PN 140: Test 1 NCLEX Practice Questions with

PN 140: Test 1 NCLEX Practice Questions with

Correct Answers The immobilized patient asks why the nurse is encouraging deep breaths and coughing every couple of hours. What is the nurse's best response?

• "Coughing will help strengthen the chest muscles."
• "Coughing helps strengthen the abdominal muscles."
• "Coughing helps move secretions up the bronchial tree gradually."
• "Coughing encourages the rapid and sudden expulsion of large amounts of mucus." - Correct

Answer D. "Coughing encourages the rapid and sudden expulsion of large amounts of mucus." Deep breathing and coughing help the patient expand the lungs and move secretions up the bronchial tree, thus preventing respiratory complications that often occur with immobility. Coughing does not generally lead to rapid and sudden expulsion of large amounts of mucus or strengthen the chest or abdominal muscles.The nurse recognizes that calcium channel blockers prescribed for treatment of angina exert their

effect by:

• Increasing preload.
• Decreasing afterload.
• Positive chronotropic effect.
• Positive inotropic effect. - Correct Answer B) Decreasing afterload.

Rationale: Calcium channel blockers cause arteriolar smooth muscle relaxation, leading to lowered peripheral resistance and decreased blood pressure (decreased afterload). This decreases myocardial oxygen demand, and reduces frequency of anginal pain.The teaching plan for a client being started on long-acting nitroglycerin includes the action of this drug. The nurse teaches that this drug relieves chest pain by which action?

• Dilating just the coronary arteries
• Decreasing the blood pressure
• Increasing contractility of the heart 1 / 3

• Dilating arteries and veins - Correct Answer D) Dilating arteries and veins

When discussing appropriate food choices with a patient who has iron-deficiency anemia and follows a low-cholesterol diet, the nurse will encourage the patient to increase the dietary intake of

• eggs and muscle meats.
• nuts and cornmeal.
• milk and milk products.
• legumes and dried fruits - Correct Answer d. legumes and dried fruits

Rationale: Legumes and dried fruits are high in iron and low in fat and cholesterol.The nurse assesses a patient with emphysema and notes a barrel chest. What is the reason for this patient's chest anomaly?

• Collapse of distal alveoli
• Use of accessory muscles
• Hyperinflation of the lungs
• Long-term, chronic hypoxia - Correct Answer C. Hyperinflation of the lungs

A patient with emphysema develops a barrel chest as a result of the trapping of air in the lungs, which causes them to hyperinflate. Collapsed alveoli, use of accessory muscles, and long-term, chronic hypoxia do not cause a barrel chest.The nurse recognizes that the mechanism for action of beta-adrenergic blockers in the treatment of

angina is:

• Positive chronotropic effect.
• Negative inotropic effect.
• Positive inotropic effect.
• Antidysrhythmia. - Correct Answer B) Negative inotropic effect. 2 / 3

Rationale: Beta blockers decrease the workload of the heart by slowing heart rate (negative chronotropic effect) and reducing contractility (negative inotropic effect).The nurse is instructing the patient with stable angina about the use of nitroglycerin. Which of the following statements, made by the patient, indicates the need for further teaching?

• "When the pain is really bad, I can crush the tablet with my teeth to make it work faster"
• "I will be sure to never remove the pills from the container they are in"
• "It's probably a good idea to take the medication before I have sex with my wife"
• "I should call my doctor if I experience flushing of the face or a HA" - Correct Answer Answer: D.

These are common side effects of this medication and there is not a need to call the physician for this issue. The patient can crush the tablet between his teeth, then place sublingually for hastening of effect. The nitroglycerin pills must be stored in a dry, cool place and should be kept in the dark bottles they come in. Nitroglycerin should be taken in advance of any activity that may produce pain, such as sexual activity.The nurse notes that the respiratory symptoms of the patient with chronic obstructive pulmonary disease (COPD) have affected his nutrition. Which would most help improve the patient's nutrition?

• Eat three large meals to increase stomach fullness.
• Extra protein is required to repair damaged tissues.
• Exercise before eating each meal three times a day.
• Drink six to eight glasses of caffeinated fluids each day. - Correct Answer B. Extra protein is

required to repair damaged tissues.Nutrition is very important for the patient with COPD because the extra work to breathe properly uses more calories and anorexia may be present. Extra protein is required to repair damaged tissues.It is helpful to drink six to eight glasses of noncaffeinated fluids per day to keep mucus thin and easier to cough up, unless the physician has the patient on a fluid restriction. The patient should rest before eating, not exercise before meals. The patient should avoid overeating and should eat four to six small meals a day rather than three regular meals to decrease stomach fullness and reduce fatigue.The nurse determines that treatment of a client with a beta-adrenergic blocker for myocardial

infarction has been effective when:

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