NCLEX-RN Practice Test 16 — Questions and Answers
Question 1: 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?
- Anesthesia reaction.
- Hyperglycemia.
- Hypoglycemia. (Correct answer)
- Diabetic ketoacidosis.
Correct answer: Hypoglycemia.
The patient's history of diabetes, post-operative status, and inability to eat solid foods significantly increase the risk of hypoglycemia (low blood sugar). Confusion and shakiness are classic and critical symptoms of hypoglycemia, as the brain lacks sufficient glucose for proper function. Prompt recognition and treatment are essential to prevent further complications.
Question 2: 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?
- The patient will be admitted to the medicine unit for observation and medication
- The patient will be admitted to the day surgery unit for sclerotherapy
- The patient will be admitted to the surgical unit and resection will be scheduled (Correct answer)
- The patient will be discharged home to follow-up with his cardiologist in 24 hours
Correct answer: The patient will be admitted to the surgical unit and resection will be scheduled
A rapidly enlarging abdominal aortic aneurysm (AAA) is a life-threatening condition due to the high risk of rupture, which can lead to massive internal bleeding and death. Surgical resection is the definitive and urgent treatment to prevent this catastrophic event. Therefore, immediate admission to the surgical unit for intervention is the appropriate course of action.
Question 3: 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?
- Possible fracture of the tibia. (Correct answer)
- Bruising of the gastrocnemius muscle.
- Possible fracture of the radius.
- No anatomic injury, the child wants his mother to carry him.
Correct answer: Possible fracture of the tibia.
A two-year-old child refusing to walk after an injury, coupled with swelling of the lower affected leg, strongly suggests a significant musculoskeletal injury. Given the age and symptoms, a fracture, particularly of a long bone like the tibia, is a primary concern that requires immediate medical evaluation. Bruising alone is less likely to cause complete refusal to bear weight.
Question 4: 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?
- Massaging the groin area twice a day until the fluid is gone.
- Referral to a surgeon for repair.
- No treatment is necessary; the fluid is reabsorbing normally. (Correct answer)
- Keeping the infant in a flat, supine position until the fluid is gone.
Correct answer: No treatment is necessary; the fluid is reabsorbing normally.
Hydroceles in infants are often congenital and typically resolve spontaneously as the communication between the abdomen and scrotum closes and the fluid is reabsorbed. A decrease in scrotal size and visible fluid on illumination at 1 month indicates this normal reabsorption process is occurring. Surgical intervention is usually considered only if the hydrocele persists beyond 12-18 months of age or becomes symptomatic.
Question 5: 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.
- Urine specific gravity of 1.040. (Correct answer)
- Urine output of 350 ml in 24 hours. (Correct answer)
- Brown (“tea-colored”) urine. (Correct answer)
- Generalized edema.
Correct answer: Urine specific gravity of 1.040.
Acute glomerulonephritis is characterized by inflammation of the kidney's filtering units, leading to impaired function. This results in decreased urine output (oliguria, e.g., 350 ml/24 hours), concentrated urine (high specific gravity like 1.040), and hematuria, which often presents as brown or 'tea-colored' urine due to red blood cells. Generalized edema is also common due to fluid retention.
Question 6: Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy?
- Air embolus.
- Cerebral hemorrhage. (Correct answer)
- Expansion of the clot.
- Resolution of the clot.
Correct answer: Cerebral hemorrhage.
Thrombolytic therapy works by dissolving blood clots, which is beneficial in ischemic stroke. However, its primary and most significant complication is an increased risk of bleeding, particularly cerebral hemorrhage, which can be life-threatening. Nurses must closely monitor for signs of bleeding and neurological changes during and after administration.
Question 7: 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?
- Family history of heart disease. (Correct answer)
- Overweight.
- Smoking
- Age
Correct answer: Family history of heart disease.
Hereditary risk factors are those passed down through genes, making a family history of heart disease a key indicator of genetic predisposition to atherosclerosis. While age, overweight, and smoking are significant risk factors, they are considered non-hereditary or modifiable factors. A strong family history suggests an inherited susceptibility to the condition.
Question 8: The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?
- The patient must maintain a low-calorie diet.
- The patient must maintain a high protein/low carbohydrate diet.
- The patient should limit sweets and sugary drinks.
- The patient should limit fatty foods. (Correct answer)
Correct answer: The patient should limit fatty foods.
Cholecystitis is inflammation of the gallbladder, often triggered by gallstones. The gallbladder's primary function is to store and release bile, which aids in fat digestion. Consuming fatty foods stimulates bile release, which can exacerbate pain and symptoms in a patient with cholecystitis, making a low-fat diet crucial for symptom management.
Question 9: 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?
- Bowel perforation (Correct answer)
- Viral gastroenteritis
- Colon cancer.
