NCLEX-RN PRACTICE QUESTION (OA)

When assessing a patient diagnosed with osteoarthritis (OA), the healthcare provider looks for which characteristic of this condition?

Please choose from one of the following options.

• 
  

  Waddling gait
• 
  

  Decreased grip strength
• 
  

  Joint crepitus
• 
  

  Bilateral joint swelling

HINTS:

1.  Malfunction of the chondrocytes, the cells that create and sustain cartilage, is a key feature OA pathogenesis.

2.  The function of cartilage is to cushion the joints.

3.  Crepitus is present when cartilage is lost. It is characterized by a popping, grating sound, or sometimes the patient feels bone rubbing against bone secondary to loss of cartilage. Decreased grip strength and bilateral joint swelling are more often seen in rheumatoid arthritis. A waddling gait (a duck-like gait) is sometimes seen in the third trimester of pregnancy (due to anatomical and hormonal changes) or with muscular diseases such as muscular dystrophy.

ANSWER: 3

NCLEX-RN PRACTICE QUESTION

NCLEX-RN PRACTICE QUESTION

1.  A patient is prescribed ibuprofen 800 mg every 4 hours for the treatment of rheumatoid arthritis (RA). Which of these clinical manifestations should the healthcare provider anticipate observing if the patient is developing an adverse effect from the medication?

Select all that apply.

Select all that apply.

• Patient report of epigastric pain
• Positive fecal occult blood test
• Decreased serum albumin
• Increased blood urea nitrogen (BUN)
• Increased serum hematocrit

HINTS:

1.  Recall the medication’s mechanism of action.

2.  NSAIDs like ibuprofen inhibit COX-1 and COX-2

3.  Inhibiting COX-1 and COX-2 results in decreased prostaglandins

4.  Pain is managed when COX-1 is inhibited.

5.  COX-2 is sometimes referred to as “good COX” (while COX-1 is sometimes called “bad COX), because when COX-2 is inhibited, prostaglandins that serve important normal functions are impaired. Prostaglandins are needed for the integrity of the peptic mucosal lining and maintenance of renal perfusion. Epigastric pain (peptic ulcer), blood in the stool (bleeding ulcer), and increased BUN (decreased renal perfusion and increased reabsorption of blood from the GI tract) are all indications that the patient may be experiencing a bleeding peptic ulcer.

ANSWER: 1, 2, 4

NCLEX-RN PRACTICE QUESTION/ASTHMA DURING PREGNANCY

NCLEX-RN Practice Question

A patient who has mild intermittent asthma is 23 weeks pregnant. Which of these recommendations will the healthcare provider give the patient to promote the health of the woman and her baby? Select all that apply.

“Measure your peak flow rate once or twice per day.”

“Keep all of your appointments for non-stress testing .”

“Avoid exercise while you are pregnant because this can trigger an attack.”

“You should not receive a flu shot until after the baby is born.”

“Use a humidifier in your home to increase the level of humidity.”

“Call our office immediately if you notice a decrease in your baby’s movements.”

HINTS:
Recommendations for this patient are aimed at controlling asthma severity because poorly controlled asthma can cause maternal hypoxia and impairment of fetal oxygenation.

Because there are no known risks of the flu shot for a developing fetus, women who are pregnant during flu season should receive a flu shot.

Increasing humidity can increase dust and dust mite activity and trigger an asthma attack.

Vigorous exercise may trigger an asthma attack in some patients but moderate exercise should not be discouraged.

The woman should monitor her peak flow rate because decreasing flow rates usually signal a worsening of asthma even if she is feeling well.

CORRECT ANSWER:
Items 1, 2, 4, 6

NCLEX-RN PRACTICE QUESTION/INDERAL

The healthcare provider is performing an assessment on a patient who is taking propranolol (Inderal) for supraventricular tachycardia. Which assessment finding is an indication the patient is experiencing an adverse effect of this drug?

1. Dry mouth 2. Bradycardia 2. Urinary retention 4. ParesthesiaHint: Propranolol is a nonselective beta-adrenergic antagonist.

Hint @2 Beta-1 receptors are found in the cardiac conduction system and myocytes.

Hint: Propranolol is a nonselective beta-adrenergic antagonist.

Answer is #2 Bradycardia

NCLEX-RN PRACTICE QUESTION/MED CALCULATION

NCLEX-RN PRACTICE QUESTION:

The order is to administer 15 mg of morphine IM. It is supplied as gr 1/6 per mL. How much would you give?

A. 4.5 mL
B. 4 mL
C. 2 mL
D. 1.5 mL



ANSWER: D
15mg X 1gr/60mg X 1ml/1/6gr = 1.5ml

NCLEX-RN PRACTICE QUESTION/CPR

NCLEX Practice Question:

The healthcare provider is caring for a patient on a telemetry unit. The patient loses consciousness, and the healthcare provider and notes this waveform on the patient’s cardiac monitor. Which intervention should the healthcare provider do first?

1. Ask the unit secretary to call the cardiologist.
2. Begin cardiopulmonary resuscitation (CPR) and call for a defibrillator.
3. Document the findings and continue to monitor.
4. Administer 100% oxygen via face mask at 8 liters/minute.

Try to answer before looking below at the hints

Hints:
1. The heart rhythm is irregular.
2. There are no P waves and the PR interval is not measurable.
3. Instead of QRS complexes, there are irregular undulating waves.
4. Because the ventricles are fibrillating, treatment will include immediate defibrillation along with CPR

Correct Answer is 2

NCLEX-RN PRACTICE QUESTION/LASIX

NCLEX-RN EXAM PRACTICE QUESTION:

A nurse is administering IV furosemide to a patient admitted with congestive heart failure. After the infusion, which of the following symptoms is NOT expected?

A. Increased urinary output.
B. Decreased edema.
C. Decreased pain.
D. Decreased blood pressure.

HINTS:
Furosemide is a loop diuretic
Furosemide does not alter pain.
Furosemide acts on the kidneys to increase urinary output.
Fluid may move from the periphery, decreasing edema.
Fluid load is reduced, lowering blood pressure.

ANSWER: C