NCLEX Questions On Fundamentals Of Nursing! Quiz

1. A client with Congestive heart failure is about to take a dose of furosemide (Lasix). Which of the following potassium level. if noted in the client's record. should be reported before giving the due medication?

5.1 mEq/L.

4.9 mEq/L.

3.9 mEq/L.

3.3 mEq/L.

The normal potassium level is 3.5 to 5.5 mEq/L. Low potassium levels can be dangerous. especially for people with CHF. Low potassium can cause fatal heart arrhythmias.

Explanation

The normal potassium level is 3.5 to 5.5 mEq/L. Low potassium levels can be dangerous. especially for people with CHF. Low potassium can cause fatal heart arrhythmias.

2. A client is brought to the emergency department states that he has accidentally been taking two times his prescribed dose of Warfarin (Coumadin). After observing that the client has no evidence of any obvious bleeding. the nurse should do which of the following?

Draw a sample for activated partial thromboplastin time (aPTT) level.

Draw a sample for prothrombin time (PT) level and international normalized ratio (INR).

Prepare to administer Vitamin K.

Prepare to administer Protamine sulfate.

The next action for the nurse to take is to draw a sample for INR and PT level to check the client’s anticoagulation status and risk for bleeding. These results will provide information on how to manage the client either giving an antidote such as Vitamin K or administering a blood transfusion.Option A: The aPTT determines the effects of heparin therapy.Option C: The results of the INR and PT level will be needed first.Option D: Protamine sulfate is the antidote for heparin overdose.

Explanation

The next action for the nurse to take is to draw a sample for INR and PT level to check the client’s anticoagulation status and risk for bleeding. These results will provide information on how to manage the client either giving an antidote such as Vitamin K or administering a blood transfusion.Option A: The aPTT determines the effects of heparin therapy.Option C: The results of the INR and PT level will be needed first.Option D: Protamine sulfate is the antidote for heparin overdose.

3. A male client with atrial fibrillation who is receiving maintenance therapy of warfarin (Coumadin) has a prothrombin time of 37 seconds. Based on the result. the nurse will follow which of the following doctor's order?

Administering the next dose of the warfarin.

Increasing the next dose of warfarin.

Decreasing the next dose of warfarin.

Withholding the next dose of warfarin.

The normal prothrombin time is 9.6 to 11.8 seconds (male adult). A therapeutic level PT level is 1.5 to 2 times higher than the normal level. Since the value of 37 seconds is high. the nurse should expect that the client next dose of warfarin will be withheld.

Explanation

The normal prothrombin time is 9.6 to 11.8 seconds (male adult). A therapeutic level PT level is 1.5 to 2 times higher than the normal level. Since the value of 37 seconds is high. the nurse should expect that the client next dose of warfarin will be withheld.

4. A client went to the emergency room with sudden onset of high fever and diaphoresis. Serum sodium was one of the laboratory test taken. Which of the following values would you expect to see?

130 mEq/L.

148 mEq/L.

143 mEq/L.

139 mEq/L.

The normal sodium level is 135-145 mEq/L. Diaphoresis and a high fever can lead to free water loss through the skin. resulting in increased sodium level (hypernatremia).

Explanation

The normal sodium level is 135-145 mEq/L. Diaphoresis and a high fever can lead to free water loss through the skin. resulting in increased sodium level (hypernatremia).

5. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin time is 77 seconds. Based on this result. the nurse anticipate which of the following prescription?

Maintain the rate of the heparin infusion.

Decrease the rate of the heparin infusion.

Increase the rate of the heparin infusion.

Discontinue the heparin infusion.

The normal activated partial thromboplastin time is between 20 to 36 seconds. In the treatment of deep vein thrombosis. the therapeutic range is to maintain the aPTT level between 1.5 and 2.5 times the normal. This means that the client’s aPTT level should not be less 30 seconds or greater than 90 seconds. Thus the client’s aPTT of 77 seconds is within the normal therapeutic range. and the dose/rate should not be changed.

Explanation

The normal activated partial thromboplastin time is between 20 to 36 seconds. In the treatment of deep vein thrombosis. the therapeutic range is to maintain the aPTT level between 1.5 and 2.5 times the normal. This means that the client’s aPTT level should not be less 30 seconds or greater than 90 seconds. Thus the client’s aPTT of 77 seconds is within the normal therapeutic range. and the dose/rate should not be changed.

6. An adult male client has a hemoglobin count of 12.5 g/dL. Based on the result. the client is most likely having this due to which of the following noted in the client's record?

