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NCLEX-Adult Health Exam Questions And Correct Answers
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NCLEX-Adult Health Exam Questions AndCorrect Answers
The nurse is writing a proposal to provide a pet therapy program for a nursing home.
What information would the nurse include in the proposal to support providing this
program?
Select all that apply
1. There is evidence that animals can directly affect a person's mental and physical
status.
2. A nursing home for older adults can utilize a model in which a pet is brought into a
facility to enhance socialization.
3. The blood pressure of a client is lowered while petting an animal.
4. Animals actually may retard the aging process among those who live alone as some
researchers believe.
5. Clients in nursing homes are more submissive after petting an animal. - ANSWER 1.,
2., 3. & 4. Correct: All of these statements are correct in reference to pet therapy
programs. Petting a dog or cat has been shown to lower blood pressure. Studies have
found that as compared with reading aloud or sitting quietly, systolic pressure fell 7 mm
Hg and diastolic pressure dropped 8 mm Hg in volunteers during times when they talked
with or would stroke their dogs. 5. The patients are not more submissive or passive after
pet therapy. Evidence does show increased mental and physical well-being with pet
therapy.
When planning a care plan for a patient undergoing a barium enema, which of the
following should the nurse include in the care plan?
1. Cardiac monitoring for arrhythmias
2. Monitoring elimination patterns for urinary output
3. Ordering a laxative or enema post-procedure
4. Reordering the client's diet - ANSWER 3. Correct: The client must eliminate the
barium post procedure. If the barium is not eliminated it can dry in the colon and cause
,an obstruction.
1. Incorrect: It is not common practice to place clients on a cardiac monitor after a
barium enema.
2. Incorrect: This has nothing to do with monitoring the procedure of urine output and
does not answer the specific question related to this diagnostic procedure.
4. Incorrect: Although important, reordering of the client's diet is not as life-threatening
as a bowel obstruction.
The nurse is teaching a client who will be scheduled for an outpatient 24 hour
electrocardiogram monitoring via a Holter monitor. What should the nurse instruct the
client to avoid while monitoring is in progress?
Select all that apply
1. Showering or bathing
2. Performing daily exercises
3. Working around high voltage equipment
4. Being screened at airport security
5. Eating foods that are rich in potassium - ANSWERS 1., 3., and 4. Correct: The client
with a monitor should be taught by the nurse to continue the usual activities while
wearing the monitor with some limitations.
The monitor should not get wet to avoid malfunctioning. The client should not take a
shower or bath or swim while wearing the monitor. These electrodes could also become
detached from the skin if they become wet, further interfering with an accurate reading.
The client should also be instructed to avoid working around high voltage equipment
because areas of high voltage can interfere with the function of the electrocardiogram
monitoring. Furthermore, magnetic fields, like those used in airport screenings,
interfere with the functioning of the Holter monitor and should be avoided. 2. Incorrect
This client should be encouraged to continue normal routine unless otherwise
instructed by the primary health care provider. The client can do the usual daily
exercise but should be advised to avoid activities that may result in excessive
perspiration that could lead to the electrodes becoming loosened from the skin. 3.
Incorrect: There are usually no dietary restrictions during use of the Holter monitor
unless specifically requested by the primary health care provider.
,For the following question, select all options that are correct.
Which of the following teaching points would the nurse include in a client's nutrition
teaching plan to fulfill the objective of a gluten free diet?
Choose all that are correct
1 Gluten is a protein found in wheat
2 The major starchy foods that a person can have are made with barley.
3. Fruits are allowed on a gluten-free diet.
4. Uncontaminated, pure oats are an allowable food of the grain type that the client may
consume.
5. Inadvertent intake of gluten-containing foods may cause abdominal cramping and
diarrhea.
- ANSWER 1., 3., 4., & 5. Correct: Gluten-free diets are used for the treatment of celiac
disease.
Gluten is a food protein found in the grains barley, rye, and wheat. All products
prepared from these cereals must be excluded. Rice and corn may be used. Oats free
from contamination with wheat, barley and/or rye may be safely ingested by most clients
with celiac disease or other sensitivity to gluten. The reduction of the fiber content of
the diet also is often advised. Fruits, vegetables, nuts, dairy products, and meats not
prepared with gluten-containing ingredients may be consumed. Inadvertent intake of
food containing gluten may lead to abdominal pain and diarrhea. Some are
asymptomatic, but this does not imply that it is not causing damage to the small
intestine. As little as trace amounts of gluten may be causing damage. 2. The starchy
foods that one can eat are basically made with rice, corn, potatoes, quinoa, and
Tapioca. A client newly diagnosed with Celiac disease is taught about a gluten-free diet
by the nurse. Which statement by the client would the nurse suspect the client needs
further teaching? 1. "I will still experience occasional abdominal discomfort."
2. "I may have to take iron or vitamin supplements."
, 3. "I am allowed to eat eggs, but not wheat toast for breakfast".
4. "I cannot eat fresh apples and strawberries.". QUESTION 4 Correct: The nurse is
evaluating client statements for any knowledge deficit and need for further teaching.
In Celiac disease, the villi of the intestine swell up every time gluten enters the stomach
through the consumption of food.
However, fruits and vegetables are gluten-free; therefore, fresh apples and
strawberries would absolutely be accepted foods for this client.
Therefore, this statement by the client is incorrect, and it requires further explanation
from the nurse. 1. Incorrect The client appropriately identifies that some incidences of
abdominal distress may still occur because it is virtually impossible to avoid all gluten.
Even purchasing "gluten-free" foods, sometimes minute quantities of gluten may
contaminate foods and symptoms will return. In addition, eating out in a restaurant
could become problematic for anyone with Celiac disease. Because the client identifies
these potential symptoms, teaching was effective. However, the question requests
identifying evidence the client requires additional teaching. 2. Incorrect: This is a
correct statement the client has made about Celiac disease. Due to inflammation of the
villi in the intestines, which may cause poor nutrient absorption or anemia, the client
may have to take supplements long term. This response does not give any indication
that the client is having a problem with his understanding of teaching. 3. The Celiac
client should be encouraged to eat as healthy and varied a diet as possible as
malnutrition occurs secondarily to poor nutrient absorption in the bowel. A key
component in the diet includes protein, such as eggs, dairy products, and beans.
Those foods producing the most severe symptoms include grains such as wheat, rye
and barley along with the "malt barley" that acts as a thickening agent in some
products.
ADL's
A client is to be discharged after a left modified-radical mastectomy. While discussing
ADL's to be performed at home, the nurse expects the client to have the most difficulty
performing which of the following tasks? Choose all that apply 1. Cook a meal. 2.
Shampoo hair.
3. Launder and press clothes.
4. Vacuum carpets.
5. Change bed linen.
- QUESTIONS 2, 3, & 5. CORRECT: The modified-radical mastectomy is a surgical
treatment for cancer in which the breast tissue and nipple along with the axillary lymph
nodes are removed, but the chest muscles are preserved.
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