NCLEX REVIEW 2023 Questions with correct Answers

Symptomatic bradycardia treatment? - ANSWER-ATROPINE Hypertensive crisis nursing priority assessment? - ANSWER-LOC Hypertensive crisis treatment? - ANSWER-- IV NITRATES - ANTIHYPERTENSIVES Hypertensive crisis treatment medications? - ANSWER-- NITROPRUSSIDE, LABETALOL, NICARDIPINE Client with CAD; rhythm strip showing a second-degree AV block, type 1. What should the nurse do first? - ANSWER-- MEASURE VITAL SIGNS AV block can be associated with what? - ANSWER-- MI - MEDICATIONS (Beta blockers, Digoxin) Acute aortic dissection; priority prior to surgery? - ANSWER-- ADMINISTER IV LABETALOL (to maintain BP within normal ranges) Signs and symptoms of hypovolemia? - ANSWER-- TACHYCARDIA - HYPOTENSION Hypovolemic shock? - ANSWER-NARROWING PULSE PRESSURE Signs of adequate rehydration? - ANSWER-- CAP REFILL LESS THAN 3 SECONDS - URINE OUTPUT 30ML/HR - NORMAL SPECIFIC GRAVITY (1.003-1.030) What can occur 24-72 hours after extensive abdominal surgery? - ANSWER-THIRD SPACING OF FLUIDS What age group should be able to first eat with a spoon? - ANSWER-TODDLER (by 18 months) Client with sepsis and AFR. The adverse effect of PPV? - ANSWER-HYPOTENSION Neutrophil count - ANSWER- ( 500 indicates SEVERE NEUTROPENIA) Black box warning contraindicated in pregnancy - ANSWER-ARBs and ACE INHIBITORS Acute failure exacerbation; lab? - ANSWER-INCREASED BNP Water intoxication (more susceptible in infants) results in what? - ANSWER-HYPONATREMIA Tetralogy of Fallot 4 specific characteristics (*OPRV*) - ANSWER-1. Overriding aorta 2. Pulmonary stenosis 3. Right ventricular hypertrophy 4. Ventricular septal defect Tetralogy of Fallot patient should be placed in what position? - ANSWER-KNEE-TO-CHEST POSITION IV opiates safest for clients who will give birth when? - ANSWER-2-4 HOURS AFTER ADMINISTRATION Butorphanol tartrate IV safely given when and to who? - ANSWER-- NULLIPARA 7 cm DILATED WITH CONTRACTIONS Butorphanol crosses the placental barrier peaking when and for how long? - ANSWER-PEAKING at 30-60 MINUTES DURATION is 2-4 HOURS Opioid administration may do what? - ANSWER-SLOW LABOR PROGRESSION IN THE LATENT PHASE Latent stage of labor? - ANSWER-0-5 cm Active stage of labor? - ANSWER-6-10 cm Borborygmi sound - ANSWER-LOUD, GURGLING = INCREASED PERISTALSIS (Gastroenteritis, Diarrhea) Bruit sound - ANSWER-SWISHING OR BUZZING SOUND Bruit indicates what? - ANSWER-TURBULENT BLOOD FLOW Narcissistic personality disorder helps to maintain what? - ANSWER-SELF-ESTEEM How much should a child weigh by 30 months of age? - ANSWER-~4X GREATER THAN THE BIRTH WEIGHT Toddlers weight - ANSWER-SLOWS DURING TODDLER YEARS WITH AN AVERAGE YEARLY WEIGHT GAIN OF 4-6LBS Purpura - ANSWER-REDDISH, PURPLE BLOTCHES ON THE SKIN THAT DO NOT BLANCH WITH PRESSURE D/T BLEEDING UNDER THE SKIN Abnormal finding of a boggy liver edge below the rib cage - ANSWER-HEPATOMEGALY Babinski sign can indicate what? - ANSWER-AN UPPER MOTOR NEURON LESION FROM DAMAGE TO THE CORTICOSPINAL TRACT A normal Babinski sign in an adult - ANSWER-TOES TO POINT DOWNWARD Where do you check a pulse on a 3-month old who has stopped breathing? - ANSWER--BRACHIAL ARTERY Third degree AV block on an ECG presents as what? - ANSWER-REGULAR RATE AND RHYTHM WITH DISSOCIATED P WAVES AND QRS COMPLEXES RAIU test for hyperthyroidism, what instructions are given? - ANSWER--ANTITHYROID MEDICATIONS SHOULD BE HELD 5-7 DAYS BEFORE PROCEDURE -NPO 2-4 HOURS PRIOR TO PROCEDURE -MAY RESUME EATING 1-2 HOURS AFTER SWALLOWING IODINE -PATIENT WILL BE AWAKE AND WILL HAVE NO PAIN -DO NOT BREASTFEED IMMEDIATELY AFTER TEST General anesthesia - ANSWER-MALIGNANT HYPERTHERMIA (RARE) Soft restraints; what can be delegated to the UAP? - ANSWER-- ASSIST WITH USING BEDPAN - PERFORM