PRACTICE QUESTIONS ON VARIOUS TOPICS

 I hope these questions help you prepare for your NCLEX exam!

1. A client with heart failure has been prescribed furosemide (Lasix). Which laboratory value would the nurse monitor closely while the client is taking this medication? a. Sodium b. Potassium c. Calcium d. Glucose

2. A client is admitted to the emergency department with an acute asthma attack. Which medication would the nurse expect to administer first? a. Albuterol b. Prednisone c. Beclomethasone d. Theophylline

3. A client with a history of diabetes is admitted to the hospital with a foot wound that is not healing. Which nursing intervention would be most important to include in the client's plan of care? a. Administering insulin as prescribed b. Encouraging the client to exercise regularly c. Assessing the client's blood glucose levels frequently d. Applying topical antibiotics to the wound

4. A client with chronic kidney disease is prescribed a low-protein diet. Which food item would the nurse instruct the client to limit? a. Apples b. Yogurt c. Lentils d. Brown rice

5. A client with Parkinson's disease is prescribed levodopa/carbidopa (Sinemet). Which adverse effect would the nurse monitor the client for? a. Hypotension b. Hypertension c. Diarrhea d. Urinary retention

6. A client is receiving intravenous heparin therapy for the treatment of a deep vein thrombosis. Which laboratory value would the nurse monitor closely while the client is receiving this medication? a. Platelet count b. Prothrombin time (PT) c. International normalized ratio (INR) d. Activated partial thromboplastin time (aPTT)

7. A client is scheduled to undergo surgery under general anesthesia. Which nursing intervention would be most important to include in the client's preoperative care? a. Administering an opioid analgesic to reduce pain b. Encouraging the client to ambulate frequently to prevent blood clots c. Administering a sedative medication to promote relaxation d. Ensuring the client has been NPO for the appropriate period of time

8. A client with pneumonia is prescribed oxygen therapy. Which nursing intervention would be most important to include in the client's plan of care? a. Encouraging the client to ambulate frequently to improve oxygenation b. Monitoring the client's oxygen saturation levels regularly c. Administering an antitussive medication to reduce coughing d. Encouraging the client to eat a high-protein diet to promote healing

9. A client with bipolar disorder is prescribed lithium carbonate. Which laboratory value would the nurse monitor closely while the client is taking this medication? a. Sodium b. Potassium c. Calcium d. Magnesium

10. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium bromide (Atrovent). Which adverse effect would the nurse monitor the client for? a. Hypotension b. Hypertension c. Tachycardia d. Bradycardia

Here are the answers with rationales:

1. B - Potassium. Furosemide is a loop diuretic that can cause potassium loss through increased urine output, so it's important to monitor the client's potassium levels and administer supplements as needed.

2. A - Albuterol. Albuterol is a fast-acting bronchodilator that can quickly relieve bronchoconstriction and improve breathing in an acute asthma attack.

3. C - Assessing the client's blood glucose levels frequently. Clients with diabetes are at increased risk for poor wound healing, and high blood glucose levels can impair healing even further. Therefore, it's important to monitor blood glucose levels frequently to ensure they are within a target range.

4. C - Lentils. Lentils are a high-protein food that would need to be limited on a low-protein diet.

5. A - Hypotension. Levodopa/carbidopa can cause hypotension, especially when first starting the medication or when the dose is increased.

6. D - Activated partial thromboplastin time (aPTT). Heparin is an anticoagulant that can increase bleeding risk, so it's important to monitor the client's aPTT levels to ensure they are within a therapeutic range.

7. D - Ensuring the client has been NPO for the appropriate period of time. It's important to ensure the client has an empty stomach before undergoing general anesthesia to prevent aspiration of stomach contents.

8. B - Monitoring the client's oxygen saturation levels regularly. Oxygen therapy is used to improve oxygenation, so it's important to monitor the client's oxygen saturation levels regularly to ensure they are within a target range.

9. A - Sodium. Lithium can cause sodium depletion, which can lead to lithium toxicity. Therefore, it's important to monitor the client's sodium levels and adjust the medication dosage as needed.

10. C - Tachycardia. Ipratropium bromide can cause tachycardia as a side effect, so it's important to monitor the client's heart rate for any signs of increased heart rate.

I hope these rationales help you understand why each answer is correct.

STRESS AND ITS IMPACT ON THE BODY

 Stress is a normal physiological response to challenges or demands in life. It is the body's way of preparing to respond to perceived threats or challenges. When a person experiences stress, the body releases stress hormones, such as adrenaline and cortisol, which trigger the "fight or flight" response. This response causes physical changes, such as increased heart rate and blood pressure, to prepare the body for action.

