NSG 330 NCLEX Kaplan Med Surg 2 Final Exam Predictor Test

NSG 330: NCLEX Kaplan Med surg 2 Final Exam Predictor Test
Previous Final Exam Questions

1. You are assigned to the Emergency Department as triage RN. Your patient 54 yr-old male presents with
projectile hematemesis and a history of alcohol abuse. The RN suspects the hematemesis: bloody vomit is
from:
a. Melena black, tarry stool
b. Esophageal varices
c. Epistaxis
d. Asterixis
2. The emergency department RN is assigned to a 24-yr. old male patient who was in a motor vehicle
accident (MVA). The patient uses inappropriate words (3) when asked what happened. He has normal
flexion (withdrawal) (4) and he opens his eyes spontaneously to sound (4). He has paralysis in the lower
extremities with complete, but temporary, loss of motor, sensory, reflex and autonomic function.
What is his Glascow Coma Scale rating?
a. Ten
b. Eleven
c. Twelve
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d. Eight
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3. The MVA patient’s immediate response to the injury is
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a. Paraparesis from spinal shock paraparesis = weakness
b. Paraparesis from neurogenic shock
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c. Paraplegia from spinal shock paraplegia = paralysis
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d. Paraplegia from neurogenic shock
4. The nurse anticipates giving the following IV medication to the MVA patient to decrease spinal cord edema
a. Methylprednisolone corticosteroid
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b. Furosemide loop diuretic

c. Baclofen muscle relaxant
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d. Dopamine
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5. The MVA patient’s spinal x-rays show a low cervical fracture with an incomplete spinal cord injury. After
surgical stabilization, a halo fixator is established with four (4) screws inserted into the skull. The
interventions while in a halo fixation device include
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a. Adjust the halo screws to maintain adequate traction PRN

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b. Check skin integrity under the halo jacket every shift and PRN
c. Keep special wrench needed to loosen halo jacket for CPR at bedside
d. Monitor signs and symptoms of infection at external pin sites every shift
e. Answers b, c, and d
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6. The MVA patient is admitted to SICU the first 12 hours post spinal cord injury. His cardiac output is
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dropping resulting in bradycardia of 48/min and BP 82/46 mm Hg. He has dependent edema of the lower
extremities which are cool to touch. His level of consciousness has declined, and his urinary output has
decreased to below 20 mL/hr. The nurse assesses the patient and determines he is experiencing the
following spinal trauma complication
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a. Hypovolemic shock
b. Neurogenic shock
c. Septic shock
d. Anaphylactic shock
7. The following is anticipated for the MVA patient during this life-threatening emergency
a. Increased fluids to support circulatory volume
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b. Norepinephrine and dopamine intravenously
c. Diuretic intravenous therapy
d. Answers a and b
8. The nurse is admitting a patient into the Acute Physical Rehab unit. The patient's Injury is at T6 after a
MVA. She is progressing well in physical and occupational therapies. Resting in bed, she complains of a
sudden severe headache, blurred vision, and nausea. BP 220/110 mm Hg, HR 52/min. with flushed face,
restlessness, diaphoresis, piloerection (goosebumps) and lower extremity pallor. The suspects she is
experiencing
a. Spinal shock
b. Neurogenic shock
c. Autonomic dysreflexia
d. Septic shock
Identify the priority intervention for this patient

a. Sit the patient up in bed
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b. Call the Rapid Response Team
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c. Determine and mediate the cause
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d. All of the above
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9. Nursing education for this patient must include
a. Recognition of emergent signs and symptoms
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b. Bladder and bowel programs
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c. Pain management
d. Wearing loose clothing
e. All of the above
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11. A female, 50 yr. old non-smoker, presents to the Emergency Dept. with her husband. She was unable to
move her right arm and had slurred speech for 45 minutes at home. She states that she is fine now, but
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the event scared her. Her history includes obesity, hypertension, diabetes mellitus-Type II, hyperlipidemia.
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Vitals at admission were BP 180/102 mm Hg, HR 110/min - irregular, fingerstick blood glucose 240 mg/dL.
Currently, she is having no difficulty speaking, and has full function of her right arm. Medications include:
Enteric coated aspirin, 1 daily, PO; Metoprolol 25 mg, 1 daily, PO, Metformin 500 mg, BID PO. The RN
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anticipates a diagnosis of
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a. Ischemic stroke
b. Transient ischemic attack (Symptoms resolve <24hrs)
c. Cerebral infarction
d. Embolic stroke
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12. Identify the following risk factors for this patient

