Blog about quiz / question and answer NCLEX (National Council Licensure Examination) For Nursing Student, Example Question NCLEX RN and NCLEX PN. Exam for Nurse
1. Arterial blood gases (ABG) are obtained on a client with pneumonia. The ABG results are pH, 7.50; PCO2, 30 mm Hg; HCO , 20 mEq/L; PO2, 75 mm Hg; SaO2, 90%. The nurse interprets these results and determines that which of the following acid-base conditions exists?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
Answer: A. Respiratory alkalosis
Rationale: Normal pH is 7.35 to 7.45. Normal PCO2 is 35 to 45 mm Hg. Remember that when a respiratory condition exists, an opposite effect will be found between the pH and the PCOB. In respiratory alkalosis, the pH will be elevated and the PCO2 level decreased.
Test-Taking Strategy: Remember that in acidosis the pH is decreased, and in alkalosis the pH is elevated. Therefore eliminate options 2 and C. Noting that the PCO2 is low will assist in directing you to option A. Review ABG values if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Adult Health/Respiratory
Reference: Chernecky, C., & Berger, B. (2004). Laboratory tests and diagnostic procedures (4th ed.). Philadelphia: W.B. Saunders, p. 245.
2. A nurse is admitting a client to the nursing unit who is scheduled for several diagnostic tests. When obtaining a medication history, the nurse discovers that the client is taking tacrolimus (Prograf) daily. On further data collection, the nurse would expect to note that the client:
A. Has a history of coronary artery disease
B. Has a history of hypertension
C. Had an allogenic liver transplant
D. Had an ileal conduit created
Answer: C. Had an allogenic liver transplant
Rationale: Tacrolimus is an immunosuppressant medication used in the prophylaxis of organ rejection in clients receiving allogenic liver transplants. It should be used concurrently with adrenal corticosteroids. It may also be used in clients receiving kidney, bone marrow, heart, pancreas, and small bowel transplants. Options 1, 2, and 4 are not associated with this use of this medication.
Test-Taking Strategy: Use the process of elimination. Use your knowledge of medical terminology to help you select the correct option. If you remember that “pro” means “for” and “graf” means “graft,” you will know that the action of Prograf is to prevent transplant rejection. Review this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 1002.
3. A nurse is monitoring a client receiving torsemide (Demadex) 5 mg orally daily. Which of the following would indicate to the nurse that a therapeutic effect has occurred?
A. A blood pressure of 128/80 mm Hg
B. The presence of dependent edema
C. A sodium level of 130 mEq/L
D. A potassium level of 3.1 mEq/L
Answer: A. A blood pressure of 128/80 mm Hg
Rationale: Torsemide is a loop diuretic used primarily in the treatment of hypertension. It may be used alone or in combination with other antihypertensives. It may also be used in the treatment of edema associated with congestive heart failure (CHF), renal disease, or hepatic cirrhosis. Overdose of the medication produces acute, profound water loss, volume and electrolyte depletion, dehydration, decreased blood volume, and circulatory collapse. The presence of edema would not indicate a therapeutic effect. The normal sodium level is 135 to 145 mEq/L, and the normal potassium level is 3.5 to 5.1 mEq/L. Options 3 and 4 indicate abnormal electrolyte values.
Test-Taking Strategy: Note the key words therapeutic effect. Knowledge of the action of torsemide and of normal laboratory values is required to answer this question. Option 1 is the only option that identifies a normal finding. Review the action of this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 1059.
4. A nurse is caring for a client who was told that he had Bell’s palsy 1 week ago. Which of the following data would indicate a potential complication associated with Bell's palsy?
A. Partial facial paralysis
B. Excessive tearing
C. Negative outcomes on the electromyography
D. The ability to taste food
Answer: B. Excessive tearing
Rationale: Complications of Bell's palsy include abnormal regeneration of the nerve; “crocodile tears” (autonomic fibers reconnect to the lacrimal duct instead of the salivary glands so that the client experiences excessive tearing while eating); abnormal facial movements caused by reinnervation of inappropriate muscles; and spasms, atrophy, and contractures caused by incomplete motor fiber reinnervation. Partial facial paralysis is a factor indicating recovery. Negative outcomes on the electromyography performed 1 week after symptom onset indicates that nerve regeneration is present (negative test result indicates a positive prognostic outcome). Tasting food 1 week after symptom onset indicates a good prognosis for recovery.
Test-Taking Strategy: Focus on the key word complication. Partial facial paralysis is a factor indicating recovery, whereas total facial paralysis indicates a poor prognosis. Negative outcomes on the electromyography indicate a positive prognostic outcome. Tasting food 1 week after symptom onset indicates a good prognosis for recovery. Review the complications associated with Bell’s palsy if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Neurological
Reference: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis: Mosby, pp. 1605-1606.
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