Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow
Student Elements

NCLEX Review

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results. At the end of each exam, you have the option to e-mail your results to your instructor.

1:  Which lab tests would most likely be used to aid in the diagnosis of metabolic syndrome X?
A: Liver function studies and bilirubin.
B: Fasting glucose and lipid profile.
C: Complete blood count (CBC) and blood urea nitrogen (BUN).
D: Basic metabolic profile and troponin I.

2:  Which patient is at greatest risk for the development of teratogenic effects of drug therapy?
A: A patient in the first trimester of pregnancy.
B: An elderly patient with decreased renal function.
C: A neonate whose liver function is immature.
D: An adult patient who is being treated for cancer.

3:  Which patient would be the most likely to receive continuous renal replacement therapy (CRRT)?
A: A 20-year-old, hemodynamically unstable, trauma patient.
B: A 68-year-old patient with renal insufficiency and congestive heart failure.
C: A 45-year-old patient with post-renal failure.
D: A 39-year-old, hypertensive, diabetic patient with end-stage renal disease.

4:  Which action will promote the best outcome for a patient who is experiencing pulseless electrical activity?
A: Initiation of CPR and rapid cardioversion.
B: Rapid defibrillation and administration of epinephrine.
C: Treatment of a potassium level of 7.0 mEq/dL with insulin and calcium.
D: Administration of sodium bicarbonate for a patient with a pH of 7.55.

5:  A patient who is diagnosed with respiratory failure is intubated and being mechanically ventilated. The patient pulls out the endotracheal tube. What is the priority action for the nurse to take?
A: Administer oxygen via a 100% non-rebreather mask.
B: Ensure that the patient's airway is open.
C: Prepare for reintubation.
D: Provide nasotracheal suctioning.

6:  A patient has a cerebral perfusion pressure (CPP) of 39. Based on the nurse's knowledge of cerebral perfusion pressures, which statement is true?
A: The increased pressure within the cerebral spinal fluid circulation could result in herniation.
B: According to the Monroe-Kellie hypothesis, the brain will accommodate for the elevated cerebral perfusion pressure.
C: Autoregulation of blood flow through the brain is maintained at a CPP of 39.
D: The pressure is too low, and the patient is experiencing impairment of cerebral perfusion.

7:  Identify the person who would be at greatest risk for the development of an ischemic, embolic stroke?
A: A 44-year-old patient with uncontrolled hypertension.
B: A 68-year-old patient with chronic atrial fibrillation.
C: A 75-year-old patient with thrombocytopenia.
D: A 36-year-old patient with an arteriovenous malformation.

8:  The nurse is caring for a patient with a serum potassium of 6.2 mEq/L. Which statement is true regarding appropriate treatment options for the patient?
A: An intravenous infusion of KCl is appropriate as long as the infusion rate doesn't exceed 10 mEq/h.
B: Intravenous calcium chloride is appropriate for the patient because it moves potassium out of the cells and into the extracellular fluid.
C: Dextrose and insulin are appropriate for the patient because they help the kidneys eliminate potassium from the body.
D: Sodium polystyrene sulfonate (Kayexalate) is appropriate for the patient because it is an exchange resin that can remove potassium from the body.

9:  A patient who is diagnosed with anorexia nervosa experiences amenorrhea, decreased breast size, and a loss of pubic hair. What is the cause of these clinical manifestations?
A: Lack of dietary protein.
B: Decreasing estrogen levels.
C: Lack of calcium and phosphorus in the diet.
D: Increasing levels of progestin.

10:  Which assessment parameters should the nurse consider as the most reliable indicator of the existence and intensity of acute pain?
A: Vital signs.
B: Self-report of pain.
C: Severity of the condition.
D: Nonverbal behavior.

11:  Which person is at the highest risk for development of erectile dysfunction?
A: A 35-year-old CEO of a company with a huge debt.
B: A 40-year-old smoker who drinks socially.
C: A 60-year-old man with a 15-year history of uncontrolled diabetes.
D: A 55-year-old man with diet-controlled hypertension.

12:  Upon physical examination of a patient who has been on prolonged bed rest, the nurse identifies that the patient has wasting of the muscles from disuse. Which term would be appropriate for the nurse to use to document the finding?
A: Atrophy.
B: Apraxia.
C: Hemiparesis.
D: Dyskinesia.

13:  Upon inspection of the skin, the nurse identifies an area of injury that is reddened, but the skin is not torn. Which finding would the nurse document in the patient's record?
A: Hematoma.
B: Laceration.
C: Contusion.
D: Petechiae.

14:  Which electrolyte and acid-base imbalances are associated with acute renal failure?
A: Hypokalemia, hyponatremia, and respiratory acidosis.
B: Hypermagnesemia, hypernatremia, and metabolic alkalosis.
C: Hyperkalemia, hypocalcemia, and metabolic acidosis.
D: Hyperphosphatemia, hypocalcemia, and respiratory alkalosis.

