NCLEX Marathon

NCLEX Marathon

by Ginny Bayes

Multiple Choice

A patient with an absolute neutrophil count of 300/uL is admitted to the oncology unit. Which staff member should the charge nurse assign to provide care for this patient, under the supervision of an experienced oncology RN?

• LPN who has floated from the same-day surgery unit

• RN from a staffing agency who is being oriented to the oncology unit

• LPN with 2 years experience on the oncology unit

• RN who recently transferred to the oncology unit from the emergency department

Multiple Choice

A patient who has been receiving cyclosporine after an organ transplant is experiencing the following symptoms. Which one is of most concern?

• Bleeding of the gums while brushing teeth

• Nontender lump in the right groin

• Occasional nausea after taking the medication

• Numbness and tingling of the feet

Multiple Choice

After the nurse receives the change-of-shift report,

which patient should be assessed first?

• A 20 year old patient with possible acute myelogenous leukemia who has just arrived on the medical unit

• A 38 year old patient with aplastic anemia who needs teaching about decreasing infection risk before discharge

• A 40 year old patient with lymphedema who requests help in putting on compression stockings before getting out of bed

• A 60 year old patient with non-Hodgkin lymphoma who is refusing the prescribed chemotherapy regimen

Fill in the Blank

Enter your answers from the previous slide in the blank. Enter each number with a comma and space after it, for example: 1, 2, 3, 4

Multiple Choice

The nurse is monitoring the cardiac rhythms of patients in the coronary care unit. Which patient will need immediate intervention?

• Patient admitted with heart failure who has atrial fibrillation with a rate of 88 beats/min while at rest

• Patient with a newly implanted demand ventricular pacemaker who has occasional periods of sinus rhythm at a rate of 90 to 100 beats/min

• Patient who has had an acute myocardial infarction and has sinus rhythm at a rate of 76 beats/min with frequent PVCs

• Patient who recently started taking atenolol and has a first degree block with a rate of 58 beats/min

​Ok, so what is a demand ventricular pacemaker?

Pacemaker lead usually placed in the right ventricular apex. ​There may be episodic pacing in patients who have a ventricular demand pacemaker. The pacemaker is activated and delivers a stimulus only when the intrinsic ventricular rate falls below a predetermined lower limit; pacemaker activity is suppressed when the intrinsic heart rate is faster.

Multiple Choice

The nurse is caring for an older adult patient with type I diabetes and diabetic retinopathy. What is the nurse's priority concern for assessing this patient?

• Assess ability to measure and inject insulin and to monitor blood glucose levels

• Assess for damage to motor fibers, which can result in muscle weakness

• Assess which modifiable risk factors can be reduced

• Assess for albuminuria, which may indicate kidney disease

Multiple Choice

An older patient with type 2 diabetes has cardiovascular autonomic neuropathy (CAN). Which instruction would the nurse provide for the assistive personal (AP) assisting the patient with morning care?

• Provide a complete bed bath for this patient

• Sit the patient up slowly on the side of the bed before standing

• In order to conserve energy only let the patient wash his face and brush his teeth

• Be sure to provide rest periods between activities

Multiple Select

A 58 year old patient with type 2 diabetes was admitted to the acute care unit with a diagnosis of COPD exacerbation. When the RN prepares a care plan for this patient, what would he be sure to include?

Select all that apply.

• Sliding scale insulin dosing as prescribed

• Bed rest until the COPD exacerbation is resolved

• Teaching focused on the Atkins diet for weight loss

• Demonstration of the components of foot care

• Discussing the relationship between illness and increased glucose levels

Multiple Choice

The nurse is providing the immediate postoperative care for a patient who had fundoplication to reinforce the lower esophageal sphincter for the purpose of a hiatal hernia repair. What is the priority action in the care of this patient?

• Elevate the head of the bed at least 30 degrees

• Assess the nasogastric tube for yellowish-green drainage

• Assist the patient to start taking a clear liquid diet

• Assess the patient for gas bloat syndrome

Multiple Choice

The nurse is admitting a 66 year old male patient suspected of having a urinary tract infection (UTI). Which part of the patient's medical history supports this diagnosis?

• Patient's wife had a UTI one month ago

• Followed for prostate disease for 2 years

• Intermittent catheterization 6 months ago

• Laser lithotripsy for kidney stone removal 1 year ago

Multiple Choice

A patient with incontinence will be taking oxybutynin chloride 5 mg by mouth three times a day after discharge. Which information would the nurse be sure to teach this patient before discharge?

• "Drink fluids or use hard candy when you experience dry mouth."

• "Be sure to notify your health care provider if you experience a dry mouth."

• "If necessary, your health care provider can increase your dose up to 40 mg/day."

• "You should take this medication with meals to avoid stomach ulcers."

Multiple Choice

When providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change?

• Decreased hematocrit

• Increased sodium level

• Decreased potassium level

• Decreased calcium level

​An autoimmune condition in which the body's immune system attacks the actual intrinsic factor protein or the cells in the lining of your stomach that make it.

Multiple Choice

For a patient with osteogenic sarcoma,

which laboratory value causes the most concern?

• Sodium level of 147 mEq/L

• Calcium level of 13 mg/dL

• Potassium level of 4.9 mEq/L

• Blood urea nitrogen (BUN) of 25 mg/dL