Stress can be caused by various factors, including work or school demands, relationships, financial worries, health issues, or changes in life circumstances. Chronic or excessive stress can have negative effects on physical and mental health, including increased risk of heart disease, depression, anxiety, and other health problems.

The physiological response to stress is often referred to as the "fight or flight" response. When a person experiences stress, the body releases stress hormones, such as adrenaline and cortisol, which activate the sympathetic nervous system. This triggers a series of physical changes designed to help the body respond to a perceived threat.

The physiological changes that occur during the stress response include:

1. Increased heart rate: The heart beats faster to pump more blood and oxygen to the muscles, preparing the body for action.

2. Elevated blood pressure: The increased heart rate and constriction of blood vessels raise blood pressure, increasing the flow of oxygen and nutrients to the muscles.

3. Increased breathing rate: Faster breathing brings in more oxygen to support the increased metabolic activity in the body.

4. Dilation of the pupils: The pupils dilate to improve visual acuity and prepare the eyes for sudden changes in light.

5. Increased muscle tension: The muscles tense and become ready for action, improving the body's ability to respond to a threat.

6. Suppressed digestion: The digestive system slows down to conserve energy for the "fight or flight" response.

7. Increased sugar levels: The liver releases sugar into the bloodstream to provide energy for the muscles.

Chronic or excessive stress can lead to a prolonged activation of the stress response, which can have negative effects on physical and mental health. It is important to find effective ways to manage stress to prevent these negative effects, such as through exercise, deep breathing, meditation, talking to a trusted friend or family member, or seeking support from a mental health professional.

MCQ ON STRESS

 A client is reporting symptoms of stress, including muscle tension, headaches, and difficulty sleeping. Which nursing intervention would be most appropriate for this client?

a. Encouraging the client to participate in stress-relieving activities, such as yoga or meditation b. Prescribing a sedative medication to help the client sleep c. Referring the client to a counselor for individual therapy d. Recommending the client drink a glass of warm milk before bed each night A client has been diagnosed with stress-induced hypertension. Which nursing action would be most important to include in the client's care plan? a. Monitoring the client's blood pressure regularly b. Encouraging the client to participate in aerobic exercise c. Administering anti-anxiety medication as prescribed d. Referring the client to a dietitian to address dietary changes A client is reporting symptoms of stress and has requested to speak with a nurse about ways to manage stress. What would be the most appropriate nursing response? a. Providing the client with a list of stress-management techniques b. Referring the client to a stress management support group c. Encouraging the client to talk to a friend or family member about their stress d. All of the above

ANSWERS WITH RATIONAL

A. Encouraging the client to participate in stress-relieving activities, such as yoga or meditation. This is the most appropriate nursing intervention as it promotes relaxation and helps the client manage stress in a healthy and effective manner. Yoga and meditation have been shown to reduce muscle tension, improve sleep quality, and decrease symptoms of stress and anxiety.
A. Monitoring the client's blood pressure regularly. This is the most important nursing action as hypertension is a common physical manifestation of stress. Monitoring blood pressure regularly allows the nurse to assess the effectiveness of the care plan and make necessary modifications to manage the client's stress and hypertension.

D. All of the above. All of the options provided are appropriate nursing responses for a client reporting symptoms of stress. Providing a list of stress-management techniques can educate the client on available options for managing stress. Referring the client to a stress management support group can provide additional support and a sense of community. Encouraging the client to talk to a friend or family member about their stress can also provide emotional support and help the client process their feelings.

PRACTICE QUESTIONS

 

1. A client with a history of heart disease has been prescribed a beta-blocker to control hypertension. What should the nurse monitor for when administering this medication? a. Drowsiness b. Nausea c. Bradycardia d. Hyperactivity

2. A client with diabetes mellitus has been instructed to check their blood glucose levels every morning before breakfast. What should the nurse teach the client about the importance of monitoring their blood glucose levels? a. To check for signs of diabetic ketoacidosis b. To adjust insulin doses based on blood glucose levels c. To identify changes in blood glucose levels d. All of the above

3. A client has been diagnosed with pneumonia and is prescribed antibiotics. What should the nurse teach the client about taking antibiotics? a. To take the antibiotics with food to avoid stomach upset b. To stop taking the antibiotics when symptoms improve c. To take the antibiotics exactly as prescribed, even if symptoms have improved d. To double the dose if symptoms worsen

