Exam Cram NCLEX RN Practice Questions

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A patient born in 1955 had hepatitis A infection 1 year ago. According to Centers for Disease Control and Prevention (CDC) guidelines, which action should the nurse include in care when the patient is seen for a routine annual physical exam?

  • A. Start the hepatitis B immunization series.
  • B. Teach the patient about hepatitis A immune globulin.
  • C. Ask whether the patient has been screened for hepatitis C.
  • D. Test for anti-hepatitis-A virus immune globulin M (anti-HAV-IgM).
Correct Answer: C

Rationale: The correct action for the nurse to include in care when the patient is seen for a routine annual physical exam, according to CDC guidelines, is to ask whether the patient has been screened for hepatitis C. CDC guidelines recommend screening patients born between 1945 and 1965 for hepatitis C due to the high prevalence of undiagnosed cases in this age group. Starting the hepatitis B immunization series is not necessary as the patient already had hepatitis A infection. Teaching the patient about hepatitis A immune globulin is not indicated in this scenario. Testing for anti-hepatitis-A virus immune globulin M (anti-HAV-IgM) is not needed as the patient has already had hepatitis A.

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Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a
negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms
of TB. Which information should the occupational health nurse plan to teach the staff nurse?

  • A. Standard four-drug therapy for TB
  • B. Need for annual repeat TB skin testing
  • C. Use and side effects of isoniazid (INH)
  • D. Bacille Calmette-Gurin (BCG) vaccine
Correct Answer: C

Rationale: The nurse is considered to have a latent TB infection and should be treated with INH daily for 6
to 9 months. The four-drug therapy would be appropriate if the nurse had active TB. TB skin
testing is not done for individuals who have already had a positive skin test. BCG vaccine is not
used in the United States for TB and would not be helpful for this individual, who already has a
TB infection.

Select the age group that is coupled with an infectious disease that is most common in this age group.

  • A. Infants: High bilirubin
  • B. Pre-School and School Age Children: Shingles
  • C. Young Adults and Teenagers: Sexually transmitted diseases
  • D. The Elderly: Malaria
Correct Answer: C

Rationale: Young adults and teenagers are at the highest risk for sexually transmitted diseases due to their sexual activity. High bilirubin is a laboratory finding related to jaundice and not an infectious disease. Shingles is more common in the elderly population, not in pre-school and school-age children. Malaria is not most common in the elderly; it is prevalent in regions with specific mosquito vectors. Therefore, the correct answer is that young adults and teenagers are most commonly associated with sexually transmitted diseases.

You are turning your patient in bed and notice that a confused and lethargic patient had loose car keys and lipstick in the bed and had been lying on them. What is this person at risk for due to all three of these factors: confusion, lethargy, and items in the bed?

  • A. Falls
  • B. Skin breakdown
  • C. Apnea
  • D. Lack of mobility
Correct Answer: B

Rationale: This patient is at great risk for skin breakdown due to the presence of three specific risk factors: confusion, lethargy, and items in the bed. While confusion puts the patient at risk for falls, confusion and lethargy together may lead to a lack of mobility. However, skin breakdown is the primary concern in this scenario as it is associated with all three risk factors - confusion, lethargy, and the presence of items in the bed. Therefore, the correct answer is 'Skin breakdown'.

Elderly patients are more prone to dehydration than younger people because the elderly ___________.

  • A. drink more coffee and tea
  • B. have more stomach mucus production
  • C. have more saliva
  • D. have less sense of thirst
Correct Answer: D

Rationale: Elderly patients are prone to dehydration because they have a lower and diminished sense of thirst. This reduced sensation of thirst makes them less likely to drink an adequate amount of fluids, leading to dehydration. While it is true that elderly individuals may also have changes such as decreased stomach mucus production and saliva production, these factors do not directly contribute to dehydration. Drinking more coffee and tea, as mentioned in choice A, is not a consistent behavior among all elderly individuals and is not a primary reason for their increased risk of dehydration.

A complication of osteoporosis is _______________?

  • A. rheumatoid arthritis
  • B. gouty arthritis
  • C. dorsiflexion
  • D. joint deformity
Correct Answer: D

Rationale: Joint deformity is a well-known complication of osteoporosis, leading to structural changes in the joints due to bone loss and fragility. Gouty arthritis and rheumatoid arthritis are distinct types of arthritis that are not direct complications of osteoporosis. Dorsiflexion is a movement related to the foot's range of motion and is not a typical complication of osteoporosis.

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