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Exam (elaborations)

NCLEX RN ACTUAL EXAM TEST BANK OF REAL QUESTIONS & ANSWERS NCLEX 2023 A+

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  • July 29, 2024
  • 322
  • 2023/2024
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Created by: A Solution


NCLEX RN ACTUAL EXAM TEST BANK OF REAL
QUESTIONS & ANSWERS NCLEX 2023 A+
QUESTION 1
Which classification of drugs is contraindicated for the client with hypertrophic
cardiomyopathy?


A. Positive inotropes
B. Vasodilators
C. Diuretics
D. Antidysrhythmics


Answer: A Explanation:
(A) Positive inotropic agents should not be administered owing to their action of increasing
myocardial contractility. Increased ventricular contractility would increase outflow tract
obstruction in the client with hypertrophic cardiomyopathy. (B) Vasodilators are not typically
prescribed but are not contraindicated. (C) Diuretics are used with caution to avoid causing
hypovolemi
A. (D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.


QUESTION 2
Signs and symptoms of an allergy attack include which of the following?


A. Wheezing on inspiration
B. Increased respiratory rate
C. Circumoral cyanosis
D. Prolonged expiration


Answer: D Explanation:
(A) Wheezing occurs during expiration when air movement is impaired because of constricted
edematous bronchial lumin


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A. (B) Respirations are difficult, but the rate is frequently normal. (C) The circumoral area is
usually pale. Cyanosis is not an early sign of hypoxi
A. (D) Expiration is prolonged because the alveoli are greatly distended and air trapping occurs.


QUESTION 3
A client confides to the nurse that he tasted poison in his evening meal. This would be an
example of what type of hallucination?
A. Auditory
B. Gustatory
C. Olfactory
D. Visceral


Answer: B Explanation:
(A) Auditory hallucinations involve sensory perceptions of hearing. (B) Gustatory hallucinations
involve sensory perceptions of taste. (C) Olfactory hallucinations involve sensory perceptions of
smell. (D) Visceral
hallucinations involve sensory perceptions of sensation.




QUESTION 4
Which of the following findings would be abnormal in a postpartal woman?


A. Chills shortly after delivery
B. Pulse rate of 60 bpm in morning on first postdelivery day
C. Urinary output of 3000 mL on the second day after delivery
D. An oral temperature of 101F (38.3C) on the third day after delivery


Answer: D Explanation:
(A) Frequently the mother experiences a shaking chill immediately after delivery, which is
related to a nervous response or to vasomotor changes. If not followed by a fever, it is clinically

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innocuous. (B) The pulse rate during the immediate postpartal period may be low but presents no
cause for alarm. The body attempts to adapt to the decreased pressures intra-abdominally as well
as from the reduction of blood flow to the vascular bed. (C) Urinary output increases during the
early postpartal period (12–24 hours) owing to diuresis. The kidneys must eliminate an estimated
2000–3000 mL of extracellular fluid associated with a normal pregnancy. (D) A temperature of
100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However,
any temperature greater than 100.4F needs further investigation to identify any infectious
process.


QUESTION 5
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the
teaching of the parents, the nurse states that:


A. Sustained temperature elevation over 103F is generally related to febrile seizures
B. Febrile seizures do not usually recur
C. There is little risk of neurological deficit and mental retardation as sequelae to febrile
seizures
D. Febrile seizures are associated with diseases of the central nervous system


Answer: C Explanation:
(A) The temperature elevation related to febrile seizures generally exceeds 101F, and seizures
occur during the temperature rise rather than after a prolonged elevation. (B) Febrile seizures
may recur and are more likely to do so when the first seizure occurs in the 1st year of life. (C)
There is little risk of neurological deficit, mental retardation, or altered behavior secondary to
febrile seizures. (D) Febrile seizures are associated with disease of the central nervous system.


QUESTION 6
A client diagnosed with bipolar disorder continues to be hyperactive and to lose weight. Which
of the following nutritional interventions would be most therapeutic for him at this time?
A. Small, frequent feedings of foods that can be carried
B. Tube feedings with nutritional supplements

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C. Allowing him to eat when and what he wants
D. Giving him a quiet place where he can sit down to eat meals


Answer: A Explanation:
(A) The manic client is unable to sit still long enough to eat an adequate meal. Small, frequent
feedings with
finger foods allow him to eat during periods of activity. (B) This type of therapy should be
implemented when other methods have been exhausted. (C) The manic client should not be in
control of his treatment plan. This type of client may forget to eat. (D) The manic client is unable
to sit down to eat full meals.


QUESTION 7
A client with bipolar disorder taking lithium tells the nurse that he has ringing in his ears, blurred
vision, and diarrhe
A. The nurse notices a slight tremor in his left hand and a slurring pattern to his speech. Which
of the following actions by the nurse is appropriate?
A. Administer a stat dose of lithium as necessary.
B. Recognize this as an expected response to lithium.
C. Request an order for a stat blood lithium level.
D. Give an oral dose of lithium antidote.


Answer: C Explanation:
(A) These symptoms are indicative of lithium toxicity. A stat dose of lithium could be fatal.
(B) These are toxic effects of lithium therapy. (C) The client is exhibiting symptoms of
lithium toxicity, which may be validated by lab studies. (D) There is no known lithium antidote.


QUESTION 8
A diagnosis of hepatitis C is confirmed by a male client‘s physician. The nurse should be
knowledgeable of the differences between hepatitis A, B, and C. Which of the following are
characteristics of hepatitis C?



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