NCLEX-RN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #441 : Conditions And Treatments

The nurse provides education to a patient newly diagnosed with Addison’s disease. The patient wants to learn about lifestyle modifications such as nutrition and diet changes. Which of the following statements by the nurse would be inappropriate?

Possible Answers:

“Try a low-sodium diet by cutting out additional salts.”

“Have a glass of water for every non-water drink you consume (i.e. soda, coffee, alcohol).”

“You can increase your intake of fiber and whole grains.”

“Make sure to eat enough calories for your height and weight.”

“A diet high in protein is best for you.”

Correct answer:

“Try a low-sodium diet by cutting out additional salts.”

Explanation:

Patients with Addison’s disease are more susceptible to becoming dehydrated and may lose salts more quickly than others. Because of this, it is important to make sure these patients have a well-rounded diet with an emphasis on fluids. Protein, whole grains, and fibers are routinely recommended in a healthy, balanced diet, but it is not recommended to have a sodium-restricted diet.

Example Question #1 : Cardiovascular Conditions

When checking on a patient receiving parenteral nutrition the nurse observes that the patient has gained excessive weight, has increased blood pressure, and has a bounding pulse. The nurse responds by:
Possible Answers:
Administering insulin
Restricting fluids and administering diuretics
Administering dextrose intravenously
Placing the client in a left-side lying position with the head lower than the feet
Correct answer: Restricting fluids and administering diuretics
Explanation: A client with excessive weight gain, headache, increased blood pressure, and bounding pulse is demonstrating symptoms of hypervolemia. The nurse should slow or stop the IV infusion, restrict fluids, an administer diuretics.

Example Question #2 : Cardiovascular Conditions

What is cardiac tamponade?

Possible Answers:

A potentially life-threatening arrhythmia arising from improper ventricular electrical activity

A loud, systolic mumur heard best over the 5th left intercostal space

Pain in the chest due to ischemia that is worse with exertion and better with rest

Accumulation of fluid in the pericardium that puts pressure on the heart

Correct answer:

Accumulation of fluid in the pericardium that puts pressure on the heart

Explanation:

Cardiac tamponade is a condition in which blood, air, pus, or some other type of fluid accumulates in the pericardium, putting pressure on the heart and reducing it's ability to fill during diastole. Cardiac tamponade is not an arrhythmia, a murmur, or any type of ischemia. Signs include pulsus paradoxus (a greater than 10mmHg drop of systolic blood pressure on inspiration) and changes on ECG.

Example Question #3 : Cardiovascular Conditions

A 60-year-old male enters the emergency room complaining of burning pain under his sternum that radiates to his jaw. He has been experiencing this pain for three weeks, periodically, with episodes that occur as often as three times a week. The nurse proceeds in which of the following ways?

Possible Answers:

Prepares the patient for immediate transfer to the cardiac laboratory

Administers 25 grams of 50% dextrose solution

Administers a dose of ibuprofen

Immediately calls the physician

Asks the patient if he has tried antacids

Correct answer:

Asks the patient if he has tried antacids

Explanation:

The patient is describing symptoms of heartburn. While it is important to rule out a cardiac-related cause, the nurse must do more assessment before reaching a conclusion.

Example Question #4 : Cardiovascular Conditions

Which of the following is not a risk factor for hypertension?

Possible Answers:

Family history

All the choices are risk factors

Race

Gender

Correct answer:

All the choices are risk factors

Explanation:

All of the answer choices listed are risk factors for hypertension:

Gender - more common in men

Race - more common in people of African American descent

Family history - more common in patients who have family members with a history of hypertension

Example Question #5 : Cardiovascular Conditions

What EKG rhythm is considered "irregularly irregular?"

Possible Answers:

Atrial fibrillation

All of these

Sinus bradycardia

Atrial flutter

Sinus tachycardia

Correct answer:

Atrial fibrillation

Explanation:

Atrial fibrillation (AFib) is considered an "irregularly irregular" rhythm. There are no discernible p waves because the atria are not contracting properly. The rate is irregular. This means that the rate varies from beat to beat. 

Example Question #4 : Cardiovascular Conditions

The nurse recognizes the following as a client's successful response to defibrillation:
Possible Answers:
Arousable, sinus rhythm, BP 116/72 mm Hg
Arousable, marked bradycardia, BP 86/54 mm Hg
Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg
Nonarousable, sinus rhythm, BP 88/60 mm Hg
Correct answer: Arousable, sinus rhythm, BP 116/72 mm Hg
Explanation: If defibrillation is successful, the client should be arousable, have a sinus rhythm, and have BP in a normal range.

Example Question #5 : Cardiovascular Conditions

Which part of the heart is most susceptible to infective endocarditis?

Possible Answers:

The myocardium

The endocardium

The valves

The chordae tendinae

Correct answer:

The valves

Explanation:

Because the valves of the heart don't have their own blood vessels, white blood cells can't directly get there via the bloodstream. In addition, due to the lack of vasculature, if infection does occur antimicrobial medications may have difficulty reaching the infection.

Example Question #6 : Cardiovascular Conditions

A 65-year-old male client has been admitted for complications due to chronic heart failure, and is receiving several medications. Medications include digoxin, Lasix, and metoprolol. The nurse enters the client room and he informs her that he is feeling nauseous and has vomited. She suspects the client is experiencing digoxin toxicity.

What has most likely caused the client to experience digoxin toxicity? 

Possible Answers:

Change in heart rate due to metoprolol

Right sided heart failure

Digoxin level of 

Hypokalemia due to Lasix 

Left ventricular hypertrophy

Correct answer:

Hypokalemia due to Lasix 

Explanation:

Digoxin toxicity is often precipitated by low potassium levels (hypokalemia). Hypokalemia is a risk with the taking of loop diuretics such as Lasix, so monitoring of potassium levels should be performed to prevent digoxin toxicity. 

Example Question #7 : Cardiovascular Conditions

Which of the following results would indicate a therapeutic effect in the client taking epoetin alfa?

Possible Answers:

Blood urea nitrogen level of 15 mg/dL

White blood cell count of 6,000 cells/mm3

Platelet count of 400,000 cells/mm3

Hematocrit of 32%

Correct answer:

Hematocrit of 32%

Explanation:

Epoetin alfa is used to treat anemia by causing bone marrow to produce oxygen-carrying red blood cells. Patients experiencing the therapeutic effects of the drug will have hematocrit in the range of 27-32%.

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