4. A client with a history of drug abuse has been admitted to the hospital for detoxification. What should the nurse do to ensure the safety and well-being of the client during the detoxification process? a. Regularly assess the client's vital signs and level of consciousness b. Provide a calm and quiet environment to promote relaxation c. Administer medications as prescribed to manage withdrawal symptoms d. All of the above

5. A client has been diagnosed with anemia and has been prescribed iron supplements. What should the nurse teach the client about taking iron supplements? a. To take iron supplements on an empty stomach to increase absorption b. To avoid taking iron supplements with calcium-rich foods c. To drink plenty of fluids while taking iron supplements d. To double the dose if symptoms do not improve

6. A client has been diagnosed with a deep vein thrombosis (DVT) and is at risk for pulmonary embolism. What should the nurse do to prevent the development of a pulmonary embolism? a. Administer anticoagulant medication as prescribed b. Encourage the client to ambulate frequently and perform leg exercises c. Assess the client's deep vein system regularly for signs of swelling or redness d. All of the above

7. A client has been diagnosed with acute kidney injury and is being treated with continuous renal replacement therapy (CRRT). What should the nurse monitor for when administering CRRT? a. Fluid and electrolyte imbalances b. Changes in blood pressure c. Hemodynamic stability d. All of the above

8. A client with a history of alcoholism has been admitted to the hospital for detoxification. What should the nurse assess for when caring for a client in alcohol withdrawal? a. Tremors b. Seizures c. Hallucinations d. All of the above

9. A client with a history of congestive heart failure has been prescribed a loop diuretic. What should the nurse teach the client about taking a loop diuretic? a. To take the medication in the morning to prevent sleep disturbances b. To take the medication with food to reduce the risk of gastrointestinal side effects c. To report signs of dehydration, such as dry mouth and increased thirst d. To double the dose if symptoms do not improve

ANSWERS WITH RATIONAL

1. C. Bradycardia. Beta-blockers can slow the heart rate, so it's important for the nurse to monitor for bradycardia, which is a decreased heart rate. Drowsiness, nausea, and hyperactivity are not typically associated with beta-blockers.

2. D. All of the above. Monitoring blood glucose levels helps the client identify changes in their blood glucose levels, adjust insulin doses based on blood glucose levels, and check for signs of diabetic ketoacidosis.

3. C. To take the antibiotics exactly as prescribed, even if symptoms have improved. The nurse should teach the client to complete the full course of antibiotics as prescribed, even if symptoms have improved, to ensure that the bacteria causing the infection are fully eradicated. Taking antibiotics with food may help prevent stomach upset, but stopping the antibiotics early can lead to antibiotic resistance. Doubling the dose if symptoms worsen is not appropriate.

4. D. All of the above. The nurse should regularly assess the client's vital signs and level of consciousness, provide a calm and quiet environment to promote relaxation, and administer medications as prescribed to manage withdrawal symptoms.

5. B. To avoid taking iron supplements with calcium-rich foods. Calcium can interfere with iron absorption, so the nurse should teach the client to avoid taking iron supplements with calcium-rich foods such as dairy products, calcium supplements, and antacids. Taking iron supplements on an empty stomach may increase absorption, but it can also cause stomach upset. Drinking plenty of fluids while taking iron supplements is important for hydration, but does not impact iron absorption. Doubling the dose if symptoms do not improve is not appropriate.

6. D. All of the above. Administering anticoagulant medication, encouraging the client to ambulate frequently and perform leg exercises, and assessing the client's deep vein system regularly for signs of swelling or redness can all help prevent the development of a pulmonary embolism in a client with a DVT.

7. D. All of the above. Continuous renal replacement therapy can cause fluid and electrolyte imbalances, changes in blood pressure, and disruptions in hemodynamic stability, so the nurse should monitor for all of these potential complications.

8. D. All of the above. Alcohol withdrawal can cause tremors, seizures, and hallucinations, so the nurse should assess for all of these potential symptoms when caring for a client in alcohol withdrawal.

9. C. To report signs of dehydration, such as dry mouth and increased thirst. Loop diuretics can cause dehydration, so the nurse should teach the client to report signs of dehydration such as dry mouth, increased thirst, and dark yellow urine. Taking the medication in the morning may help prevent sleep disturbances, but is not related to the risk of dehydration. Taking the medication with food may reduce the risk of gastrointestinal side effects, but does not impact the risk of dehydration. Doubling the dose if symptoms do not improve is not appropriate.