NCLEX-RN Practice Test 16

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A patient with a history of diabetes mellitus is on the second post-operative day following cholecystectomy. She has complained of nausea and isn’t able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient’s symptoms?

Correct! Wrong!

A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. Option A: An anesthesia reaction would not occur on the second postoperative day. Options B and D: Hyperglycemia and ketoacidosis do not cause confusion and shakiness.

A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?

Correct! Wrong!

A rapidly enlarging abdominal aortic aneurysm is at significant risk of rupture and should be resected as soon as possible. No other appropriate treatment options currently exist.

A two-year-old child has sustained an injury to the leg and refuses to walk. The nurse in the emergency department documents swelling of the lower affected leg. Which of the following does the nurse suspect is the cause of the child’s symptoms?

Correct! Wrong!

The child's refusal to walk, combined with swelling of the limb is suspicious for fracture. Option B: Toddlers will often continue to walk on a muscle that is bruised or strained. Option C: The radius is found in the lower arm and is not relevant to this question. Option D: Toddlers rarely feign injury to be carried, and swelling indicates a physical injury.

An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth, but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?

Correct! Wrong!

A hydrocele is a collection of fluid in the scrotum that results from a patent tunica vaginalis. Illumination of the scrotum with a pocket light demonstrates the clear fluid. In most cases, the fluid reabsorbs within the first few months of life and no treatment is necessary. Options A and D: Massaging the area or placing the infant in a supine position would have no effect. Option B: Surgery is not indicated.

A teen patient is admitted to the hospital by his physician who suspects a diagnosis of acute glomerulonephritis. Which of the following findings is consistent with this diagnosis? Note: More than one answer may be correct.

Please select 3 correct answers

Correct! Wrong!

Acute glomerulonephritis is characterized by high urine specific gravity related to oliguria as well as dark "tea-colored" urine caused by large amounts of red blood cells. Option D: There is periorbital edema, but generalized edema is seen in nephrotic syndrome, not acute glomerulonephritis.

Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy?

Correct! Wrong!

Cerebral hemorrhage is a significant risk when treating a stroke victim with thrombolytic therapy intended to dissolve a suspected clot. The success of the treatment demands that it be instituted as soon as possible, often before the cause of stroke has been determined. Air embolus is not a concern. Thrombolytic therapy does not lead to Option A: Air embolus is not a concern. Options C and D: Thrombolytic therapy does not lead to the expansion of the clot, but to resolution, which is the intended effect.

A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?

Correct! Wrong!

A family history of heart disease is an inherited risk factor that is not subject to lifestyle change. Having a first-degree relative with heart disease has been shown to significantly increase risk. Options B and C: Overweight and smoking are risk factors that are subject to lifestyle change and can reduce risk significantly. Option D: Advancing age increases the risk of atherosclerosis but is not a hereditary factor.

The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?

Correct! Wrong!

Cholecystitis, inflammation of the gallbladder, is most commonly caused by the presence of gallstones, which may block bile (necessary for fat absorption) from entering the intestines. Patients should decrease dietary fat by limiting foods like fatty meats, fried foods, and creamy desserts to avoid irritation of the gallbladder.

A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern?

Correct! Wrong!

Bowel perforation is the most serious complication of fiberoptic colonoscopy. Important signs include progressive abdominal pain, fever, chills, and tachycardia, which indicate advancing peritonitis. Options B and C: Viral gastroenteritis and colon cancer do not cause these symptoms. Option D: Diverticulitis may cause pain, fever, and chills, but is far less serious than perforation and peritonitis.

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