NCLEX-RN Practice Test 14

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A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?

Correct! Wrong!

In a hospitalized patient on prolonged bed rest, the most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs. These clots can then break loose and travel to the lungs. Options A and D: Myocardial infarction and atherosclerosis are unlikely in a 27-year-old woman, as is congestive heart failure due to fluid overload. Option C: There is no reason to suspect an anxiety disorder in this patient. Though anxiety is a possible cause of her symptoms, the seriousness of pulmonary embolism demands that it be considered first.

A child is seen in the emergency department for scarlet fever. Which of the following descriptions of scarlet fever is NOT correct?

Correct! Wrong!

Petechiae on the soft palate are characteristic of rubella infection. Options A, B, and D are characteristic of scarlet fever, a result of group A Streptococcus infection.

A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?

Correct! Wrong!

Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. Option B: Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Option C: Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Option D: Furosemide is a loop diuretic and is NOT contraindicated in a patient with gastritis.

A toddler has recently been diagnosed with cerebral palsy. Which of the following information should the nurse provide to the parents? Note: More than one answer may be correct.

Please select 3 correct answers

Correct! Wrong!

Delayed developmental milestones are characteristic of cerebral palsy, so regular screening and intervention is essential. Because of injury to upper motor neurons, children may have ocular and speech difficulties. Parent support groups help families to share and cope. Physical therapy and other interventions can minimize the extent of the delay in developmental milestones.

Which of the following conditions most commonly causes acute glomerulonephritis?

Correct! Wrong!

Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis.

Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct? Select all that apply:

Please select 3 correct answers

Correct! Wrong!

Claudication describes the pain experienced by a patient with a peripheral vascular disease when oxygen demand in the leg muscles exceeds the oxygen supply. The tissue becomes hypoxic, causing cramping, weakness, and discomfort. Option B: This most often occurs during activity when demand increases in muscle tissue.

A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?

Correct! Wrong!

Hepatitis C is a viral infection transmitted through bodily fluids, such as blood, causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Cholecystitis (gallbladder disease), diverticulosis, and history of Crohn’s disease do not preclude blood donation.

A child is admitted to the hospital several days after stepping on a sharp object that punctured her athletic shoe and entered the flesh of her foot. The physician is concerned about osteomyelitis and has ordered parenteral antibiotics. Which of the following actions is done immediately before the antibiotic is started?

Correct! Wrong!

Antibiotics must be started after the blood culture is drawn, as they may interfere with the identification of the causative organism. Option C: The blood count will reveal the presence of infection but does not help identify an organism or guide antibiotic treatment. Option D: Parental presence is important for the adjustment of the child but not for the administration of medication.

A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose?

Correct! Wrong!

This child weighs 30 kg, and the pediatric dose of diphenhydramine is 5 mg/kg/day (5 X 30 = 150/day). Therefore, the correct dose is 150 mg/day. Divided into 3 doses per day, the child should receive 50 mg 3 times a day rather than 25 mg 3 times a day. Dosage should not be titrated based on symptoms without consulting a physician.

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