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a. Hypertension, Diabetes Mellitus, Hyperlipidemia, Obesity

b. Tachycardia, Obesity, Hyperlipidemia, Smoking (Non-Smoker)
c. Obesity, Tachycardia, Alcohol Intake (No Evidence), Hypertension
d. Hypertension, Oral Contraceptives (Stop at 50), Tachycardia, Obesity
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13. Teaching for this patient will include

a. Blood pressure reduction with medication adjustment
b. Improved diabetic glucose management
c. Heart-healthy food choices
d. All of the above
14. The patient is admitted to the Stroke Unit. 12 Lead ECG shows uncontrolled Atrial Fibrillation. Normal
Saline IV is started at 75 mL/hr. Orders: Cardiology, and nutrition consults; telemetry monitoring; Cardiac
Echocardiogram; bedrest. You have initiated the Diltiazem/Cardizem and Heparin drips. Her husband is at
her bedside and calls the nurse 2 hours later stating his wife is having trouble talking to him and
understanding what he is saying to her. You assess the patient who is speaking in incomprehensible words
in an abnormal flexion position with eyes opens to sound. She is unable to move her right arm or leg to
command. The RN suspects that she is experiencing
a. Embolic right cerebral stroke
b. Thrombotic right cerebral stroke
c. Embolic left cerebral stroke
d. Thrombotic left cerebral stroke left = in charge of right side of body
15. The patient’s speech states
a. Expressive aphasia
b. Receptive aphasia
c. Expressive and receptive aphasia
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d. Expressive and receptive dysphasia
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16. The RN’s first response to her patient’s change of condition is to
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a. Call the Stroke Team
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b. Call the Code Blue Team no mention of pt oxygen declining
c. Initiate oxygen at 10 L/min non-rebreather mask no mention of a need for oxygen
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d. Cardiovert Atrial Fibrillation to Sinus Rhythm
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17. Identify the priority nursing intervention(s)
a. Convert Atrial Fibrillation to NSR
b. Maintain an open airway
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c. Initiate anticoagulation therapy

d. All of the above
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18. Identify the highest priority diagnostic test to evaluate this patient
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a. CT of the brain
b. International Normalized Ratio (INR)
c. Prothrombin Time (PT)
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d. Partial Thromboplastin Time (PTT)

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19. Brain imaging is done on this patient and is negative for hemorrhagic stroke. She is transferred to Neuro
ICU. Her anticoagulation international normalized ratio (INR) is 1.9 and baseline National Institutes of
Health Stroke Scale is greater than 25. BP is 198/110 mm Hg. The patient has the following medical
intervention options
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a. Activase (TPA) infusion

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b. Intra-arterial thrombolysis
c. Mechanical embolectomy
d. All of the above
e. Answers b and c
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20. A 72-year-old male patient came to the Emergency Dept. intubated status post motor vehicle accident
(MVA). He is not responding to verbal commands(1); body position is extension (2); eyes open to deep
pain stimulation (2). Brain CT Scan shows bleeding into the space beneath the dura and above the
arachnoid. There is no skull fracture. The RN records the patient's Glascow Coma Scale as
a. Two
b. Nine
c. Five
d. Seven
21. Traumatic Brain Injury to this patient is classified as
a. Mild
b. Moderate
c. Severe
d. Brain Herniation
22. The bleeding noted on the CT Scan indicates a(n)
a. Epidural hematoma
b. Subdural hematoma
c. Intracerebral hemorrhage
d. Brain contusion
23. The patient is admitted to the Neuro ICU status post supratentorial craniotomy for a malignant primary
brain tumor. His head of the bed is elevated 30°. He is extubated and on 6L/min oxygen using a simple
mask with saturation maintained above 93%. Identify postoperative nursing interventions
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a. Monitor for increased intracranial pressure (ICP)
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b. Avoid extreme hip or neck flexion
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c. Maintain midline, neutral head position
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d. All of the above
24. Post-operative drugs routinely given for this surgery include
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a. Antiepileptics, histamine blockers/proton pump inhibitors, glucocorticoids
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b. Anticoagulants, antibiotics, histamine blockers/pump inhibitors
c. Antiepileptics, anticoagulants, antibiotics, Ativan
d. Analgesics, anticoagulants, antiepileptics, glucocorticoids
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25. The RN reports this sign immediately as increased cranial pressure (ICP)
a. Change in level of consciousness
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b. Change in breathing pattern

