NCLEX-RN : NCLEX

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #1211 : Nclex

The home health nurse visits the home of a patient who has just been discharged from the hospital after a small bowel resection. Which of the following patient statements concerns the nurse?

Possible Answers:

“I drink a lot of apple juice.”

“I limit the amount of milk I drink to one glass each day with breakfast.”

“I have stopped drinking coffee every day.”

“I enjoy eating corn bread with my dinner.”

“I make my sandwiches with white bread and smoked turkey.”

Correct answer:

“I enjoy eating corn bread with my dinner.”

Explanation:

Patients recovering from lower bowel surgery, such as small bowel resection, must adhere to a low-residue diet to minimize intestinal activity. A low-residue diet includes white breads, cereals, and pastas, well-cooked vegetables without skins, fresh fruits without peels or seeds, tender and well-cooked meats, limited dairy, meat broths and strained soups, and clear juices. The patient must avoid high-residue foods, including whole-grain breads such as corn bread, strong cheeses and yogurt, raw vegetables, dried fruits or legumes, juices with pulp, coffee or other caffeinated beverages, popcorn, nuts, and seeds.

Example Question #1212 : Nclex

Which of these is a proper lifestyle change to fight gastroesophageal reflux disease (GERD)?

Possible Answers:

Eating meals less than one hour before bedtime

Decreasing fluid intake

Cessation of soda intake

Increasing spicy food intake

Eating acidic foods

Correct answer:

Cessation of soda intake

Explanation:

Soda intake exacerbates symptoms of GERD. Along with this, individuals should wear loose clothing, exercise regularly, drink plenty of fluids, avoid eating within 1-2 hours of bed time, and avoid spicy and acidic foods. 

Example Question #1211 : Nclex

A nurse is counseling a 60 year old woman who recently found out that she has chronic hepatitis C. She is not sure how she became infected, though she does state that she had a blood transfusion in 1989 due to postpartum hemorrhage. She is concerned about the stigma of the disease and wonders how common it is in the United States. The nurse informs her of which of the following?

Possible Answers:

Hepatitis C is the third most common chronic blood-borne infection in the US. Two million Americans have had or are currently infected with the virus.

Hepatitis C is not particularly common: approximately 300,000 people in the United States have a current or past infection with the virus.

Hepatitis C is a rare infection: there are currently approximately 30,000 people in the United States living with this disease.

Hepatitis C is the most common chronic blood-borne infection in the US. 3.9 million Americans have had or are currently infected with the virus.

Correct answer:

Hepatitis C is the most common chronic blood-borne infection in the US. 3.9 million Americans have had or are currently infected with the virus.

Explanation:

Hepatitis C is the most common chronic blood-borne infection in the US. Approximately 3.9 million Americans have antibodies against the virus. Of those, approximately 70% (2.7 million) have chronic hepatitis C infections.

Example Question #1 : Identifying Endocrine Conditions

Most pituitary adenomas are non functional (incidentalomas). Of the functional adenomas, which are the most common?

Possible Answers:

Gonadotrophic adenomas

Null cell adenoma

Somatotrophic adenomas

Prolactinomas

Correct answer:

Prolactinomas

Explanation:

Prolactinomas (prolactin-secreting) make up 30% of functional pituitary adenomas. The second most common type are somatotrophic (growth hormone-secreting) adenomas, which make up 15%, followed by gonadotrophic (gonadotrophin-releasing) adenomas, which make up 10% of reported cases. Null cell adenomas are non functional (they do not secrete hormones).

Example Question #1211 : Nclex

Which of the following are common cardiac signs with hyperthyroidism? 

Possible Answers:

High cardiac output, tachycardia, and atrial fibrillation

Atrial stenosis and tachycardia

Premature ventricular contractions and low cardiac output

Diastolic murmurs and low cardiac output

Correct answer:

High cardiac output, tachycardia, and atrial fibrillation

Explanation:

A cardiac workup on a patient with hyperthyroidism will often reveal high cardiac output, tachycardia, atrial fibrillation, a prominent (fourth heart sound) S4, and flow murmurs. This condition is not associated with low cardiac output and while it may be seen with murmurs it is not specifically associated with atrial stenosis.

