NCLEX-RN Practice Test 14 — Questions and Answers

Question 1: 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?

Myocardial infarction due to a history of atherosclerosis.
Pulmonary embolism due to deep vein thrombosis (DVT). (Correct answer)
Anxiety attack due to worries about her baby’s health.
Congestive heart failure due to fluid overload.

Correct answer: Pulmonary embolism due to deep vein thrombosis (DVT).

A pregnant patient on complete bed rest for an extended period is at a significantly increased risk for developing deep vein thrombosis (DVT) due to venous stasis and the hypercoagulable state of pregnancy. Sudden shortness of breath and chest pain are classic symptoms of a pulmonary embolism (PE), which often arises when a DVT dislodges and travels to the lungs. This is a life-threatening emergency.

Question 2: A child is seen in the emergency department for scarlet fever. Which of the following descriptions of scarlet fever is NOT correct?

Scarlet fever is caused by infection with group A Streptococcus bacteria
“Strawberry tongue” is a characteristic sign.
Petechiae occur on the soft palate. (Correct answer)
The pharynx is red and swollen.

Correct answer: Petechiae occur on the soft palate.

Scarlet fever is caused by Group A Streptococcus bacteria and is characterized by a distinctive 'strawberry tongue' and a red, swollen pharynx. While a rash is prominent, petechiae (small, pinpoint hemorrhages) on the soft palate are not a characteristic or defining sign of scarlet fever. This symptom is more commonly associated with other conditions like infectious mononucleosis or viral infections.

Question 3: A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?

Naproxen sodium (Naprosyn). (Correct answer)
Calcium carbonate.
Clarithromycin (Biaxin).
Furosemide (Lasix).

Correct answer: Naproxen sodium (Naprosyn).

Acute gastritis involves inflammation of the stomach lining. Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium are known to irritate the gastrointestinal mucosa and can exacerbate or cause gastritis by inhibiting the production of protective prostaglandins. Therefore, NSAIDs are contraindicated in patients with acute gastritis to prevent further damage and worsening of symptoms.

Question 4: 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.

Regular developmental screening is important to avoid secondary developmental delays. (Correct answer)
Cerebral palsy is caused by injury to the upper motor neurons and results in motor dysfunction, as well as possible ocular and speech difficulties. (Correct answer)
Developmental milestones may be slightly delayed but usually will require no additional intervention.
Parent support groups are helpful for sharing strategies and managing health care issues. (Correct answer)

Correct answer: Regular developmental screening is important to avoid secondary developmental delays.

Cerebral palsy (CP) results from injury to the developing brain, primarily affecting motor function, but can also lead to ocular and speech difficulties. Regular developmental screening is crucial to identify and address any secondary developmental delays early. Additionally, parent support groups are highly beneficial for sharing strategies and managing the complex healthcare needs associated with CP. Developmental milestones are typically significantly delayed and require intervention, making option C incorrect.

Question 5: Which of the following conditions most commonly causes acute glomerulonephritis?

A congenital condition leading to renal dysfunction.
Prior infection with group A Streptococcus within the past 10-14 days (Correct answer)
Viral infection of the glomeruli
Nephrotic syndrome

Correct answer: Prior infection with group A Streptococcus within the past 10-14 days

Acute glomerulonephritis (AGN) is most commonly a post-infectious complication, specifically following an infection with nephritogenic strains of Group A Beta-hemolytic Streptococcus (GABHS), such as strep throat or impetigo. The immune response to the bacterial infection leads to the formation of antigen-antibody complexes that deposit in the glomeruli, causing inflammation and damage. This typically occurs about 1-3 weeks after the initial streptococcal infection.

Question 6: Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct? Select all that apply:

It results when oxygen demand is greater than oxygen supply. (Correct answer)
It is characterized by pain that often occurs during rest.
It is a result of tissue hypoxia. (Correct answer)
It is characterized by cramping and weakness. (Correct answer)

Correct answer: It results when oxygen demand is greater than oxygen supply.

Claudication is a classic symptom of peripheral vascular disease (PVD), characterized by pain, cramping, or weakness in the legs during exercise. This occurs because narrowed arteries restrict blood flow, leading to an inadequate supply of oxygen and nutrients to the muscles (ischemia) when metabolic demand increases during activity. The pain subsides with rest as oxygen demand decreases, making the correct answer the most encompassing explanation.

Question 7: A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?

A history of hepatitis C five years previously. (Correct answer)
Cholecystitis requiring cholecystectomy one year previously.
Asymptomatic diverticulosis.
Crohn’s disease in remission.

Correct answer: A history of hepatitis C five years previously.

A history of hepatitis C, even if resolved, permanently disqualifies an individual from donating blood due to the risk of transmitting the virus. Blood donation centers prioritize donor and recipient safety, and hepatitis C is a serious blood-borne pathogen. Other conditions listed, like cholecystectomy, diverticulosis, or Crohn's disease in remission, generally do not prevent blood donation if the donor is healthy and meets other criteria.

Question 8: 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?

The admission orders are written.
A blood culture is drawn. (Correct answer)
A complete blood count with differential is drawn.
The parents arrive.

Correct answer: A blood culture is drawn.