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c. Change in cardiac rhythm

d. Answers b and c
26. An 83-yr. old female patient is brought to the Emergency Room by a caregiver who reports recent weight
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loss of 24 lbs., increased confusion, altered sleep/wake pattern, and emesis x 2. History: alcoholic hepatitis
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(5 yrs.); hepatic encephalopathy. Vital Signs: BP 92/50 mm Hg; HR 110 with Sinus Tachycardia. The RN
expects the following assessment findings
a. Kussmaul breathing, cyanosis, vasodilation, hypoxemia
b. Jaundice, icterus, palmar erythema, asterixis
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c. Spider angiomas, ecchymoses, petechiae, ascites

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d. Answers b and c
27. The RN anticipates the following lab diagnostics to be ordered for this patient
a. Serum bilirubin, albumin, protein, creatinine
b. Prothrombin Time (PT), International Normalized Ratio (INR)
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c. Complete Blood Count (CBC), Serum Liver Enzymes

d. All of the above
28. The RN identifies the following nursing priorities for this patient
a. Fall precautions
b. Bleeding precautions
c. Isolation precautions
d. All of the above
e. Answers a and b
29. The labs come back as the RN expected
a. RBC, hemoglobin, hematocrit, and platelet counts are decreased
b. Serum bilirubin, protein, and albumin are decreased
c. Potassium, serum creatinine, and PT/INR are increased
d. All of the above
30. The ER Physician evaluates the patient and confirms she has 4 martinis/day (5 yr. history). He admits her to
the step-down unit. A nutrition consult is ordered. She states her belly is making it hard to breath.
Respirations 26/min; SPO2 92% on O2 @ 3L/min/cannula. Excessive ascetic fluid volume may cause
respiratory problems and
a. Hepatopulmonary syndrome
b. Spontaneous bacterial peritonitis (SBP)
c. Primary biliary cirrhosis
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d. Portal-systemic encephalopathy
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e. Answers a and b
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31. ED Physician does the following to address her respiratory concerns
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a. Rapid Sequence Intubation (RSI)
b. Paracentesis
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c. Thoracentesis
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d. Pericardiocentesis
32. The RN expects the following diet orders for this patient
a. Sodium intake restriction and vitamin supplements
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b. High protein and high fat

c. Heart healthy and high cholesterol
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d. Regular diet and vitamin supplements

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33. The physician orders the following medications

a. Opioids, lactulose, antibiotics, sedative
b. Beta-blocker, antibiotics, lactulose, diuretics
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c. Barbiturates, opioids, antibiotics, diuretics

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d. Beta-blocker, antiemetics, antibiotics, sedative

34. The RN is teaching high-school seniors about the prevention of viral hepatitis. Five (5) major types of acute
viral hepatitis are reviewed for mode of transmission, manner of onset, signs and symptoms, and
incubation periods. Students are taught the following hepatitis viruses can be transmitted by blood
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exposure
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a. HAV, HBV, HCV

