Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 49

1. A 67-year-old client will be undergoing a coronary arteriography in the morning. Client teaching about postprocedure nursing care should include that:

A) Bed rest with bathroom privileges will be ordered
B) He will be kept NPO for 8 - 12 hours
C) Some oozing of blood at the arterial puncture site is normal
D) The leg used for arterial puncture should be keptstraight for 8 - 12 hours

2. A client had a myocardial infarction 5 days ago. His physician has ordered an echocardiogram to determine how his myocardial infarction has affected his ventricular wall motion. When the client asks if this test is painful, an appropriate response is:

A) 'No, but you must be able to ride on a stationary bicycle while the test is being performed.'
B) 'No, but you will have to lie still and the gel that is used may be cool.'
C) 'Yes, but your physician will be there and will order pain medicine for you.'
D) 'Your physician has ordered medicine, which you will be given before you go for the test, which will make you sleepy.'

3. A 55-year-old man has recently been diagnosed with hypertension. His physician orders a low-sodium diet for him. When he asks, 'What does salt have to do with high blood pressure? the nurses initial response would be:

A) 'The reason is not known why hypertension is associated with a high-salt diet.'
B) 'Large amounts of salt in your diet can cause you to retain fluid, which increases your blood pressure.'
C) 'Salt affects your blood vessels and causes your blood pressure to be high.'
D) 'Salt is needed to maintain blood pressure, but too much causes hypertension.'

4. A client has consented to have a central venous catheter placed. The best position in which to place the client is the Trendelenburg position. The reason is that the Trendelenburg position:

A) Allows the physician to visualize the subclavian vein
B) Reduces the possibility of air embolism
C) Reduces the possibility of hematoma formation
D) Makes the procedure more comfortable for the client

5. A newborn infant is exhibiting signs of respiratory distress. Which of the following would the nurse recognize as the earliest clinical sign of respiratory distress?

A) Cyanosis
B) Increased respirations
C) Sternal and subcostal retractions
D) Decreased respirations

1. Right Answer: D
Explanation: (A) Bed rest will be ordered for 812 hours postprocedure. Flexing of the leg at the arterial puncture site will occur if the client gets out of bed, and this is contraindicated after arteriography. (B) The client will be able to eat as soon as he is alert enough to swallow safely and that will depend on what medications areused for sedation during the procedure. (C) Oozing at the arterial puncture site is not normal and should be closely evaluated. (D) The leg where the arterial puncture occurred must be kept straight for 812 hours to minimize the risk of bleeding.

2. Right Answer: B
Explanation: (A) Riding a stationary bicycle or walking on a treadmill is done during a stress test. (B) During an echocardiogram, the client must lie supine while a technician performs the test. To perform the test, the technician uses a conductive gel and a transducer to obtain ultrasound tracings of the heart. (C) A physician need not be present during an echocardiogram, and it is neither invasive nor painful. (D) There is no premedication required for an echocardiogram.

3. Right Answer: B
Explanation: (A) This response is untrue. (B) Decreasing salt intake reduces fluid retention and decreases blood pressure. (C) Salt does not have an effect on the blood vessels themselves, but on fluid retention, which accompanies salt intake. (D) This response is untrue.

4. Right Answer: B
Explanation: (A) The subclavian vein is not visible during central line insertion regardless of the clients position. (B) The Trendelenburg position reduces the possibility of air embolism because it places slight positive pressure on the central veins. It also distends the veins, and distention facilitates insertion. (C) This response is untrue; it has no effect on hematoma formation. (D) This position is not necessarily more comfortable for the client, and many clients, especially those who may be short of breath, may find the position uncomfortable and difficult to maintain.

5. Right Answer: C
Explanation: (A) Cyanosis is a late clinical sign of respiratory distress. (B) Rapid respirations are normal in a newborn. (C) The newborn has to exert an extra effort for ventilation, which is accomplished by using the accessory muscles of ventilation. The diaphragm and abdominal muscles are immature and weak in the newborn.(D) Decreased respirations are a late clinical sign. In the newborn, decreased respirations precede respiratory failure.

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