Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 31

1. Which of the following would indicate the need for further teaching for the client with COPD? The client verbalizes the need to:

A) Eat high-calorie, high-protein foods
B) Take vitamin supplementation
C) Eliminate intake of milk and milk products
D) Eat small, frequent meals

2. A dose of theophylline may need to be altered if a client with COPD:

A) Is allergic to morphine
B) Has a history of arthritis
C) Operates machinery
D) Is concurrently on cimetidine for ulcers

3. The nurse working in a prenatal clinic needs to be alert to the cardinal signs and symptoms of PIH because:

A) Immediate treatment of mild PIH includes the administration of a variety of medications
B) Psychological counseling is indicated to reduce the emotional stress causing the blood pressure elevation
C) Self-discipline is required to control caloric intake throughout the pregnancy
D) The client may not recognize the early symptoms of PIH

4. Which of the following changes in blood pressure readings should be of greatest concern to the nurse when assessing a prenatal client?

A) 130/88 to 144/92
B) 136/90 to 148/100
C) 150/96 to 160/104
D) 118/70 to 130/88

5. A 16-year-old client comes to the prenatal clinic for her monthly appointment. She has gained 14 lb from her 7th to 8th month; her face and hands indicate edema.She is diagnosed as having PIH and referred to the high-risk prenatal clinic. The clients weight increase is most likely due to:

A) Overeating and subsequent obesity
B) Obesity prior to conception
C) Hypertension due to kidney lesions
D) Fluid retention

1. Right Answer: C
Explanation: (A) Protein is vital for the maintenance of muscle to aid in breathing. A high-calorie diet using higher fat than carbohydrate content is given because clients are unable to breathe off the excess CO2that is an end product of carbohydrate metabolism. (B) Inadequate nutritional status, in particular, deficiencies in vitamins A and C, decreases resistance to infection. (C) Milk does not make mucus thicker. It may coat the back of the throat and make it feel thicker. Rinsing the mouth with water after drinking milk will prevent this problem. (D) Small, frequent meals minimize a fullness sensation and reduce pressure on the diaphragm. The work of breathing and SOB are also reduced.

2. Right Answer: D
Explanation: (A) The effects of morphine or an allergic response to the drug will not affect theophylline clearance. (B) Xanthines are used cautiously in clients with severe cardiac disease, liver disease, cor pulmonale, hypertension, or hyperthyroidism. Arthritis does not influence the dosage of theophylline. (C) Theophylline does not cause sedation or drowsiness. Conversely, its side effects may be exhibited by central nervous system stimulation. (D) Cimetidine decreases theophylline clearance from the system and increases theophylline levels in the blood, thus increasing the risk of toxicity.

3. Right Answer: D
Explanation: (A) Mild PIH is not treated with medications. (B) Emotional stress is not the cause of blood pressure elevation in PIH. (C) Excessive caloric intake is not the cause of weight gain in PIH. (D) The client most frequently is not aware of the signs and symptoms in mild PIH.

4. Right Answer: D
Explanation: (A, B, C) The individuals systolic and diastolic changes are more significant than the relatively high initial blood pressure readings. (D) The systolic pressure went up 12 mm Hg and the diastolic pressure 18 mm Hg. This is a more significant rise than the increases in AC choices, and client should receive more frequent evaluations and care.

5. Right Answer: D
Explanation: (A) Overeating can lead to obesity, but not to edema. (B) There is no indication of obesity prior to pregnancy. PIH is more prevalent in the underweight than in the obese in this age group. (C) Hypertension can be due to kidney lesions, but it would have been apparent earlier in the pregnancy. (D) The weight gain in PIH is due to the retention of sodium ions and fluid and is one of the three cardinal symptoms of PIH.

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