b. HCV, HDV, HEV
c. HBV, HCV, HDV
d. HDV, HAV, HCV
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35. A 40-yr. old female presents to Emergency Dept. with chief complaint of anorexia, nausea, vomiting, and
pain after eating a high fat or high-volume meal radiating to the right shoulder. She has lost 10 lbs.
unintentionally in 2 weeks and relates a positive familial history of cholelithiasis. Cholecystitis requires a
a. Ultrasonography (US) of the right upper quadrant
b. Abdominal x-ray
c. Hepatobiliary scan (HIDA scan)
d. Endoscopic Retrograde Cholangiopancreatography (ERCP)
36. The patient is admitted to the Surgical Unit. Diagnostics confirm the need for gallbladder surgery. Surgeon
reviews operation, risks, benefits, and possible complications with the patient. The "gold standard"
surgical procedure for her is
a. Laparoscopic cholecystectomy (lap chole)
b. Traditional open approach cholecystectomy
c. Endoscopic retrograde cholangiopancreatography (ERCP)
d. Natural orifice transluminal endoscopic surgery (NOTES)
37. A 65 yrs. old male goes to the Emergency Dept. with complaints of intense, continuous, gnawing/burning
abdominal pain, and weight loss. Physical Exam: jaundice, abdominal tenderness, ascites; upper quadrant
abdominal palpable mass. He drinks six (6) twelve-ounce (12 oz.) cans of beer daily for five (5) years. The
RN knows that alcoholism is the primary risk factor for
a. Chronic calcifying pancreatitis
b. Chronic obstructive pancreatitis
c. Idiopathic chronic pancreatitis
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d. Autoimmune pancreatitis
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38. Diagnostic assessment for this patient includes
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a. Endoscopic retrograde cholangiopancreatography (ERCP)
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b. Abdominal ultrasound
c. Serum amylase, lipase, bilirubin, alkaline phosphatase
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d. All of the above
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e. Answers b and c
39. He is admitted to step-down. He is NPO and an inserted nasogastric tube is connected to low, intermittent
suction. He is given an opioid analgesic. His oral temperature is 102.8°F; diagnostic work-up shows a
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pancreatic abscess. The RN expects the following urgent medical intervention(s) to prevent sepsis from the
pancreatic abscess
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a. Intravenous antibiotics
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b. Surgical incision and drainage

c. Pancreatectomy
d. Answers a and b
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40. Patient/ Family education for self-management on pancreatic enzymes include

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a. Take with meals/snacks and a full glass of water

b. Take enzymes after antacid/H2 blockers
c. No chewing, crush (enteric coated), or mix in protein foods
d. All of the above
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41. A 67-yr. old male presents with vague, constant, dull abdominal pain in the upper abdomen, fatigue, and
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15 lb. wt. loss in two weeks. Medical History includes chronic pancreatitis (3 yrs.); Family history of Cancer;
smokes 1 cigarette pack/day. Elevated tumor markers and diagnostics confirm a large tumor on the head
of the pancreas. The RN knows pancreatic cancer is
a. Leading cause of cancer deaths in the United States
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b. Difficult to diagnose early since hidden by other organs

c. %-year survival rates are high with good prognosis
d. Answers a and b
42. For this diagnosis the surgical option is
a. Partial pancreatectomy
b. Whipple procedure
c. Partial gastrectomy
d. Choledochjejunostomy
43. An 88-yr. old male is admitted to ICU with influenza from the Skilled Nursing Facility. Nausea, vomiting,
and diarrhea reported during the last week with less than 400 mL/day dark amber urinary output. He was
medicated with NSAIDs to manage arthritic pain, malaise, and temperature elevations. Initial labs show
azotemia. History of Chronic Kidney Disease (CKD), Anemia, Arthritis, Hypertension. Vital Signs: BP 140/90
mm Hg; HR 120/min; RR 26/min; Temp. 100.4°F; SPO2 90% on 4L O2/min/nasal prongs. The RN recognizes
the current medical presentation as
a. Acute kidney injury
b. Chronic kidney disease
c. Acute on chronic kidney disease
d. End stage renal disease
44. The influenza with severe dehydration has led to
a. Prerenal failure
b. Intrarenal/intrinsic failure
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c. Postrenal failure
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d. Azotemia failure
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45. Diagnostics for this patient include
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a. Complete metabolic panel and blood count (CMP, CBC)
b. CT scan of abdomen with contrast
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c. Kidney, ureters, bladder (KUB) x-ray
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d. All of the above
e. Answers a and c
46. The patient leaves ICU in End-Stage Kidney Disease (ESKD) with an arteriovenous (AV) shunt for
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intermittent hemodialysis access. He is transferred to Telemetry. The Telemetry RN assesses the patient
checking the AV shunt for
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a. Bruit to auscultation
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b. Bruit to palpation
c. Thrill of palpation
d. Thrill to auscultation
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e. Answers a and c
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47. His weight should be monitored

a. Weekly
b. Daily
c. Monthly
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d. Every other day

