NCLEX-RN
NCLEX RN Practice Questions Quizlet
1. A client has no pulse or respirations. After calling for help, what should the nurse's first action be?
- A. Start a peripheral IV
- B. Initiate high-quality chest compressions
- C. Establish an airway
- D. Obtain the crash cart
Correct answer: B
Rationale: In a situation where a client has no pulse or respirations, the initial action recommended by the American Heart Association is to start high-quality chest compressions. This action helps maintain blood flow to vital organs such as the brain until normal heart rhythm is restored. Starting CPR with chest compressions before checking the airway and providing rescue breaths is crucial to improve outcomes. While establishing an airway and obtaining a crash cart are important steps in resuscitation, initiating chest compressions takes precedence to ensure oxygenated blood circulation. Starting with chest compressions applies to adults, children, and infants but not newborns.
2. In which of the following conditions would a healthcare provider not administer erythromycin?
- A. Campylobacteriosis infection
- B. Legionnaires disease
- C. Pneumonia
- D. Multiple Sclerosis
Correct answer: D
Rationale: Erythromycin is an antibiotic used to treat bacterial infections. Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system, involving the brain and spinal cord. Since MS is not caused by bacteria, administering erythromycin would not be appropriate. Campylobacteriosis infection, Legionnaires disease, and pneumonia are bacterial infections that can be treated with erythromycin, making them incorrect choices for conditions where erythromycin would not be administered.
3. A teen patient is admitted to the hospital by his physician who suspects a diagnosis of acute glomerulonephritis. Which of the following findings is consistent with this diagnosis? Select one that doesn't apply.
- A. Urine specific gravity of 1.040.
- B. Urine output of 350 ml in 24 hours.
- C. Brown ("tea-colored"?) urine.
- D. Generalized edema.
Correct answer: D
Rationale: The correct answer is 'Generalized edema.' Acute glomerulonephritis typically presents with periorbital edema, not generalized edema. Findings in acute glomerulonephritis include dark, smoky, or tea-colored urine (hematuria) due to red blood cells in the urine, elevated blood pressure, and proteinuria. The urine specific gravity may be high due to decreased urine output, but a urine output of 350 ml in 24 hours is extremely low and suggestive of renal impairment. Generalized edema is more commonly associated with nephrotic syndrome, where there is significant proteinuria leading to hypoalbuminemia and subsequent fluid retention in tissues. In acute glomerulonephritis, the edema is usually limited to the face and lower extremities, not generalized.
4. Mr. B is recovering from a surgical procedure that was performed four days ago. The nurse's assessment finds this client coughing up rust-colored sputum; his respiratory rate is 28/minute with expiratory grunting, and his lung sounds have coarse crackles on auscultation. Which of the following conditions is the most likely cause of these symptoms?
- A. Tuberculosis
- B. Pulmonary edema
- C. Pneumonia
- D. Histoplasmosis
Correct answer: C
Rationale: In this scenario, the client's presentation of coughing up rust-colored sputum, increased respiratory rate, expiratory grunting, and coarse crackles on lung auscultation suggests the development of pneumonia. Pneumonia is characterized by lung tissue inflammation or infection, often caused by various organisms. Symptoms may include productive cough, dyspnea, and abnormal breath sounds. Tuberculosis (Choice A) typically presents with a chronic cough, weight loss, and night sweats and is less likely in this acute post-operative setting. Pulmonary edema (Choice B) is characterized by pink, frothy sputum, crackles throughout the lungs, and typically occurs in the context of heart failure. Histoplasmosis (Choice D) is a fungal infection that usually presents with flu-like symptoms and is less likely to manifest with the specific respiratory findings described in this case.
5. A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings?
- A. Elevated serum calcium
- B. Low serum parathyroid hormone (PTH)
- C. Elevated serum vitamin D
- D. Low urine calcium
Correct answer: A
Rationale: In primary hyperparathyroidism, there is excess secretion of parathyroid hormone (PTH) leading to increased resorption of calcium from bones and decreased excretion of calcium by the kidneys. This results in elevated serum calcium levels. Elevated serum calcium is a hallmark characteristic of primary hyperparathyroidism, making it the correct answer. Low serum parathyroid hormone (PTH) (Choice B) is incorrect because primary hyperparathyroidism is associated with elevated PTH levels due to the malfunction of the parathyroid glands. Elevated serum vitamin D (Choice C) is incorrect because primary hyperparathyroidism is not typically associated with elevated vitamin D levels. Low urine calcium (Choice D) is incorrect as primary hyperparathyroidism leads to decreased calcium excretion by the kidneys, resulting in high levels of calcium in the urine.
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