- Diverticulitis
Correct answer: Bowel perforation
Increasing abdominal pain, fever, and chills 18 hours after a colonoscopy are classic and concerning signs of bowel perforation, a serious and life-threatening complication. During a colonoscopy, there is a risk of inadvertently puncturing the bowel wall, leading to peritonitis and sepsis. This requires immediate medical attention and often surgical intervention.
Question 10: What should be included in “scholarly literature”? Select all that apply.
- Research reports reported in primary sources only
- Conceptual and theoretical literature from primary sources only
- Published and unpublished reports of research (Correct answer)
- Primary and secondary sources (Correct answer)
Correct answer: Published and unpublished reports of research
Scholarly literature encompasses a broad range of academic works, including both published articles in peer-reviewed journals and books, as well as unpublished research reports like dissertations or conference proceedings. It also includes both primary sources (original research) and secondary sources (reviews, analyses of primary sources) that contribute to the body of knowledge in a field. This comprehensive approach ensures a thorough understanding of the topic.
Question 11: Reviews of the literature are conducted for PURPOSES OF RESEARCH as well as for the CONSUMER OF RESEARCH. How are these reviews similar? Select all that apply.
- Amount of literature required to be reviewed
- Degree of critical reading required (Correct answer)
- Importance of conceptual literature (Correct answer)
- Purpose of the review
Correct answer: Degree of critical reading required
Both researchers and consumers of research need to critically evaluate the literature to understand its strengths, limitations, and relevance, requiring a high degree of critical reading. Additionally, understanding the underlying conceptual and theoretical frameworks (conceptual literature) is important for both groups to grasp the context and implications of the research. While the amount of literature and the ultimate purpose may differ, these aspects of engagement are shared.
Question 12: What are characteristics of the literature review required for a quantitative research study? Select all that apply.
- The review is exhaustive and must include all studies conducted in the area
- Doctoral dissertations and masters’ theses are excellent sources of information (Correct answer)
- Computer-accessed materials are acceptable (Correct answer)
- Primary sources are not as important as secondary sources
Correct answer: Doctoral dissertations and masters’ theses are excellent sources of information
For quantitative research, a literature review should be comprehensive, focusing on relevant, high-quality evidence. Doctoral dissertations and master's theses are valuable primary sources of research, often containing detailed methodologies and findings not yet published elsewhere. Computer-accessed materials, such as reputable electronic databases, are essential and acceptable tools for efficient literature searching, providing access to a vast array of scholarly work.
Question 13: Which of the following is an example of a primary source in a research study?
- A published commentary on the findings of another study
- A doctoral dissertation that critiques all research in the area of attention deficit disorder
- A textbook of medical-surgical nursing
- A journal article about a study that used large, previously unpublished databases generated by the United States census (Correct answer)
Correct answer: A journal article about a study that used large, previously unpublished databases generated by the United States census
A primary source presents original research, data, or ideas directly from the source. A journal article reporting on a study that used large, previously unpublished databases generated by the United States census is a primary source because it's the first publication of the analysis and interpretation of that specific dataset. Commentaries, critiques, and textbooks are typically secondary or tertiary sources.
Question 14: What is the best source to use when conducting a level I systematic meta-analysis of the literature?
- An electronic database
- Doctoral dissertations
- The Cochrane Statistical Methods (Correct answer)
- An electronic database and Doctoral dissertations
Correct answer: The Cochrane Statistical Methods
For a Level I systematic meta-analysis, which involves rigorously combining and analyzing data from multiple studies, the Cochrane Statistical Methods (part of the Cochrane Library) are considered the gold standard. They provide comprehensive guidelines and software for conducting high-quality systematic reviews and meta-analyses, ensuring methodological rigor and minimizing bias. While electronic databases are used to find studies, the Cochrane methods guide the analysis itself.
Question 15: What is a characteristic of an audio recording of an unpublished research study reported at a professional conference?
- Databased literature (Correct answer)
- Secondary Sources
- Are more difficult to analyze than written reports.
- Are not useful because they are not published
Correct answer: Databased literature
An audio recording of an unpublished research study reported at a professional conference is considered 'databased literature' or 'grey literature.' It represents original research findings, even if not formally peer-reviewed and published in a journal. It is a primary source of information, though it may require more critical evaluation due to its unpublished nature.
Question 16: What is the first step in the qualitative research process?
- Data analysis
- Sample
- Review of literature (Correct answer)
- Study design
Correct answer: Review of literature
In qualitative research, the initial step, similar to quantitative research, involves a review of existing literature. This helps the researcher understand what is already known about the phenomenon, identify gaps in knowledge, and refine the research question without imposing preconceived notions that might bias the emergent findings. It provides essential context and justification for the study.
NCLEX-RN Practice Test 16
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?