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48. Which of these medications will be ordered to treat anemia?

a. Neupogen/ filgrastim for cancer patients
b. Epoetin alfa/ Epogen
c. Oprelvekin/ Neumega avoided b/c of adverse effects
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d. Ondansetron/ Zofran
49. The patient is returning to the skilled nursing facility. Discharge instructions include
a. Monitor weight daily. Report 1 kg increase to provider.
b. Follow dietary restrictions.
c. Balance client’s activity and rest.
d. All of the above
50. The family is convening for a family conference. Discussion should include
a. Acute care rehospitalization criteria
b. Palliative care with treatment options
c. Long term hemodialysis implications and risks
d. All of the above
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Client has vomiting and diarrhea. ABG analysis results are ph 7.48 paco2 40mmhg, hcos 35, pa02 95,
sao2 98%. Which IV solution does nurse anticipate for client?
Normal saline 3%
Normal saline 0.9%
Dextrose 5% in water
Ringer solution
Client comes with difficultly breathing, runny nose, pulse of 100, sneezing and coughin. Diagnosis of
asthma is made. Which information is most important for nurse to obtain? Select all that apply
Any previous attacks like this
Exposure to known allergans
Family history of allergies
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Any symptoms while exercising
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Past history of psychological problems
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Current list of medications
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Client reports difficultly moving right arm. Numbness and tingling in arm. Clitn has difficulty speaking
and diagnosis of stroke is made. The nurse understands this is what type of stroke?
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Double hemisphere stroke

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Hemmorhagic stroke
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Left brain stroke
R right brain stroke

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Nurse teaches client who had stapedectomy. Teaching is understood when which client request is made.
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Physical therapy for vertigo
Neck brace with padding

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Diet sheet that lists high protein foods

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Prescription for stool softener
Client diagnoses with pulmonary embolism. Which priority does nurse apply?
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Give supportive care during healin
Cardiac monitoring
Prevent further embolism
Administer thrombolytic agents
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Client diagnoses with meniere disease. Client has sudden attack of vertigo, nausea, vomiting, and
sweating. Nurse provides which interventions? Select all that apply
GLYCEROL TEST
D diet high in dosium and caffeine
Warm, moist environment
Dark quiet environment
Lorazepam and meclizine
IV lfuids and medications
Client has respiratory failure. Client becomes agitate, restless, and disoriented. Client has nasal flaring
and RR of 26. Most important client goal for nurse to activate?
Will have clear breath sounds in all lyng areas
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Will have pao2 of 90mmHg
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Will have heart rate of at least 110 bpm
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Will cough and deep breath 10 tims an hour
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Client in middle stage of Parkinson. Client no long able to work at job held for years and gave up hand
crafts. Client cries and says” this is to hard I cant do the things I want to do. I never thought I would be
like this.” Which is the most important goal for this client?
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Will indicate reduced feeling of depression

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Will oibtain new job in preferred field of work
Will join Parkinson support group

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Will maintain independence in activities of daily living

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Clikent diagnoses with bell palsy. Client is concerned because facial appearance has changed. Feelings of
fear and qanxiety are expressed to the nurse. Which is the best goal for this client?
Client will take meds as ordered

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Client will state understanding of disease process

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Client will share prognosis with spouse
Client will express decrease in fear and anxiety

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Client has hypertension. Client says “I think I can stop taking my medication now. I don’t have those
headcahces anymore, so I am over this.” Which is the nurses best response?
Remember, you can have hyptertension and not have any symptoms
Don’t you remember, I told you the medication would needc to be taken for life
We will see what your BP is. Maytbe you can stop. How about your diet?
Tell me thwat you remember from our conversation about hypertension
Client reports sharp burngin pain in lower gums and jaw. Client diagnoses with trigeminal neuralgia.
Eating and brushing teeth often trigger pain. Carbamazepine is prescribed. Nurse knows the medication
has the anticipated effects when the client makes which statement?
I have to have two new cavities filled in my back molars
I have regained the 10 punds lost before the treatment
I wish I could use my fan when the house gets hot
I miss seeing my friends at my bridge club every week
Client receives hearing aid because of decreased hearing in both ears. Nurse speak softly and high-
pitched to turn right and go up the stairs. The client turns left and goes down the stairs. Which
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interpretation does the nurse make?
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Hearing aid needs volume adjustment
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Different type of hearing aid is needed
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Mental changes should be assessed
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Loud-speaking voice is needed
Client who is HIV positive receives a Mantoux test. Nurse identifies a 7mm induration at test site. Which
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interpretation does nruse make?