Example Question #411 : Conditions And Treatments

What HbA1c level is diagnostic for type II diabetes?

Possible Answers:

Greater than 

Greater than 

Greater than 

Greater than 

Correct answer:

Greater than 

Explanation:

A hemoglobin A1c level of 6.5% or greater is considered diagnostic of type II diabetes. A HgA1c level of less than 6.5% does not exclude a diagnosis of diabetes, however, and should be looked at alongside fasting blood glucose and oral glucose tolerance testing.

Example Question #1 : Endocrine Conditions

What is the most common cause of hyperthyroidism?

Possible Answers:

Graves' disease

Hashimoto's thyroiditis 

Toxic nodular goiter

Thyroid storm

Correct answer:

Graves' disease

Explanation:

Graves' disease is the most common cause of hyperthyroidism. Graves disease is an autoimmune condition in which antibody is produced against the thyroid-stimulating hormone (TSH) receptor, which binds to receptors, resulting in continuous stimulation of the gland to synthesize and secrete excess quantities of the thyroid hormones T4 and T3. Thyroid storm and toxic nodular goiter are less common causes of elevated thyroid hormone levels. Hashimoto's thyroiditis is the most common cause of hypothyroidism. 

Example Question #2 : Endocrine Conditions

What is the most common sign of primary hyperparathyroidism?

Possible Answers:

Depressed serum potassium

Depressed serum calcium

Elevated serum phosphorous

Elevated serum calcium

Correct answer:

Elevated serum calcium

Explanation:

The most common manifestation of primary hyperparathyroidism is elevated serum calcium. Parathyroid hormone (PTH) activates osteoclasts, which mobilize calcium and phosphate from bone. PTH also increases renal tubular absorption of calcium and inhibits the reabsorption of phosphate, resulting in elevated blood calcium levels while maintaining normal phosphate levels. High PTH has no significant direct effect on potassium levels.

Example Question #2 : Identifying Endocrine Conditions

A male client presents to the outpatient clinic for care for recently diagnosed hyperparathyroidism. He has been undergoing care for this condition. The nurse recognizes this patient will be at risk for several clinical manifestations.

All of the following are signs and symptoms associated with hyperparathyroidism except __________.

Possible Answers:

delirium and confusion

painful muscle cramps and tremors

skeletal pain and backaches

kidney stones and urinary tract infections

shortened QT interval on ECG

Correct answer:

painful muscle cramps and tremors

Explanation:

Painful muscle cramps and tremors are associated with low calcium levels which is indicative of hypoparathyroidism. All the other choices are associated with high calcium levels and therefore are symptoms associated with hyperparathyroidism.

Example Question #7 : Endocrine Conditions

A 35-year-old male client presents to the emergency department after wife found him unresponsive at home. The wife informs the nurse her husband is a diabetic, and had not taken his insulin for the past two days. The client appears flushed, breathing is rapid and deep, and has a fruity smell on the breath.

The nurse suspects this presentation is diabetic ketoacidosis, which diagnostic finding would confirm this pathology?

Possible Answers:

Elevated blood urea nitrogen (BUN)

Serum bicarbonate of 

Blood glucose 

Decreased serum osmolality

Blood pH of 7.26

Correct answer:

Blood pH of 7.26

Explanation:

The acidic pH is what is most consistent with the diagnosis of diabetic ketoacidosis (DKA). A pH of less than 7.30 is what is seen in DKA. The blood glucose will be elevated but the nurse may also see a similar elevation in hyperosmolar hyperglycemic syndrome as well. The serum bicarbonte will be low and the serum osmolality would be elevated, yet both findings are not specific for DKA. Elevated BUN (blood urea nitrogen) is not specific for DKA as well. 

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