NCLEX-RN Practice Test 13 — Questions and Answers

Question 1: A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?

Onset of pulmonary edema (Correct answer)
Metabolic alkalosis
Respiratory alkalosis
Parkinson’s disease type symptoms

Correct answer: Onset of pulmonary edema

Aspirin (salicylate) overdose is a serious condition that can lead to various complications, including direct toxicity to the lungs. This toxicity can cause non-cardiogenic pulmonary edema, which is a life-threatening accumulation of fluid in the lungs. Monitoring for this acute respiratory complication is crucial during the management of aspirin overdose.

Question 2: A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?

Yersinia pestis
Helicobacter pylori
Vibrio cholerae
Haemophilus aegyptius (Correct answer)

Correct answer: Haemophilus aegyptius

Conjunctivitis, commonly known as 'pink eye,' is an inflammation of the conjunctiva. While various microorganisms can cause it, *Haemophilus aegyptius* is a well-known bacterial pathogen specifically associated with acute purulent conjunctivitis, especially in tropical regions. It is also linked to Brazilian purpuric fever.

Question 3: A 24-year-old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?

Diverticulosis
Hypercalcaemia (Correct answer)
Hypocalcemia
Irritable bowel syndrome

Correct answer: Hypercalcaemia

The patient's symptoms of confusion, constipation, intense abdominal pain, and polyuria, combined with a history of myeloma, are classic indicators of hypercalcemia. Multiple myeloma often causes bone destruction, leading to an excessive release of calcium into the bloodstream. This elevated calcium level can manifest with the described neurological, gastrointestinal, and renal symptoms.

Question 4: A 50-year-old blind and deaf patient have been admitted to your floor. As the charge nurse, your primary responsibility for this patient is?

Let others know about the patient’s deficits
Communicate with your supervisor your patient safety concerns
Continuously update the patient on the social environment
Provide a secure environment for the patient (Correct answer)

Correct answer: Provide a secure environment for the patient

For a patient who is both blind and deaf, their primary vulnerability is to their physical safety within an unfamiliar environment. As the charge nurse, the most immediate and critical responsibility is to provide a secure environment, minimizing hazards and ensuring the patient can navigate safely. While communication and informing staff are important, ensuring physical safety takes precedence.

Question 5: A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following?

Observe for neurological changes.
Check the food diary.
Observe for signs of bleeding. (Correct answer)

Correct answer: Observe for signs of bleeding.

Tissue plasminogen activator (tPA), such as alteplase, is a potent thrombolytic agent designed to dissolve blood clots. Its mechanism of action carries a significant risk of bleeding, which can range from minor superficial bleeding to life-threatening hemorrhage. Therefore, closely observing for any signs of bleeding is the highest nursing priority during tPA therapy.

Question 6: A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Select all that apply:

Warfarin (Coumadin) (Correct answer)
Finasteride (Propecia, Proscar) (Correct answer)
Celecoxib (Celebrex)
Clonidine (Catapres)
Transdermal nicotine (Habitrol)
Clofazimine(Lamprene)

Correct answer: Warfarin (Coumadin)

Warfarin is a known teratogen, meaning it can cause severe birth defects (fetal warfarin syndrome) when taken during pregnancy. Finasteride is an anti-androgen that can cause feminization of a male fetus, making it contraindicated for pregnant women or those who could become pregnant. Both medications pose significant risks to fetal development.

Question 7: A 28-year-old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?

Blood sugar check (Correct answer)
CT scan
Blood cultures
Arterial blood gases

Correct answer: Blood sugar check

The symptoms of confusion, sweating, and pallor are classic signs of hypoglycemia, or low blood sugar. This condition can rapidly become life-threatening if not addressed promptly. A blood sugar check is a quick, non-invasive, and essential diagnostic test to confirm hypoglycemia and guide immediate treatment, making it the most likely first test performed.

Question 8: A patient who has been diagnosed with vasospastic disorder (Raynaud’s disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient?

An adolescent male.
An elderly woman.
A young woman. (Correct answer)
An elderly man.

Correct answer: A young woman.

Raynaud's disease (primary Raynaud's phenomenon) is a common vasospastic disorder characterized by episodic constriction of small blood vessels, typically in the fingers and toes, in response to cold or stress. It most frequently affects young women, often beginning between the ages of 15 and 30. Therefore, a young woman is the most likely demographic to fit this description.

Question 9: An infant is brought to the clinic by his mother, who has noticed that he holds his head in an unusual position and always faces to one side. Which of the following is the most likely explanation?

Torticollis, with shortening of the sternocleidomastoid muscle. (Correct answer)
Craniosynostosis, with premature closure of the cranial sutures.
Plagiocephaly, with flattening of one side of the head.
Hydrocephalus, with increased head size.