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False positive, previous bacilli Calmette-guerin vaccine
Negative reaction, less than 10 mm
Negative ractio, less than 15 mm

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Posititve reaction, greater than 5 mm
Client diagnosed with liver cancer has partial hepatectomy. Client has anorexia, nauseam and vomiting
with weight loss prior to surgery. The nurse communicates which intervention to the client? Select all
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Here is a sheet we wily se to track I and O and calories for the day
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We will ask the dietitian to help you select foods that are low in protein and calories
We will help you plan your diet around foods you like
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Let ys plan for 6 small meals each day to help with the nausea
Lets talk about how to decrease your fluid intake to 1000 ml per day
You can help us watch your skin to make sure it is not excoriated or sore
Client is diagnosed with glaucoma. Client asks “why do I need to take these eye drops? They hurt my
eyes.” Which is the nurses best response?
Drops help preserve your vision. Maybe less painful medication can be found.
The eye care provider says you need to take them. I am sorry they hurt you
Lets talk to your eye care provider to see if there is a medication that is less irritating.
You will lose your vision if you don’t use the drops as prescibred.
Client diagnosed with stroke. Nurse observes while client eats lunch. Client coughs after many bites,
swallows solids very slowly, swallows liquids without difficulty. The client makes stranged movements
with tongue during eating. Which action does the nurse take next?
Asks client for favorite food choices
Encourages client to chew slowly
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Requests dietary consult
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Rquests occupational therapy consult
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Nurse teaches a class about circulatory disease. Which symptom of peripheral arterial disease does te
nurse include? Select all
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Pain in lower extremeties
Yellow toe nails

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Numbness and tngling in toes

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Thin, shiny, skin on legs
Pale foot when leg is elevated

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Chest pain and dyspnea

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Client diagnosed with inefetive endocarditis is discharged home on IV antibiotic therapy. The nurse
knows the client understands the discharge treatment plan when the client makes which statement?
When I get home, I can take off these compression stockings when I am walking
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I can go back to my job next week and start back traveling

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I will tell my dentist about this illness before havng my teeth cleaned
I can help care for my grandchildren whenthey are sick and stay home from school
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Client undergoes brachytherapy. Which action is most important for the nurse to take?
Werar film badge dosimeter
Deliver all client care at one time
Place client in neutropenic precautions
Provide meals using disposable dishes
Dlient is to receive 2 unites of blood. Client has an IV in the right forearm with D5W in normal saline that
is used to administer an antibiotic every 4 hours. Which does the nurse do first?
Insert a microdrip chamber into IV
Start a second IV with isotonic saline
Use a filtered tubing to administer the blood
Receive the first unit of blood from the blood bank
Client experiences a right-brain stroke. Which is the priorty intervention for the nruse when giving care?
Assess emotional status
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Give range of motion exercises
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Keep client safe
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Provide communication assistance
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Client receives low-flow oxygen at 10 L/min at concentration of 50%. Which is the best oxygen
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administration for the nurse to chose.
Partial non rebreathing mask

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Simple face mask

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Nasal cannula
Oxygen-conserving cannula
Client unresponsive after a closed-head injury. Glascow coma scle is 7. Nurse identifies the clients state
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as which best description?