Emphysema.

Client living at a high altitude.

Dehydration.

History of an enlarged spleen.

The normal hemoglobin level for an adult male is 14-16.5 g/dL. An enlarged spleen may cause anemia (low hemoglobin count) in clients.Options A and B: Emphysema and living at higher altitudes causes the red blood cell production to naturally increases to compensate for the lower oxygen supply.Option C: Dehydration may increase the hemoglobin level by hemoconcentration.

Explanation

The normal hemoglobin level for an adult male is 14-16.5 g/dL. An enlarged spleen may cause anemia (low hemoglobin count) in clients.Options A and B: Emphysema and living at higher altitudes causes the red blood cell production to naturally increases to compensate for the lower oxygen supply.Option C: Dehydration may increase the hemoglobin level by hemoconcentration.

7. A screen test for detection of human immunodeficiency virus (HIV) reveals a positive ELISA exam. Which of the following test will be used to confirm the diagnosis of HIV?

Indirect immunofluorescence assay (IFA).

CD4-to-CD8 ratio.

Radioimmunoprecipitation assay (RIPA) test.

P24 antigen assay.

The indirect immunofluorescence assay (IFA) test and Western Blot test result are considered as confirmatory for HIV.Option B: CD4-to-CD8 ratio monitors the progression of HIV.Option C: Radioimmunoprecipitation assay (RIPA) test detects HIV protein rather than showing antibodies.Option D: p24 antigen assay quantifies the amount of HIV viral core protein.

Explanation

The indirect immunofluorescence assay (IFA) test and Western Blot test result are considered as confirmatory for HIV.Option B: CD4-to-CD8 ratio monitors the progression of HIV.Option C: Radioimmunoprecipitation assay (RIPA) test detects HIV protein rather than showing antibodies.Option D: p24 antigen assay quantifies the amount of HIV viral core protein.

8. A nurse is handling a pregnant client who was prescribed to have an Alpha Feta Protein level. The nurse should explain to the client that this blood test:

Can indicate lung disorders and neural tube defects.

Abnormal levels are associated with an increased risk for chromosome abnormality.

Once the Alpha Feta Protein levels are abnormal. an amniocentesis will be ordered.

An Alpha Feta Protein is a definitive test for neural tube defects.

If the Alpha Feta Protein levels are abnormal. the physician will prescribe an amniocentesis to confirm or eliminate the diagnosis of a neural tube defect.Option A is incorrect since Alpha Feta Protein does not indicate lung disorders.Option B is incorrect because an increase of human chorionic gonadotropin instead is associated with an increased risk for chromosome abnormality.Option D is incorrect because an Alpha Feta Protein level is a screening test and is not a definitive test.

Explanation

If the Alpha Feta Protein levels are abnormal. the physician will prescribe an amniocentesis to confirm or eliminate the diagnosis of a neural tube defect.Option A is incorrect since Alpha Feta Protein does not indicate lung disorders.Option B is incorrect because an increase of human chorionic gonadotropin instead is associated with an increased risk for chromosome abnormality.Option D is incorrect because an Alpha Feta Protein level is a screening test and is not a definitive test.

9. Which of the following laboratory results indicates hypoparathyroidism?

Serum potassium of 3.6 mEq/L.

Serum calcium level of 4.3 mEq/L.

Serum phosphorus level of 5.7 mg/dL.

Serum magnesium level of 1.7 mg/dL.

The parathyroid is responsible for the absorption of calcium and phosphorus. When a client has hypoparathyroidism. the serum calcium levels are low and the serum phosphorus levels are high. The normal phosphorus level is 2.7 to 4.5 mg/dL.

Explanation

The parathyroid is responsible for the absorption of calcium and phosphorus. When a client has hypoparathyroidism. the serum calcium levels are low and the serum phosphorus levels are high. The normal phosphorus level is 2.7 to 4.5 mg/dL.

10. The client went to the emergency room with a sudden onset of chest pain and difficulty of breathing. Which of the following result is indicative that the client is experiencing a myocardial infarction?

Myoglobin level of 98 mcg/L.

Troponin T of 0.09 ng/mL.

Troponin I 0.5 ng/mL.

Creatine kinase (CK-MB) 155 units/L.

The normal value of myoglobin is lower than 90 mcg/L; An elevation could indicate a myocardial infarction.Options B. C. and D all have normal values.

Explanation

The normal value of myoglobin is lower than 90 mcg/L; An elevation could indicate a myocardial infarction.Options B. C. and D all have normal values.