NCLEX EXAM PREVIEW - ScienceMedicine lduffie Save NCLEX new generati...

Case Study NCLEX Questions ScienceMedicine lduffie Save NCLEX new generation case study Teacher 25 terms mycitynursePreview

NCLEX EXAM PREVIEW

110 terms kandykat1012Preview 75 Free NCLEX Questions - c/o Brilli...75 terms carey47Preview EXAM 29 terms lan Treatment modalities for estrogen-receptor positive tumors include (select all that apply):

• Estrogen-receptor downregulators (ERDs)
• Selective estrogen-receptor response modulators (SERMs)
• Hormone therapy
• Aromatase inhibitors

A, B, D

Stage IIIB describes invasive breast cancer in which:

• The tumor measures up to 2 cm and has not spread outside the breast
• No tumor is found in the breast
• Cancer may have spread to up to 9 axillary lymph nodes causing swelling
• The cancer has metastasized to other organs
• Cancer may have spread to up to 9 axillary lymph nodes causing swelling

In stage IIIB carcinoma of the breast the cancer may have spread to up to 9 axillary lymph nodes. Ms. T has 8 of 12 lymph nodes affected.Answers A or B may occur in stage I, and answer choice D describes stage IV

3.Which of the following are important interventions when caring for a patient with Cushing syndrome? (Select all that apply)

• Increase carbohydrate intake
• Monitoring blood glucose levels
• Observing for signs of hypotension
• Protecting patient from exposure to infection

B, D Hyperglycemia occurs with Cushing disease because of glucose intolerance (associated with cortisol-induced insulin resistance) and increased gluconeogenesis by the liver. High levels of corticosteroids increase susceptibility to infection and delay wound healing.In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:

• Menstrual flow
• Bone mineralization
• Hair loss
• Serum glucose level
• Serum glucose level

Serum glucose levels tend to be high in patients with Cushing's Syndrome due to excess corticosteroids in the body. When Cushing's syndrome is being treated successfully, a nurse should expect a decline in the patient's serum glucose level Mr. A has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is assessing his pain. What type of pain is associated with this diagnosis?

• Burning and aching, located in the left lower quadrant and radiating to the leg
• Severe and unrelenting, located in the epigastric area and radiating to the back
• Burning and aching, located in the epigastric area and radiating to the umbilicus
• Severe and unrelenting, located in the left lower quadrant and radiating to the hip
• Severe and unrelenting, located in the epigastric area and radiating to the back

The pain associated with acute pancreatitis is often severe and unrelenting, is located in the epigastric region, and radiates to the back. It is also described as sudden onset, deep piercing, continuous or steady. The other options are incorrect.The nurse is reviewing the prescription for Mr. A., a 55 year-old male admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.

• Administer antacids as prescribed
• Encourage coughing and deep breathing
• When food is allowed follow a high-carbohydrate, low-fat, high-protein diet
• Maintain the client in a supine and flat position.
• Give Demerol or Dilaudid as prescribed for pain.

A, B, C, E

Because abdominal pain is a prominent symptom of pancreatitis, pain medication such as Demerol or Dilaudid should be administered as prescribed. The client is susceptible to respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the client to take shallow, guarded abdominal breaths. Therefore measures such as turning, coughing, and deep breathing should be instituted. Antacids may be prescribed to suppress gastrointestinal secretions. The diet is usually high in carbohydrates since it is less stimulating the exocrine portion of the pancreas.

A patient comes into the clinic with complaints of joint stiffness and pain. For which symptom might the nurse assess to distinguish rheumatoid arthritis from other connective tissue disorders?

• The patient has unilateral joint involvement
• Morning stiffness that lasts more than one hour
• Inflammation of the great toe
• Dry mouth and dry eyes
• Morning stiffness that lasts more than one hour

You are providing education to a patient diagnosed with Rheumatoid Arthritis about how to manage her disease at home. Which statement by the patient would indicate understanding?

• "I should place a pillow under my knees before I sleep."
• "I will add weight lifting to my exercise routine."
• "When I'm having painful inflammation, I should resume total bed rest."
• "I may need 8-10 hours of sleep and daytime naps to help with fatigue."
• "I may need 8-10 hours of sleep and daytime naps to help with fatigue."

Which of the following are symptoms of a ruptured AAA? Select all that apply:

• Severe back pain
• Ripping or tearing sensation
• Polyuria
• Clammy skin
• Red rash on the abdomen

A, D Usually, with a rupture back pain becomes severe. Ripping or tearing sensation is a sign of aortic dissection. Urine output should be decreased.The patient is going into shock from blood loss which contributes to his clammy skin. A red rash on the abdomen may be caused by many other conditions, but not a ruptured AAA. Grey Turner's sign is bruising in the flank area due to AAA rupture.When teaching a patient about risk factors for AAA, which of the following, if stated by the patient indicates correct understanding?

• Taking ACE inhibitors or ARBS
• Being female
• Smoking
• Weightlifting
• Smoking

Aortic Aneurysm can be caused by being male, smoking, family history, and hypertension. ACE inhibitors or ARBS might be useful in treating AAA. Weightlifting should be avoided post AAA repair

A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the

pain goes away when he rests. This is known as:

• Unstable angina
• Variant angina
• Stable angina
• Prinzmetal angina
• Stable Angina

Chronic Stable angina, is known to be relieved by resting or by administering nitroglycerin tablets. Stable angina can also be brought on by exercise After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement?

• "I will replace my nitroglycerin supply every 6 months."
• "I can take up to five tablets every 3 minutes for relief of my chest pain."
• "I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin."
• "I will take the nitroglycerin 10 minutes before planned activity that usually causes chest pain."
• "I can take up to five tablets every 3 minutes for relief of my chest pain."

This is not the new recommended dosing for nitroglycerin. The correct use of nitroglycerin is to take one pill sublingually, and wait for the pain to subside, if the pain does not subside or worsens after five minutes the patient then should contact emergency personal. If pain is steadily subsiding a patient can repeat another dose every five minutes but with a maximum of three doses only, if pain is not completely diminished, contact EMS.The following are clinical manifestations of acute disseminated intravascular coagulation (DIC) EXCEPT:

• Hypertension
• Petechiae
• Altered mental status
• Mucosal/skin bleeding
• Hypertension

A patient experiencing acute DIC will experience hypotension, not hypertension.Which lab result would a nurse NOT expect to find in a client diagnosed with DIC?

• Prolonged prothrombin time (PT)
• Prolonged activated partial thromboplastin time (aPTT)
• A decreased platelet count
• A high fibrinogen level

A patient with DIC would have a low fibrinogen level. Fibrinogen predicts bleeding in DIC. As it decreases, the risk of bleeding increases. A prolonged PT, aPTT and decrease in platelet production are expected.