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Shows signs of visual and hearing impairment
Identified as comatose
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Has subdural hematoma

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Is alert with impaired motor function
Client receives information priord to having a PET scan done. Nurse recognizes further teaching is
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needed when the client makes which statement?
I will need to drink lots of fluid after the test
I am glad I will be asleep during the test
I know I must lie still and only move when told to move
The IV lines in my arms will give me glucose dye
Client is paraplegic because of spinal cord injury. Nurse identities nursing diagnosis “ineffective coping”
based on which client statemtn
How can I ever get a job now that I am in a wheelchair
How long will I need physical therapy before I am discharged
When can I start playing wheelchair basketball
What are my limitations? I don’t want to be held back
A client is discharged to home following a lung wedge resection for stage IIB lung cvancer. The nurse
provides information regaridn signs and symptoms to report if they occur. Which nursing statement is
best?
If you have chest pain, make syre your spouse goes outside to smoke
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Watch for decreasing pain levels, and let the health care provider know
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If you have difficulty breating or eating, call the health care providr
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Please call the health care provider if you have hemoptysis
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Client diagnosed with myasthenia gravis. Client says “I am tired all the time and don’t want to live
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anymore. If I stop taking my medicaitons, I can stop breathing.” Which is the nurses best response?
Place client on suicide watch

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Teach client about new medication

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Give client information about myasthenia gravis group
Ask client about feelings of hopelessness

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Client is diagnoses with immune thrombocytopenia purpura. Client receives corticosteroids. Nurse know
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the treatment is effections when which observation is made?
Bleeding is minimal after injection
Purpuric lesions fade to white

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Platelet count is 175,000

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Erythrocyte count is 5.1 million
A client with heart failure is to be weighed daily. Client asks why this is necessary. Which is the best
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information for the nurse to give?
Determines the number of calories for the diet
Indication of the fluid status in the body
Shows activity affects activity tolerance
Helps determine if the medication is working
Client diagnoses with flaccid neurogenic bladder due to spinal cord injury. Client has had severl urinary
tract infections. Bladder traiing program ahs been establish. Which documentation indicates the clients
bladder function is currently satisfactory?
Client has had no UTI in 3 days
Client verbalizes when to empty bladder
Client empties baldder completely every 2-3 hours
Client correctly demonstrates bladder emptying technique
Client diagnosed with COPD. Client has had asthma for 10 years, has smoked for 40 years, and has
frequent episodes of bronchitis. Nurse identiing a nursing diagnosis based on which most important
client problem?
m
Life-style that exacerbates COPD
er as
co
Problems with oxygen intake causing confusion
eH w
Low self esteem because of health status changes
o.
rs e
Interest in seeking behavior changes
ou urc
Nurse teaches client diagnoses with venous thromboembolism in the right calf. The nurse knows the
cleitn understands the teaching when the client makes which statement?
o
I need to exorcise vigorously for at least 15 minutes twice a day

aC s
vi y re
I may continue to take my fish oil and saw palmetto
I may stop taking my anticoagulants when I no longer have pain
I need to limit the amount of ginger and garlic I eat

ed d
ar stu
Nurse plans care for the client with tuberculosis. Cloient says it is difficult to remember to take ehe
medications every day since they are not helping with the cough. The nurse adds which nursing
diagnosis to the clients care plan?
is
Activity intolerance related to cough and fatigue from disease

Th
Ineffective breathing patterns related to disease process and coughing
Noncomplienace related to lack of understanding of management regime

sh
Ineffective self-health management related to lack of motivation
Nruse suctions a clienets tracheostomy. Which nechnigue does the nurse use? Select all that apply
Suctions client every hour
Use sterile technique when suctioning
Uses intermittent suctioning
Routintely instills sterile normal saline before suctioning
Rotates the catheter when withdrawing
Applies suction when inserting catheter
Client diagnoses with epilpsey. Client talks to the nurse about difficulties of managing the disorder.
Which is the most important goal for this client?
Will maintin seizure free status for 1 year
Will demonstrate methods of managing self during a seizure
Will describe ways to effectively manage the disease
Will meet requirements to get driving license again
m
Client with pancreatic cancer receives radiation as palliative care. The nurse knows the treatment is
er as
effective when they notice which observation?
co
eH w
Client requests less pain medication
o.
Famiy says patient looks less ill
rs e
ou urc
Client requests special meal
Client sleeps 4 hours in afternoon

o
Client has sustainted injurty from industrial accident. Client says large metal beam cause the contusions
aC s
to the chest, arms, and legs. The client is heaving chest pain and dyspnea. Which addition symptom does
vi y re
the nurse anticipate? Select all that ap-ply
Elevated temperature
ed d
Increasing hypotention
ar stu
Frothy sputum
Tracheal deviation
is
Flushed face and arms