ROM EXERCISES - TURN AND REPOSITION Preschool children; preprocedural education - ANSWER-- ALLOWING PARENTS TO STAY WITH CHILDREN - TELLING THEM THE PROCEDURE IS NOT PUNISHMENT - ASK THE CHILD TO ASK ANY QUESTIONS THEY MAY HAVE -UTILIZE TOYS TO COMMUNICATE ABOUT THE PROCEDURE Suspected pyloric stenosis; expected lab value? - ANSWER-HEMATOCRIT 57% (d/t dehydration manifested by hemoconcentration (elevated hematocrit and elevated blood urea nitrogen) Hypertrophic pyloric stenosis results in what? - ANSWER-PROJECTILE VOMITING Projectile vomiting leads to what? - ANSWER-HYPOkalemic metabolic alkalosis Theophylline for advanced COPD - ANSWER-BRONCHODILATOR WITH A LOW THERAPEUTIC INDEX AND NARROW RANGE (10-20) Draw blood levels for Theophylline when? - ANSWER-30 minutes AFTER dosing What 2 drugs increase Theophylline serum levels? *C&C* - ANSWER-- CIPRO - CIMETIDINE Mechanical prosthetic valves require what? - ANSWER-LONG-TERM ANTICOAGULATION THERAPY (do not take Vitamin K supplements and do not change diet) Bacterial meningitis precautions? - ANSWER-DROPLET ICP- potential risk for bacterial meningitis - ANSWER-- IRRITABLE, FEVER, HIGH-PITCHED CRY - CHANGES IN PUPIL REACTION, SUNSET EYES, DILATED SCALP VEINS - POOR FEEDING, VOMITING, BULGING FONTANELLES What is an amnioinfusion used for? - ANSWER-LOW AMNIOTIC FLUID - Oligohydramnios or ruptured membranes What is an amnioinfusion indicated to relieve? - ANSWER-PERSISTENT, RECURRENT VARIABLE DECELERATIONS (caused by umbilical cord compression Endovascular repair of an abdominal aortic aneurysm; what interventions? - ANSWER-- CHECK FOR BLEEDING AT GROIN PUNCTURE SITES - MONITOR FLUID INTAKE AND OUTPUT - PALPATE AND MONITOR PP Bee sting reaction - ANSWER-- GVE EPI, REPEAT EVERY 5-15 MINUTES - PLACE IN RECUMBENT POSITION AND ELEVATE LEGS - MAINTAIN BP WITH IV FLUIDS, VOLUME EXPANDERS OR VASOPRESSORS - GIVE BRONCHODILATORS, ANTIHISTAMINES, THEN CORTICOSTEROIDS Immediate post-op following a carotid endarterectomy; client with slurred speech/drowsiness. What finding to report to MD? - ANSWER-LEFT ARM DRIFT DURING BILATERAL ARM EXTENSION Carotid endarterectomy - ANSWER-PROCEDURE TO REMOVE PLAQUE (to improve cerebral perfusion) Increased risk for PPH? - ANSWER--MULTIPLE GESTATION -MACROCOSMIC (greater than or equal to 4000g) -EBL SVD 500ml or C/S 1000ml -UTERINE ATONY (boggy uterus) OCCURRING LESS THAN OR EQUAL TO 24 HOURS PP All glucocorticoids can cause an INCREASE in what? - ANSWER-BLOOD SUGAR Most glucocorticoids cause what TWO things? - ANSWER--FLUID RETENTION -WORSENING HTN Pediatric client with diarrhea caused by E-coli. The nurse is most concerned with what finding? - ANSWER-PETECHIAE NOTED ON THE TRUNK What is hemolytic uremic syndrome is a complication of what? - ANSWER-E-COLI diarrhea Clinical features of hemolytic uremic syndrome? - ANSWER-- ANEMIA (pallor) - LOW PLT (petechiae and purpura) - AKI (low urine output) Kawasaki disease (KD) - ANSWER-SYSTEMIC VASCULITIS OF CHILDHOOD Kawasaki disease (KD) symptoms - ANSWER- 5-day fever, nonexudative conjunctivitis, lymphadenopathy, mucositis, hand, and foot swelling, rash Kawasaki disease (KD) D/C teaching - ANSWER-CHECK TEMP EVERY 6 HOURS FOR THE FIRST 48 HOURS FOLLOWING THE LAST FEVER AND THEN CHECK DAILY UNTIL FOLLOW UP APPT Type 1 DM. What action best assesses the chronic complication of autonomic neurpathy? - ANSWER-CHECK BP SITTING AND STANDING Autonomic nervous system (*fight-or-flight*) - ANSWER-INVOLUNTARY BODY FUNCTIONS SUCH AS BP, HR, PERSPIRATION, SEXUAL FUNCTION, AND DIGESTION Peritoneal dialysis beginning to exhibit insufficient outflow. What actions should be performed initially? - ANSWER--ASSESS FOR ABDOMINAL DISTENTION AND CONSTIPATION -EXAMINE THE CATHETER FOR ANY KINKS -SIDE-LYING POSITION