NCLEXACTUALEXAM PREDICTION

NCLEXACTUALEXAM PREDICTION

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REALEXAMQUESTIONSFORYOUR

COMINGEXAM 1 / 4

ExamA

QUESTION1

Toappropriatelymonitortherapyandclientprogress,thenurseshouldbeawarethatincreasedmyocardial workandO2demandwilloccurwithwhichofthefollowing?A.Positiveinotropictherapy B.Negativechronotropictherapy C.IncreaseinbalanceofmyocardialO2supplyanddemand D.Afterloadreductiontherapy

CorrectAnswer:A

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Inotropictherapywillincreasecontractility,whichwillincreasemyocardialO2demand.(B)Decreased heartratetothepointofbradycardiawillincreasecoronaryarteryfillingtime.Thisshouldbeused cautiouslybecausetachycardiamaybeacompensatorymechanismtoincreasecardiacoutput.(C)The goalinthecareoftheMIclientwithanginaistomaintainabalancebetweenmyocardialO2supplyand demand.(D)Decreaseinsystemicvascularresistancebydrugtherapy,suchasIVnitroglycerinor nitroprusside,orintra-aorticballoonpumptherapy,woulddecreasemyocardialworkandO2demand.

QUESTION2

Thenursewouldneedtomonitortheserumglucoselevelsofaclientreceivingwhichofthefollowing medications,owingtoitseffectsonglycogenolysisandinsulinrelease?A.Norepinephrine(Levophed) B.Dobutamine(Dobutrex) C.Propranolol(Inderal) D.Epinephrine(Adrenalin)

CorrectAnswer:D

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Norepinephrine’ssideeffectsareprimarilyrelatedtosafe,effectivecareenvironmentandinclude decreasedperipheralperfusionandbradycardia.(B)Dobutamine’ssideeffectsincludeincreasedheart rateandbloodpressure,ventricularectopy,nausea,andheadache.(C)Propranolol’ssideeffectsinclude elevatedbloodureanitrogen,serumtransaminase,alkalinephosphatase,andlacticdehydrogenase.(D) Epinephrineincreasesserumglucoselevelsbyincreasingglycogenolysisandinhibitinginsulinrelease.Prolongedusecanelevateserumlactatelevels,leadingtometabolicacidosis,increasedurinary catecholamines,falseelevationofbloodureanitrogen,anddecreasedcoagulationtime.

QUESTION3

Whichofthefollowingmedicationsrequirescloseobservationforbronchospasmintheclientwithchronic obstructivepulmonarydiseaseorasthma?A.Verapamil(Isoptin) B.Amrinone(Inocor) C.Epinephrine(Adrenalin) D.Propranolol(Inderal)

CorrectAnswer:D 2 / 4

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Verapamilhastherespiratorysideeffectofnasalorchestcongestion,dyspnea,shortnessofbreath (SOB),andwheezing.(B)Amrinonehastheeffectofincreasedcontractilityanddilationofthevascular smoothmuscle.Ithasnonotedrespiratorysideeffects.(C)Epinephrinehastheeffectofbronchodilation throughβstimulation.(D)Propranolol,esmolol,andlabetalolareallβ-blockingagents,whichcanincrease airwayresistanceandcausebronchospasms.

QUESTION4

Thefollowingmedicationswerenotedonreviewoftheclient’shomemedicationprofile.Whichofthe medicationswouldmostlikelypotentiateorelevateserumdigoxinlevels?A.KCl B.Thyroidagents C.Quinidine D.Theophylline

CorrectAnswer:C

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Hypokalemiacancausedigoxintoxicity.AdministrationofKClwouldpreventthis.(B)Thyroidagents decreasedigoxinlevels.(C)Quinidineincreasesdigoxinlevelsdramatically.(D)Theophyllineisnotnoted tohaveaneffectondigoxinlevels.

QUESTION5

Intheclientwithadiagnosisofcoronaryarterydisease,thenursewouldanticipatethecomplicationof bradycardiawithocclusionofwhichcoronaryartery?A.Rightcoronaryartery B.Leftmaincoronaryartery C.Circumflexcoronaryartery D.Leftanteriordescendingcoronaryartery

CorrectAnswer:A

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Sinusbradycardiaandatrioventricular(AV)heartblockareusuallyaresultofrightcoronaryartery occlusion.TherightcoronaryarteryperfusesthesinoatrialandAVnodesinmostindividuals.(B)Occlusion oftheleftmaincoronaryarterycausesbundlebranchblocksandprematureventricularcontractions.(C) Occlusionofthecircumflexarterydoesnotcausebradycardia.(D)Sinustachycardiaoccursprimarilywith leftanteriordescendingcoronaryarteryocclusionbecausethisformofocclusionimpairsleftventricular function.

QUESTION6

Wheninspectingacardiovascularclient,thenursenotesthatheneedstosituprighttobreathe.This

behaviorismostindicativeof: 3 / 4

A.Pericarditis B.Anxiety C.Congestiveheartfailure D.Angina

CorrectAnswer:C

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Pericarditiscancausedyspneabutprimarilycauseschestpain.(B)Anxietycancausedyspnea resultinginSOB,yetitisnottypicallyinfluencedbydegreeofheadelevation.(C)Theinabilitytooxygenate wellwithoutbeinguprightismostindicativeofcongestiveheartfailure,duetoalveolardrowning.(D) Anginacausesprimarilychestpain;anySOBassociatedwithanginaisnotinfluencedbybodyposition.

QUESTION7

Whenaclientquestionsthenurseastothepurposeofexerciseelectrocardiography(ECG)inthe diagnosisofcardiovasculardisorders,thenurse’sresponseshouldbebasedonthefactthat: A.Thetestprovidesabaselineforfurthertests B.Theproceduresimulatesusualdailyactivityandmyocardialperformance C.Theclientcanbemonitoredwhilecardiacconditioningandhearttoningaredone D.IschemiacanbediagnosedbecauseexerciseincreasesO2consumptionanddemand

CorrectAnswer:D

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Thepurposeofthestudyisnottoprovideabaselineforfurthertests.(B)Thetestcausesanincrease inO2demandbeyondthatrequiredtoperformusualdailyactivities.(C)Monitoringdoesoccur,butthetest isnotforthepurposeofcardiactoningandconditioning.(D)ExerciseECG,orstresstesting,isdesignedto elevatetheperipheralandmyocardialneedsforO2toevaluatetheabilityofthemyocardiumandcoronary arteriestomeettheadditionaldemands.

QUESTION8

Inassessingcardiovascularclientswithprogressionofaorticstenosis,thenurseshouldbeawarethat

thereistypically:

A.Decreasedpulmonarybloodflowandcyanosis B.Increasedpressureinthepulmonaryveinsandpulmonaryedema C.Systemicvenousengorgement D.Increasedleftventricularsystolicpressuresandhypertrophy

CorrectAnswer:D

Section:QuestionsSetA

Explanation

Explanation/Reference:

Explanation:

(A)Thesesignsareseeninpulmonicstenosisorinresponsetopulmonarycongestionandedemaand mitralstenosis.(B)Thesesignsareseenprimarilyinmitralstenosisorasalatesigninaorticstenosisafter leftventricularfailure.(C)Thesesignsareseenprimarilyinright-sidedheartvalvedysfunction.(D)Left

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