Exam Cram NCLEX RN Practice Questions

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Your patient has been diagnosed with acute bronchitis. You should expect that all of the following will be ordered EXCEPT:

  • A. Increased fluid intake
  • B. Cough medications
  • C. Antibiotics
  • D. Use of a vaporizer
Correct Answer: C

Rationale: In the management of acute bronchitis, antibiotics are not typically prescribed unless there is a confirmed bacterial infection. Acute bronchitis is usually caused by a virus, so antibiotics are not effective in treating it. The primary focus is on symptom management and supportive care. Increased fluid intake helps keep the airway moist and liquefy secretions, aiding in their removal. Cough medications can help relieve cough symptoms. The use of a vaporizer can help moisten the air, making breathing more comfortable for the patient. It is crucial to differentiate between viral and bacterial causes of respiratory infections to avoid unnecessary antibiotic use and prevent antibiotic resistance. Therefore, the correct answer is 'Antibiotics.' Increased fluid intake, cough medications, and the use of a vaporizer are commonly recommended for managing symptoms and improving comfort in patients with acute bronchitis.

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A mother brings her 5-week-old infant to the health care clinic and tells the nurse that the child has been vomiting after meals. The mother reports that the vomiting is becoming more frequent and forceful. The nurse suspects pyloric stenosis and asks the mother which assessment question to elicit data specific to this condition?

  • A. Are the stools ribbon-like, and is the infant eating poorly?
  • B. Does the infant suddenly become pale, begin to cry, and draw the legs up to the chest?
  • C. Does the vomit contain sour, undigested food without bile, and is the infant constipated?
  • D. Does the infant cry loudly and continuously during the evening hours but nurses or takes formula well?
Correct Answer: C

Rationale: Vomiting undigested food that is not bile stained and constipation are classic symptoms of pyloric stenosis. Stools that are ribbon-like and a child who is eating poorly are signs of congenital megacolon (Hirschsprung's disease). An infant who suddenly becomes pale, cries out, and draws the legs up to the chest is demonstrating physical signs of intussusception. Crying during the evening hours, appearing to be in pain, eating well, and gaining weight are clinical manifestations of colic.

Which of the following statements best describes postural drainage as part of chest physiotherapy?

  • A. Tapping on the chest wall to loosen secretions
  • B. Squeezing the abdomen to increase expansion of the upper chest
  • C. Using gravity to move secretions in the lung tissue
  • D. Dilating the trachea to facilitate better release of secretions
Correct Answer: C

Rationale: Postural drainage is a technique used in chest physiotherapy for clients with accumulated lung secretions. It involves positioning the client to utilize gravity in moving secretions from the lungs. Choice A, tapping on the chest wall, describes percussion, not postural drainage. Choice B, squeezing the abdomen, is not a correct description of postural drainage. Choice D, dilating the trachea, is not related to postural drainage but may be associated with airway clearance techniques.

Which individual is at greatest risk for developing hypertension?

  • A. 45-year-old African-American attorney
  • B. 60-year-old Asian-American shop owner
  • C. 40-year-old Caucasian nurse
  • D. 55-year-old Hispanic teacher
Correct Answer: A

Rationale: African-Americans have a higher risk of developing hypertension compared to other ethnic groups. They tend to develop high blood pressure at younger ages and are more sensitive to salt, which increases their risk of hypertension. Additionally, studies have shown that African-Americans may respond differently to hypertensive drugs. Therefore, the 45-year-old African-American attorney is at the greatest risk for developing hypertension. The other choices do not specify factors that put them at a higher risk for hypertension compared to African-Americans.

After hydrostatic reduction for intussusception, what client response should the nurse expect to observe?

  • A. Abdominal distension
  • B. Currant jelly-like stools
  • C. Severe, colicky-type pain with vomiting
  • D. Passage of barium or water-soluble contrast with stools
Correct Answer: D

Rationale: After hydrostatic reduction for intussusception, the nurse should observe the passage of barium or water-soluble contrast with stools. This indicates a successful reduction of the telescoped bowel segment. Abdominal distension and currant jelly-like stools are clinical manifestations of intussusception, not expected outcomes following hydrostatic reduction. Severe, colicky-type pain with vomiting suggests an unresolved gastrointestinal issue, not a successful reduction of intussusception.

The parents of a child with a hernia are instructed by the nurse on measures to reduce the hernia. Which statement indicates the parents understand the care for their child?

  • A. We will encourage our child to cough every few hours on a daily basis.
  • B. We will make sure that our child participates in physical activity every day.
  • C. We will provide comfort measures to reduce any crying periods by our child.
  • D. We will be sure to give our child a Fleet enema every day to prevent constipation.
Correct Answer: C

Rationale: The correct answer is providing comfort measures to reduce any crying periods by the child. This can include offering a warm bath, avoiding upright positioning, and using other comfort measures to reduce crying, which can help reduce a hernia. Encouraging coughing or physical activity can increase strain on the hernia. Giving a Fleet enema daily for constipation is not recommended as it can also increase strain on the hernia.

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