NCLEX-RN Exam Pack Set 12 (75 Questions & Answers Updated 2023)
1. 1. Question
Among the following signs and symptoms, which
would most likely be present in a client with mitral regurgitation?
o A. Altered level of consciousness
o B. Exertional Dyspnea
o C. Increase creatine phosphokina...
kris with a history of chronic infection of the ur
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Kibabii University College
EDUCATION 345 (EDUCATION345)
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NCLEX-RN Exam Pack Set 12
(75 Questions & Answers
Updated 2023)
1. 1. Question
Among the following signs and symptoms, which
would most likely be present in a client with mitral regurgitation?
o A. Altered level of consciousness
o B. Exertional Dyspnea
o C. Increase creatine phosphokinase concentration
o D. Chest pain
Correct Answer: B. Exertional Dyspnea
Mitral regurgitation (MR) is defined as an abnormal reversal of blood flow from
the left ventricle (LV) to the left atrium (LA).
Weight gain due to retention of fluids and worsening heart failure causes
exertional dyspnea in clients with mitral regurgitation. The patient will usually
complain of significant dyspnea at rest, exacerbated in the supine position, as
well as cough with clear or pink, frothy sputum.
Option A: An altered level of consciousness does not occur in clients
with mitral regurgitation. Physical examination may reveal altered
mental status, tachycardia (or bradycardia if there is ischemic
involvement of the conduction system), hypotension, tachypnea,
hypoxemia, and cyanosis.
Option C: Creatine phosphokinase (CPK) is an enzyme in the body. It is
found mainly in the heart, brain, and skeletal muscle. High levels of CPK
may be seen in people who have brain injury, convulsions, heart attack,
myocarditis, and myopathy.
Option D: The client feels no chest pain, but may feel palpitations as a
result of chronic atrial dilatation. They
, may also endorse symptoms associated with
myocardial ischemia, such as chest pain radiating to
the neck, jaw, shoulders, or upper extremities,
nausea, and diaphoresis.
• 2. Question
Kris with a history of chronic infection of the urinary system
complains of urinary frequency and burning sensation. To figure
out whether the current problem is of renal origin, the nurse
should assess whether the client has discomfort or pain in the:
o A. Urinary meatus
o B. Pain in the labium
o C. Suprapubic area
o D. Right or left costovertebral angle
Correct Answer: D. Right or left costovertebral angle
Discomfort or pain is a problem that originates in the kidney. It is
felt at the costovertebral angle on the affected side. Flank or
costovertebral angle (CVA) tenderness is most commonly
unilateral over the involved kidney, although bilateral discomfort
may be present. Discomfort varies from absent to severe. This
finding is usually not subtle and may be elicited with mild or
moderately firm palpation.
o Option A: Pain or discomfort in the urinary meatus
can also be indicative of urethritis or acute urinary
tract infection. In both men and women, common
causes of urethral pain include sexually transmitted
diseases (STDs) such as chlamydia, local irritation
from soaps or spermicides, and urinary tract infections
(UTIs). In men, prostatitis isn’t an uncommon cause,
whereas in women, vaginal dryness due to menopause
can be an issue.
o Option B: Pain in the labium can be due to a swollen
labia or vulva. Chronic yeast infections and bacterial
infections can both cause pain that ranges from mild
discomfort and itching to severe burning or throbbing.
Viral and bacterial infections, such as bacterial
, vaginosis and the herpes simplex virus, can also cause
vulvar pain or discomfort.
o Option C: Suprapubic pain has a wide variety of
causes, and can include pyelonephritis, perinephric
abscess, and nephrolithiasis. Gynecological causes are
common with suprapubic pain. Suprapubic pain
happens in the lower abdomen near where the hips
and many important organs, such as the intestines,
bladder, and genitals, are located. Suprapubic pain
can have a wide variety of causes, so the doctor may
need to do tests of vital functions before diagnosing
the underlying cause.
• 3. Question
Nurse Perry is evaluating the renal function of a male client.
After documenting urine volume and characteristics, Nurse Perry
assesses which signs as the best indicator of renal function.
o A. Blood pressure
o B. Consciousness
o C. Distension of the bladder
o D. Pulse rate
Correct Answer: A. Blood pressure
Perfusion can be best estimated by blood pressure, which is an
indirect reflection of the adequacy of cardiac output. Over time,
uncontrolled high blood pressure can cause arteries around the
kidneys to narrow, weaken or harden. These damaged arteries
are not able to deliver enough blood to the kidney tissue.
Damaged kidney arteries do not filter blood well. Kidneys have
small, finger-like nephrons that filter the blood.
o Option B: Consciousness is not an indicator of renal
function. Administration of medications that can alter
consciousness may have an effect on renal function,
according to studies conducted by The Journal of
Pharmacology and Experimental Therapeutics. During
consciousness, maximal renal vasodilation by
, papaverine or acetylcholine did not increase UNaV or
fractional Na excretion.
o Option C: Checking the distention of the bladder is
not an accurate indicator of renal function. It mostly
indicates an obstruction or a loss of tone in the
bladder muscles that fail to detect increased pressure
exerted by urine. It is usually associated with pain and
urge to urinate. Bladder catheterization should be
performed.
o Option D: Individuals with a high resting heart rate
and a low beat-to-beat heart rate variability have an
increased risk of developing kidney disease, according
to a new study by the American Society of Nephrology.
However, it is not the most accurate indicator of renal
function.
• 4. Question
John suddenly experiences a seizure, and Nurse Gina notices that
John exhibits uncontrollable jerking movements. Nurse Gina
documents that John experienced which type of seizure?
o A. Tonic seizure
o B. Absence seizure
o C. Myoclonic seizure
o D. Clonic seizure
Correct Answer: C. Myoclonic seizure
Myoclonic seizure is characterized by sudden uncontrollable
jerking movements of a single or multiple muscle group.
Myoclonus is defined as rapid, brief, jerky, or shock-like
movements involving muscle or group of muscles. Among all
hyperkinetic movement disorders, Myoclonus is considered to be
the most rapid and brief. When caused by sudden muscle
contraction, it is known as “positive myoclonus,” while a brief loss
of muscular tone results in “negative myoclonus” as in asterixis.
o Option A: A tonic seizure causes a sudden stiffness or
tension in the muscles of the arms, legs, or trunk. The
stiffness lasts about 20 seconds and is most likely to
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