Th
Cough with hemoptysis
Client with viral pneumonia is palce on 4 L of oxygen. The nruse enteres which nursing diagnosis in the
clients plan of care.
sh
Ineffective breathing pattern related to inflammatory process
Excess fluid volume related to edema in lungs
Chromic pain related to inflammatory process and congestion
Disturbed sleep pattern related to oxygen therapy
Client sustained spinal cord injury at c6 level. Client wear halo vest to stabilize the vertebrae folliwng
surrgey. Which is most important nursing action for client
Maintina adequate fluid volume
Maintina adequate respirations
Faciliatating bladder management
Facilitating adequate bowel function
Client diagnosed with sickle cell disease. The nurse teaches information for which most common
complication?
Pneumonia
Kidney damage
m
er as
Leg ulcers
co
eH w
Osteoporosis
o.
Client on chemotherapy has an absolute neutrophil count of 900 cells. Neutropenic precautions are
rs e
instituted. The client asks why the family needs to wear gowns, masks, and gloves when they visit. Which
ou urc
is the nruses best response?
This is to keep you from getting an infection

o
I know you want to touch and to be close to them but that is not possible
aC s
vi y re
You are very likely to become infefcted, and this keeps you away from their germs
You seem upset. Tell me what you know about your condition.
ed d
ar stu
is
Th
sh
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NSG 330 NCLEX Kaplan Med Surg 2 Final Exam Predictor Test

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NSG 330 NCLEX Kaplan Med Surg 2 Final Exam Predictor Test

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NSG 330: NCLEX Kaplan Med surg 2 Final Exam Predictor Test

Previous Final Exam Questions

b. Furosemide loop diuretic

a. Adjust the halo screws to maintain adequate traction PRN

Identify the priority intervention for this patient

12. Identify the following risk factors for this patient

a. Hypertension, Diabetes Mellitus, Hyperlipidemia, Obesity

13. Teaching for this patient will include

c. Initiate anticoagulation therapy

d. Partial Thromboplastin Time (PTT)

a. Activase (TPA) infusion

b. Change in breathing pattern

c. Change in cardiac rhythm

c. Spider angiomas, ecchymoses, petechiae, ascites

c. Complete Blood Count (CBC), Serum Liver Enzymes

b. High protein and high fat

d. Regular diet and vitamin supplements

33. The physician orders the following medications

c. Barbiturates, opioids, antibiotics, diuretics

d. Beta-blocker, antiemetics, antibiotics, sedative

a. HAV, HBV, HCV

b. Surgical incision and drainage

40. Patient/ Family education for self-management on pancreatic enzymes include

a. Take with meals/snacks and a full glass of water

b. Difficult to diagnose early since hidden by other organs

47. His weight should be monitored

d. Every other day

48. Which of these medications will be ordered to treat anemia?

Normal saline 0.9%

Any previous attacks like this

Exposure to known allergans

Family history of allergies

Double hemisphere stroke

Left brain stroke

R right brain stroke

Physical therapy for vertigo

Neck brace with padding

Diet sheet that lists high protein foods

Prescription for stool softener

Give supportive care during healin

Prevent further embolism

Administer thrombolytic agents

D diet high in dosium and caffeine

Warm, moist environment

Dark quiet environment

Lorazepam and meclizine

IV lfuids and medications

Will have clear breath sounds in all lyng areas

Will indicate reduced feeling of depression

Will oibtain new job in preferred field of work

Will join Parkinson support group

Will maintain independence in activities of daily living

Client will take meds as ordered

Client will state understanding of disease process

Client will share prognosis with spouse

Client will express decrease in fear and anxiety

Tell me thwat you remember from our conversation about hypertension

I have to have two new cavities filled in my back molars

I have regained the 10 punds lost before the treatment

I wish I could use my fan when the house gets hot

I miss seeing my friends at my bridge club every week

interpretation does nruse make?

False positive, previous bacilli Calmette-guerin vaccine