NCLEX-RN
NCLEX RN Exam Questions
1. A 30-year-old man is being admitted to the hospital for elective knee surgery. Which assessment finding is most important to report to the healthcare provider?
- A. Tympany on percussion of the abdomen
- B. Liver edge 3 cm below the costal margin
- C. Bowel sounds of 20/minute in each quadrant
- D. Aortic pulsations visible in the epigastric area
Correct answer: B
Rationale: The correct answer is 'Liver edge 3 cm below the costal margin.' Normally, the lower border of the liver is not palpable below the ribs, so this finding suggests hepatomegaly, which could indicate an underlying health issue. Tympany on percussion of the abdomen, bowel sounds of 20/minute in each quadrant, and aortic pulsations visible in the epigastric area are all within normal limits for a physical assessment and do not require immediate reporting to the healthcare provider.
2. The patient with chronic pancreatitis will be taught to take the prescribed pancrelipase (Viokase)
- A. at bedtime.
- B. in the morning.
- C. with each meal.
- D. for abdominal pain.
Correct answer: C
Rationale: The correct answer is to take pancrelipase (Viokase) with each meal. Pancrelipase is a pancreatic enzyme replacement medication that helps with the digestion of nutrients. Patients with chronic pancreatitis often have difficulty digesting food properly due to insufficient pancreatic enzyme production. Taking pancrelipase with each meal assists in the breakdown of fats, proteins, and carbohydrates consumed during the meal. Option A ('at bedtime') is incorrect because enzymes should be taken with meals to aid in digestion. Option B ('in the morning') is not ideal as it does not ensure optimal enzyme activity during meals. Option D ('for abdominal pain') is incorrect as pancrelipase is not meant to be taken solely for pain relief but rather to aid in digestion.
3. Which laboratory test result should the nurse monitor to evaluate the effects of therapy for a 62-year-old female patient with acute pancreatitis?
- A. Calcium
- B. Bilirubin
- C. Amylase
- D. Potassium
Correct answer: C
Rationale: The correct answer is C: Amylase. In acute pancreatitis, amylase levels are typically elevated. Monitoring amylase levels helps assess the effectiveness of therapy in managing the condition. Elevated amylase is a key indicator of pancreatic inflammation. Calcium (Choice A) levels may be affected in pancreatitis, but they are not the primary indicator for evaluating therapy effectiveness. Bilirubin (Choice B) and Potassium (Choice D) levels may also be altered in pancreatitis, but they are not specific markers for monitoring therapy response in acute pancreatitis.
4. Why is it important to genotype HCV before initiating drug therapy?
- A. Side effects of nucleotide analogs
- B. Measures for improving the appetite
- C. Ways to increase activity and exercise
- D. Administering alpha-interferon (Intron A)
Correct answer: B
Rationale: Genotyping of HCV plays a crucial role in managing treatment as it helps determine the most effective therapy for the specific viral strain. It allows healthcare providers to personalize treatment regimens and predict response rates. The statement about acute HCV infection converting to chronic state is accurate, highlighting the need for appropriate management. Immune globulin and vaccines are not available for HCV, and Ribavirin is commonly used for chronic HCV infection. Improving appetite is essential in liver health as adequate nutritional intake supports hepatocyte regeneration. Choices A, C, and D are incorrect as they do not address the specific importance of genotyping in HCV treatment or the significance of appetite improvement in liver function.
5. A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical and should be reported to the physician immediately?
- A. Hemoglobin of 11 g/dl
- B. Platelet count of 150,000
- C. INR of 2.5
- D. Potassium of 2.7 mEq/L
Correct answer: D
Rationale: The critical lab result that should be reported to the physician immediately in this case is the potassium level of 2.7 mEq/L. A potassium imbalance, especially in a patient with a history of dysrhythmia like atrial fibrillation, can be life-threatening and lead to cardiac distress. Low potassium levels (hypokalemia) can predispose the patient to dangerous arrhythmias, including worsening atrial fibrillation. Hemoglobin of 11 g/dl, platelet count of 150,000, and an INR of 2.5 are within acceptable ranges and not as immediately concerning as a low potassium level in this clinical context.
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