MEDSURG Final NCLEX questions

MED/SURG Final NCLEX questions

A student nurse is preparing blood for an A Positive patient who needs to receive a blood transfusion. The nurse intervenes after which statement?

• " Since you are A positive, you are considered a "universal recipient", therefore you

can receive any type of blood.

• "A positive blood types can receive A+, A-, O+ and O-"
• "Testing your blood type helps us determine what type of blood you need. Not all

blood types are the same and can cause a reaction"

• "Only certain people who meet a certain criteria can donate blood, but if you have

any types of symptoms during transfusion, let a health care staff member know" - A. " Since you are A positive, you are considered a "universal recipient", therefore you can receive any type of blood.

A patient has a folic acid deficiency. The nurse tells the patient to order foods rich in Folic Acid. What foods are best for the patient to look for when ordering food?

• Leafy Green Vegetables
• Citrus Fruits

C.Chicken D.Dried Beans

• Hard Candy - A. Leafy Green Vegetables
• Citrus Fruits
• Dried Beans

• A patient who was recently diagnosed with Gastroesophageal Reflux Disease

(GERD) was just educated on the importance of nutrition and what foods to avoid. What statement made by the patient, indicates the need for further teaching?

• " I will avoid foods like French fries and citrus juices to decrease my chances of acid

reflux and heart burn"

• "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I

have enough energy for the day"

• " I need to find another dessert I can eat each night before bed, because the

chocolate ice cream I eat every night will exacerbate my Gastroesophageal Reflux"

• " I need to drink more room temperature water to make sure my body has help when

properly digesting my meals" - B. "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I have enough energy for the day"

A 76-year old man with chronic anemia arrives at the Emergency department with increased fatigue and heart palpitations even at rest. The nurse would expect the

patients' laboratory test findings to include: (Select all that apply)

• Hemoglobin (Hgb) of 6.8 g/dL
• Hematocrit (Hct) value of 32%
• An Red Blood Cell count of 4,500,000/L
• A ferritin level of 8.2 ng/mL
• A White Blood Cell count of 6.5 x 109/L - A, B, D

a: hemoglobin (Hgb) of 6.8 g/dL

b: hematocrit (Hct) value of 32%

d: a ferritin level of 8.2 ng/mL

A student nurse is explaining the risk factors for metabolic syndrome which statement by the student would require correction from the nurse?

• Waist circumference of 41 for a male
• Body mass index of 30 or higher
• Triglycerides level of 130
• Blood Glucose of 168 - C. Triglycerides level of 130

A 68 year-old male suffering from chronic diarrhea is found to have a serum phosphate level of 0.9 mg/dL. After reviewing this lab value the nurse can expect the patient to exhibit which of the following symptoms? (Select all that apply)

• Confusion
• Numbness/tingling in extremities
• Muscle weakness
• Cardiac dysrhythmias
• Dry mucous membranes - A. Confusion
• Muscle weakness
• Cardiac dysrhythmias

The physician orders an arterial blood gas who is hyperventilating. The nurse can anticipate that the blood gas results will most likely reveal that the patient is in:

• Metabolic alkalosis
• Respiratory acidosis
• Metabolic acidosis
• Respiratory alkalosis - D. Respiratory alkalosis

Thalassemia is a group of diseases that causes an inadequate amount of normal hemoglobin to be produced in the body. Thalassemia minor is usually asymptomatic and requires no treatments. There is no cure for thalassemia major, however, there are

therapies available to help manage the disease. These include:

• Blood transfusions
• Subcutaneous or IV deferoxamine
• Iron supplements

• Zinc supplements
• Splenectomy - A. Blood transfusions
• Subcutaneous or IV deferoxamine
• Zinc supplements
• Splenectomy

A patient diagnosed with Stage II bladder cancer has just received a segmental cystectomy. What will the nurse correct the patient on for postoperative instructions for

discharge?:

• "I will drink only small amounts of water for the first week."
• "I will call the doctor if my urine is bright red for the first few days after surgery."
• "After a week, my urine could have dark red flakes, and that's normal."
• "I have a follow-up appointment for a cystoscopy in a few weeks." - A. "I will drink

only small amounts of water for the first week."

A patient with upper gastrointestinal cancer has been diagnosed with cancer cachexia which of the following would the nurse expect to see?

• Weight gain
• Skeletal muscle atrophy
• Increase immune function
• Improvement in metabolic abnormalities - B. Skeletal muscle atrophy

A female patient has just been diagnosed with external hemorrhoids and asks the nurse what could have contributed to her diagnoses, which of the following will the nurse mention as probable risk factors?

• Pregnancy
• Normal Body Mass Index
• Prolonged constipation
• Straining in an effort to defecate
• Heavy lifting
• Standing or sitting for a long period of time - A. Pregnancy
• Normal Body Mass Index
• Prolonged constipation
• Straining in an effort to defecate
• Heavy lifting
• Standing or sitting for a long period of time

The most common cause of cobalamin deficiency is pernicious anemia. Which of the following patients may develop a cobalamin deficiency? (Select all that apply)

• A 36-year-old morbidity obese patient that recently had the Roux-en-Y Gastric

Bypass (RYGB) Surgery

• A 45-year-old male construction working who has a history of smoking two packs of

cigarettes a day

• A 23-year-old female nurse apprentice who is having a routine colonoscopy
• A 50-year-old male yoga instructor who is on a strict vegetarian diet
• A 28-year-old female nursing student taking Pepcid and Omeprazole to control a

Pepcid ulcer for the past three years - A. A 36-year-old morbidity obese patient that recently had the Roux-en-Y Gastric Bypass (RYGB) Surgery

• A 45-year-old male construction working who has a history of smoking two packs of

cigarettes a day

• A 50-year-old male yoga instructor who is on a strict vegetarian diet
• A 28-year-old female nursing student taking Pepcid and Omeprazole to control a

Pepcid ulcer for the past three years

A 25 year old female patient is diagnosed with viral hepatitis. The provider prescribes Ribavirin, before administering the nucleoside what test will the nurse give to the patient?

a). Liver function test b). Pregnancy test c). Occult blood test d). Urinalysis - b). Pregnancy test

A Roux-en-Y Gastric Bypass (RYGB) Surgical patient is suffering from an early case of iron deficiency. Which of the following group of clinical manifestations will the patient present?

• No Symptoms
• Anorexia, Abdominal Pain, Paresthesia of the hands and feet, Nausea, Red and

Beefy Tongue

• Pallor, Glossitis, Headache, and Burning Sensation of the Tongue
• Fever, Swelling, Tachypnea, Hypertension, Tenderness, Nausea, Vomiting - A. No

Symptoms

A 67-year-old male has just been admitted into the Emergency Department late into the night. He is severely confused, agitated, and complains of severe chest pain. His wife is present with him and is very concerned about her husband. After receiving some blood tests, he is diagnosed with primary polycythemia vera. The nurse begins to provide education about how to manage his polycythemia. Which of the following would the nurse need to RE-EDUCATE based on patient response? (select all that apply)

• "If I would have received blood tests earlier, I could have prevented myself from

getting diagnosed with polycythemia."

• "I will need to get multiple phlebotomies done in order to keep my hematocrit level

less than 45%."

• "I will begin to start taking my low dose aspirin every morning."
• "During each of my phlebotomy appointments, I will lose 700mL of my blood."