When osteomyelitis is suspected, especially in a child with a puncture wound, obtaining a blood culture is crucial before initiating antibiotic therapy. This allows for the identification of the specific causative microorganism, ensuring that the most effective and targeted antibiotic can be chosen. Starting antibiotics prior to culture can mask the infection and make it difficult to identify the pathogen, leading to less effective treatment.

Question 9: 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?

It is the correct dose.
The dose is too low. (Correct answer)
The dose is too high.
The dose should be increased or decreased, depending on the symptoms.

Correct answer: The dose is too low.

The correct pediatric dose for diphenhydramine is 5 mg/kg/day. For a 30 kg child, the total daily dose should be 30 kg * 5 mg/kg/day = 150 mg/day. The prescribed dose is 25 mg three times a day, totaling 75 mg/day. Therefore, the prescribed dose of 75 mg/day is significantly lower than the recommended 150 mg/day.

Question 10: What is the purpose of grounded theory?

To support theoretical frameworks
To generate theory from data (Correct answer)
To develop explanatory models
To find significant differences among groups of people

Correct answer: To generate theory from data

Grounded theory is a qualitative research methodology that aims to construct theory directly from systematically gathered and analyzed data. Unlike other approaches that test existing theories, grounded theory involves an iterative process of data collection and analysis, allowing themes and concepts to emerge organically from the participants' experiences, ultimately leading to the development of a new theory.

Question 11: Why is it important to understand the philosophy underlying each type of research?

Conclusions reached should be congruent with the research question.
The research method that best meets intended purpose of the study should be used. (Correct answer)
The paradigm of the method should be the same as that of the researcher.
The paradigm of the method should be the same as that of the researcher.

Correct answer: The research method that best meets intended purpose of the study should be used.

Understanding the philosophical underpinnings of different research methods is essential because it guides the selection of the most appropriate method for a study's specific purpose. Each philosophy (e.g., positivism, interpretivism) dictates different assumptions about reality and knowledge, influencing how research questions are framed, data is collected, and findings are interpreted. Aligning the method with the purpose ensures the study is designed to effectively answer its research question.

Question 12: Which conceptual analysis point of the framework for rigor used for interpretive phenomenology refers to how the study findings will continue to have meaning for the reader?

Resonance
Concreteness
Actualization
Openness (Correct answer)

Correct answer: Openness

In the framework for rigor used for interpretive phenomenology, 'openness' refers to the researcher's ability to remain receptive to the data and the participants' experiences, allowing for new insights and meanings to emerge. This quality ensures that the study's findings are rich, authentic, and continue to resonate with readers by reflecting the lived experience without imposing preconceived notions. It contributes to the trustworthiness and transferability of the research.

Question 13: Which question will critique the sampling of a research project?

What is the projected significance of the work to nursing?
Are the informants who were chosen appropriate to inform the research? (Correct answer)
Is the strategy used for analysis compatible with the purpose of the study?
What are the philosophic underpinnings of the research method?

Correct answer: Are the informants who were chosen appropriate to inform the research?

Critiquing the sampling of a research project involves evaluating whether the participants (informants) selected are suitable and representative for the study's objectives. This question directly addresses the appropriateness of the sample, ensuring that the individuals chosen possess the necessary experiences or characteristics to provide meaningful data relevant to the research question. Adequate sampling is crucial for the credibility and generalizability of findings.

Question 14: Which question will critique the method of a research project?

Is the strategy used for analysis compatible with the purpose of the study? (Correct answer)
What is the projected significance of the work to nursing?
Are the informants who were chosen appropriate to inform the research?
What are the philosophic underpinnings of the research method?

Correct answer: Is the strategy used for analysis compatible with the purpose of the study?

Critiquing the method of a research project involves assessing whether the chosen research design, data collection techniques, and data analysis strategies are appropriate and aligned with the study's purpose. This specific question focuses on the compatibility of the analysis strategy, ensuring that the chosen analytical approach can effectively address the research questions and yield meaningful insights.

Question 15: Which question will critique the purpose of a research project?

Is the strategy used for analysis compatible with the purpose of the study?
What is the projected significance of the work to nursing? (Correct answer)
Are the informants who were chosen appropriate to inform the research?
What are the philosophic underpinnings of the research method?

Correct answer: What is the projected significance of the work to nursing?

Critiquing the purpose of a research project involves evaluating its overall relevance, importance, and potential contribution. Asking about the projected significance to nursing directly assesses whether the study's aims are valuable and how its findings could impact nursing practice, education, or policy. This helps determine if the research addresses a meaningful gap in knowledge or practice.

Question 16: Which question will critique the auditability of a research project?

Is the strategy used for analysis compatible with the purpose of the study?
Does the researcher document the research process? (Correct answer)
Are the researcher’s conceptualizations true to the data?
Has adequate time been allowed to fully understand the phenomenon?

Correct answer: Does the researcher document the research process?

Auditability, a key criterion for rigor in qualitative research, refers to the transparency and traceability of the research process. It means that an independent auditor should be able to follow the researcher's decision-making process, from data collection to analysis and interpretation, by examining the documented audit trail. Comprehensive documentation ensures that the study's findings are credible and verifiable.

NCLEX-RN Practice Test 14

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?