Correct answer: Torticollis, with shortening of the sternocleidomastoid muscle.

Torticollis, also known as 'wry neck,' is a condition in infants where the head is tilted to one side and rotated to the opposite side due to the shortening or spasm of the sternocleidomastoid muscle. This muscle shortening causes the characteristic unusual head position and restricted range of motion. It is a common musculoskeletal issue in infants.

Question 10: What does a level-of-evidence model use to evaluate the strength of a research study and its findings? Select all that apply.

Creativity
Quality (Correct answer)
Quantity (Correct answer)
Consistency (Correct answer)
Efficiency

Correct answer: Quality

Level-of-evidence models are frameworks used to evaluate the strength and reliability of research studies and their findings, guiding evidence-based practice. These models typically assess the **quality** of the study design and execution, the **quantity** of research on a topic, and the **consistency** of findings across multiple studies. These three criteria help determine the overall strength of the evidence.

Question 11: What are the critiquing criteria used to judge the worth of a research study? Select all that apply.

Measures (Correct answer)
Objectives
Standards (Correct answer)
Effectiveness
Evaluation guides (Correct answer)
Questions (Correct answer)

Correct answer: Measures

Critiquing a research study involves a systematic and objective appraisal of its strengths and weaknesses to determine its worth and applicability. This process is guided by established **standards**, **measures**, **evaluation guides**, and specific **questions** that assess various aspects of the study, such as its methodology, ethical considerations, and the validity of its findings.

Question 12: Which statement best describes qualitative research? Select all that apply.

Studies are conducted in natural settings. (Correct answer)
Data are collected from a large number of subjects.
Data collected tend to be numeric.
The research design is systematic and subjective. (Correct answer)

Correct answer: Studies are conducted in natural settings.

Qualitative research is characterized by its focus on understanding complex phenomena within their natural settings, exploring subjective experiences, meanings, and perspectives. It often involves in-depth data collection from a smaller number of subjects, and while the design is systematic, the interpretation of rich, descriptive data is inherently subjective. This approach aims for deep understanding rather than statistical generalization.

Question 13: What does a critique of a research study always include? Select all that apply.

Determining its strengths and weaknesses (Correct answer)
Researching similar studies
Using critical reading skills (Correct answer)
Explaining your own personal opinions

Correct answer: Determining its strengths and weaknesses

A critique of a research study is a systematic and objective appraisal that involves carefully examining the study's strengths and weaknesses. It requires the application of critical reading skills to analyze the methodology, findings, and implications. The goal is to evaluate the study's rigor and validity, not to express personal opinions or simply research similar studies.

Question 14: For which of the following research questions would qualitative methods be most appropriate?

Which pain medications decrease the need for sleep medication in elderly patients?
What is the meaning of health for migrant farm-worker women? (Correct answer)
Under what conditions does a decubitus ulcer heal most quickly?
How does frequency of medication administration impact the degree of pain experienced following knee replacement surgery?

Correct answer: What is the meaning of health for migrant farm-worker women?

Qualitative research aims to explore and understand subjective experiences, perceptions, and meanings. The question 'What is the meaning of health for migrant farm-worker women?' directly seeks to uncover the lived experiences and interpretations of a specific group, which is a hallmark of qualitative inquiry. The other options are quantitative, focusing on measurable outcomes or comparisons.

Question 15: Which of the following phrases would be found in a report of a qualitative study?

“The hypothesis of this study is?”
“Perceived pain was measured using the Abbott pain scale?”
“The control group received no instruction?”
“Subjects were asked to relate their perceptions of pain?” (Correct answer)

Correct answer: “Subjects were asked to relate their perceptions of pain?”

Qualitative studies focus on understanding subjective experiences, perceptions, and meanings. Phrases like 'Subjects were asked to relate their perceptions of pain' indicate an approach that gathers rich, descriptive, and narrative data directly from participants about their personal experiences. This is characteristic of qualitative research, which seeks in-depth understanding rather than numerical measurement.

Question 16: Which of the following phrases would be found in a report of a quantitative study?

“A convenience sample was chosen?” (Correct answer)
“The phenomenon studied was?”
“Data were analyzed and interpreted?”
“Researchers sought to explore the meaning of the hospital experience?”

Correct answer: “A convenience sample was chosen?”

Quantitative studies focus on collecting and analyzing numerical data to test hypotheses, establish relationships, and generalize findings. The phrase 'A convenience sample was chosen' refers to a non-probability sampling method used to select participants for quantitative data collection. This is a common practice in quantitative research where statistical analysis will be applied to the collected numbers.

NCLEX-RN Practice Test 13

A patient has taken an overdose of aspirin.
Which of the following should a nurse most closely monitor for during acute management of this patient?