15:  An adult patient has been diagnosed with type 2 diabetes and needs to begin daily medications and blood glucose monitoring. The patient's response was, "This is not possible. How can I have diabetes when I'm not sick?" What is the most appropriate response by the nurse?
A: "Type 2 diabetes has a latent period when blood glucose levels are very high but the body has not experienced enough deterioration to make you very ill."
B: "You are in denial, which is preventing you from experiencing many of the symptoms."
C: "Type 2 diabetes is often asymptomatic, and the best way to understand the body's actual response to managing glucose is to monitor your blood sugar at home for a period of time."
D: "Patients with newly diagnosed diabetes are very ill with nausea, vomiting, weight loss, and confusion, along with thirst and frequent urination. You should feel encouraged that you have few symptoms."

16:  A patient is receiving total parenteral nutrition (TPN). The nurse reviews the following lab values:

Glucose = 72 mg/dL
Chloride = 98 mEq/L
Sodium = 138 mEq/L
Potassium = 3.0 mEq/L

Based on the nurse's review of the lab values, which nursing action is appropriate?
A: Discontinue the TPN administration.
B: Notify the physician and discuss the need for potassium replacement.
C: Administer 50% dextrose immediately.
D: Assess the patient's vital signs and perform a physical assessment.

17:  The nurse would observe a patient diagnosed with anorexia nervosa for which complication?
A: Heavy menstrual cycles.
B: Osteoporosis.
C: Enhanced sexual characteristics.
D: Heat intolerance.

18:  A 57-year-old homeless man is being evaluated in a mobile clinic. He has recently immigrated to the United States from Southeast Asia. He presents with fatigue, anorexia, fever, night sweats, and cough. What is the most probable cause of his symptoms?
A: Tuberculosis.
B: Emphysema.
C: Pneumonia.
D: Pulmonary embolus.

19:  The nurse is caring for a patient following a thyroidectomy. During the postoperative period, the nurse notes that the patient's serum calcium is low. For which signs and symptoms would it be most appropriate for the nurse to monitor the patient?
A: Muscle weakness and constipation.
B: Facial spasms and hyperreflexia.
C: Abdominal pain and nausea.
D: Anorexia, nausea, and vomiting.

20:  The nurse is caring for a patient who has just been admitted to the hospital with severe dehydration over the past 72 hours. Which type of renal failure is this patient at risk for developing?
A: Pre-renal failure.
B: Intra-renal failure.
C: Post-renal failure.
D: Extrinsic renal failure.

21:  The nurse is caring for a patient with end-stage renal disease. The patient has experienced weight gain, peripheral edema, hypertension, and jugular neck vein distention. Which finding best explains this patient's symptoms?
A: Hypovolemia.
B: Hypervolemia.
C: Hyperkalemia.
D: Hyponatremia.

22:  The diabetic nurse educator is teaching a patient who is newly diagnosed with diabetes about site rotation for insulin injections. What is the purpose of site rotation for subcutaneous insulin injections?
A: To decrease the risk for development of lipodystrophy.
B: To ensure that insulin is delivered to all areas of the body.
C: To reduce the risk of infection associated with injection.
D: To minimize the pain associated with insulin injections.

23:  Which nursing intervention is appropriate for a patient with a platelet count of 34,000/┬ÁL?
A: Pad sharp surfaces to avoid trauma.
B: Assess for a decrease in petechiae.
C: Keep the room darkened.
D: Check for the presence of white blood cells in the urine.

24:  The nurse is caring for a patient with thrombocytopenia. For which finding would it be most appropriate for the nurse to monitor the patient?
A: Jaundice.
B: Fatigue.
C: Ecchymosis.
D: Fever.

25:  A patient is admitted with chronic obstructive pulmonary disease (COPD). The patient has dyspnea and a low PaO2 level. The nurse plans to administer oxygen as ordered. Which statement is true concerning oxygen administration to a COPD patient?
A: Elevated oxygen concentrations will cause coughing.
B: High oxygen concentrations may inhibit the hypoxic stimulus for breathing.
C: Increased oxygen use will promote oxygen dependency.
D: Oxygen administration is contraindicated.

26:  A postoperative patient is receiving the opioid morphine 2 mg IV every 2-4 hours prn for pain. Based on the nurse's knowledge of the effects of opioids on the gastrointestinal system, for which potential problem should the nurse monitor the patient?
A: Diarrhea.
B: Heartburn.
C: Flatulence.
D: Constipation.

Optional: Enter your name and your instructor's E-mail address to have your results E-mailed to him or her.
Your Name:
Instructor's E-mail Address:
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