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

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