help blood flow and prevent clots. SCDs are often used after surgery until the client can get up and walk. 30. Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma? A.Bradycardia NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success B.Large amounts of very dilute urine C.Restlessness and confusion D.Widened pulse pressure Incorrect NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Correct Answer: C. Restlessness and confusion The earliest sign of increased ICP is a change in mental status. Options A and D: Bradycardia and widened pulse pressure occur as later signs of increased ICP. Option B: The patient may void a lot of very dilute urine if his posterior pituitary is damaged. 31. When giving intravenous (I.V.) phenytoin, which of the following methods should you use? A.Use an in-line filter. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Prone D.Subluxated Incorrect Correct Answer: A. Abduction After surgical repair of the hip, keep the legs and hips abducted to stabilize the prosthesis in the acetabulum. Option B: Adduction brings the limb or hand toward or across the midline of the body, or brings the fingers or toes together. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Option C: Prone position is a body position in which the person lies flat with the chest down and the back up. Option D: A subluxation is a partial dislocation of a joint. Itʼs often the result of acute injury or repetitive motions, but it can also occur because of medical conditions where the ligaments are loose. 33. Which of the following factors should be the primary focus of nursing management in a patient with acute pancreatitis? A.Nutrition management NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success B.Fluid and electrolyte balance C.Management of hypoglycemia D.Pain control Incorrect Correct Answer: B. Fluid and electrolyte balance Acute pancreatitis is commonly associated with fluid isolation and NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success biopsy site and minimize bleeding. Options A, C, D: The other positions wonʼt do this and may cause more bleeding at the site or internally. 35. Which of the following potentially serious complications could occur with therapy for hypothyroidism? A.Acute hemolytic reaction B.Angina or cardiac arrhythmia NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Retinopathy D.Thrombocytopenia Incorrect Correct Answer B. Angina or cardiac arrhythmia Precipitation of angina or cardiac arrhythmia is a potentially serious complication of hypothyroidism treatment. Option A: Acute hemolytic reaction is a complication of blood transfusions. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Option C: Retinopathy typically is a complication of diabetes mellitus. Option D: Thrombocytopenia doesnʼt result from treating hypothyroidism. 36. Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? A.Diabetes mellitus B.Diabetes insipidus NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success B.Less insulin C.More insulin D.Oral diabetic agents Incorrect NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Correct Answer: C. More insulin During periods of infection or illness, patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels. Option A: Changes should be applied to the patientʼs daily routine to avoid complications from infection. Option B: Less insulin could lead to hyperglycemia. Option D: Oral diabetic agents may not be enough to decrease the blood glucose. 38. On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has a decreased hematocrit level. Which of the following complications does this suggest? A.Hematoma NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success B.Hypovolemia C. Infection D.Pulmonary embolus (PE) NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success Incorrect Correct Answer: C. Lactated Ringerʼs solution Lactated Ringerʼs solution replaces lost sodium and corrects metabolic acidosis, both of which commonly occur following a burn. Option A: Albumin is used as an adjunct therapy, not a primary fluid replacement. Option B: Dextrose isnʼt given to burn patients during the first 24 hours because it can cause pseudodiabetes. Option D: The patient is hyperkalemic from the potassium shift from the intracellular space to the plasma, so potassium would be detrimental. 40. Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site? NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success A.Thoroughly irrigate the wound before collecting the specimen. B.Use a sterile swab and wipe the crusty area around the outside of the wound. C.Gently roll a sterile swab from the center of the wound outward to collect drainage. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.Use a sterile swab to collect drainage from the dressing. Incorrect Correct Answer: C. Gently roll a sterile swab from the center of the wound outward to collect drainage. Rolling a swab from the center outward is the right way to obtain a culture specimen from a wound. Option A: Irrigating the wound washes away drainage, debris, and many of the colonizing or infecting microorganisms. Option B: The outside of the wound and the dressing may be colonized with microorganisms that havenʼt affected the wound, so specimens from these sites could give inaccurate results. Option D: The dressing is considered contaminated and should not be used for NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 42. There are a number of risk factors associated with coronary artery disease. Which of the following is a modifiable risk factor? A.Gender B.Age C.Obesity NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success D.Heredity Incorrect Correct Answer: C. Obesity Obesity is an important risk factor for coronary artery disease that can be modified by improved diet and weight loss. Options A, B, and D: Family history of coronary artery disease, male gender, and advancing age increase risk but cannot be modified. 43. Tissue plasminogen activator (t-PA) is considered for the treatment of a patient who arrives in the emergency NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success department following the onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA? A.Worsening chest pain that began earlier in the evening B.History of cerebral hemorrhage C.History of prior myocardial infarction NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Prevents DVT (deep vein thrombosis) D.Prevent constipations Incorrect Correct Answer: C. Prevents DVT (deep vein thrombosis) Exercise is important for all hospitalized patients to prevent deep vein thrombosis. Muscular contraction promotes venous return and prevents hemostasis in the lower extremities. Options A, B, and D: This exercise is not sufficiently vigorous to increase physical fitness, nor is it intended to prevent bedsores or constipation. NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success 45. A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock? A.Hypertension B.Bradycardia NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success C.Bounding pulse D.Confusion Incorrect Correct Answer: D. Confusion Cardiogenic shock severely impairs the pumping function of the heart muscle, causing diminished blood flow to the organs of the body. This results in diminished brain function and confusion, as well as hypotension, tachycardia, and weak pulse. Cardiogenic shock is a serious complication of myocardial infarction with a high mortality rate. Option A: The primary insult is a reduction in myocardial contractility resulting in diminished NCLEX RN Practice Questions and Answers Test Bank (2022/2023 Update) Rated A+ assured success