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NCLEX RN May 2024 Update NGN Questions & Answers Bank with Rationales
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NCLEX RN September 2023 updated May 2024 NGN Actual Questions & Answers Bank with Rationales
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NCLEX RN EXAM 2024REAL QUESTIONS AND ANSWERS
STUDY BANK WITH RATIONALES
UPDATED VERSION
100% VERIFIED
,1. 1. Question
Category: Pharmacological and Parenteral Therapies
What is the primary reason for administering morphine to a client with
myocardial infarction?
o A. To sedate the client
o B. To decrease the client’s pain
o C. To decrease the client’s anxiety
o D. To decrease oxygen demand on the client’s heart
Correct Answer: D. To decrease oxygen demand on the client’s heart
Morphine is administered because it decreases myocardial oxygen demand.
Morphine to relieve pain during a myocardial infarction (MI) has been in use
since the early 1900s. In 2005, an observational study raised some concerns, but
there are very few effective alternatives. Morphine is a potent opioid; it decreases
pain, which in turn leads to a decrease in the activation of the autonomic nervous
system. These are desirable effects when a patient is having an MI.
Option A: Morphine can also cause sedation on the client, but it is not the
main purpose of administering it. Morphine is rarely used for procedural
sedation. However, for small procedures, physicians will sometimes
combine a low dose of morphine with a low dose of benzodiazepine-like
lorazepam.
Option B: Pain is decreased when morphine is given, but it is not the
primary reason for administration. FDA-approved usage of morphine
sulfate includes moderate to severe pain that may be acute or chronic.
Most commonly used in pain management, morphine provides significant
relief to patients afflicted with pain.
Option C: Morphine will also decrease anxiety, but isn’t primarily given for
this reason. Morphine can decrease the heart rate, blood pressure, and
venous return. Morphine can also stimulate local histamine-mediated
processes.
2. 2. Question
Category: Physiological Adaptation
, Which of the following conditions is most commonly responsible for myocardial
infarction?
A. Aneurysm
B. Heart failure
C. Coronary artery thrombosis
D. Renal failure
Correct Answer: C. Coronary artery thrombosis
Coronary artery thrombosis causes occlusion of the artery, leading to myocardial
death. Myocardial infarction occurs when a coronary artery is so severely blocked
that there is a significant reduction or break in the blood supply, causing damage
or death to a portion of the myocardium (heart muscle).
Option A: An aneurysm is an outpouching of a vessel and doesn’t cause an
MI. On exertion, elevated blood pressure could cause expansion of the
aneurysmal cavity, aggravating the coronary ischemia, and eventually
would have produced myocardial infarction. However, this only occurs in
very rare cases.
Option D: Renal failure can be associated with MI but isn’t a direct cause.
All-cause mortality of dialysis patients with acute myocardial infarction
(AMI) is 59% at 1 year and about 73% at 2 years. AMI in patients with
nondialysis-dependent advanced CKD is also associated with poor long-
term cardiovascular outcomes and survival.
Option B: Heart failure is usually the result of an MI. It produces both a
vasculopathy and left ventricular dysfunction and fibrosis. It produces both
a vasculopathy and left ventricular dysfunction and fibrosis. Endothelial
dysfunction in the coronary arteries can lead to acute coronary events. Left
ventricular dysfunction will cause the progression of heart failure, and left
ventricular fibrosis and dysfunction provide an arrhythmic substrate.
3. 3. Question
Category: Pharmacological and Parenteral Therapies
What supplemental medication is most frequently ordered in conjunction with
furosemide (Lasix)?
, A. Chloride
B. Digoxin
C. Potassium
D. Sodium
Correct Answer: C. Potassium
Supplemental potassium is given with furosemide because of the potassium loss
that occurs as a result of this diuretic. Loop diuretics act at the ascending loop of
Henle in the kidney and help the body push out extra fluid that could accumulate
in the lungs or legs and ankles when the heart is unable to completely pump
blood throughout the body. But they may also cause the body to eliminate
excessive amounts of potassium, which might be expected to increase mortality
from heart arrhythmias. As a precaution, therefore, many doctors prescribe
potassium supplements to their patients receiving loop diuretics.
Option A: Chloride isn’t lost during diuresis. Continued use of diuretics, will
cause some overall sodium and chloride loss. The body, however, has a
natural way of compensating for these losses by reducing the excretion of
sodium and chloride and stabilizing the amount of sodium, chloride, and
water in the body. In this manner, fluid depletion usually is prevented.
Option B: Digoxin acts to increase contractility but isn’t given routinely
with furosemide. People with heart failure who take digoxin are commonly
given medicines called diuretics. These drugs remove excess fluid from the
body. Many diuretics can cause potassium loss. A low level of potassium in
the body can increase the risk of digitalis toxicity.
Option D: Sodium is not lost during diuresis. Diuretic drugs increase urine
output by the kidney (i.e., promote diuresis). This is accomplished by
altering how the kidney handles sodium. If the kidney excretes more
sodium, then water excretion will also increase.
4. 4. Question
Category: Physiological Adaptation
After myocardial infarction, serum glucose levels and free fatty acids are both
increased. What type of physiologic changes are these?
A. Electrophysiologic
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