NCLEX-RN Practice Quiz Test Bank #5 (75 Questions) 1. 1. Question Mr. Rodriguez is admitted with severe pain in the knees. Which form of arthritis is
... [Show More] characterized by urate deposits and joint pain, usually in the feet and legs, and occurs primarily in men over age 30? o A. Septic arthritis o B. Traumatic arthritis o C. Intermittent arthritis o D. Gouty arthritis Incorrect Correct Answer: D. Gouty arthritis Gouty arthritis, a metabolic disease, is characterized by urate deposits and pain in the joints, especially those in the feet and legs. Urate deposits don’t occur in septic or traumatic arthritis. • Option A: Septic arthritis results from bacterial invasion of a joint and leads to inflammation of the synovial lining. • Option B: Traumatic arthritis results from blunt trauma to a joint or ligament. • Option C: Intermittent arthritis is a rare, benign condition marked by regular, recurrent joint effusions, especially in the knees. 2. 2. Question A heparin infusion at 1,500 units/hour is ordered for a 64-year-old client with stroke in evolution. The infusion contains 25,000 units of heparin in 500 ml of saline solution. How many milliliters per hour should be given? • A. 15 ml/hour • B. 30 ml/hour • C. 45 ml/hour • D. 50 ml/hour Incorrect Correct Answer: B. 30 ml/hour An infusion prepared with 25,000 units of heparin in 500 ml of saline solution yields 50 units of heparin per milliliter of solution. The equation is set up as 50 units times X (the unknown quantity) equals 1,500 units/hour, X equals 30 ml/hour. • Option A: 15 ml/hr is incorrect based on the computation used. • Option C: 45 ml/hr is more than the correct milliliters to be infused based on the computation. • Option D: 50 ml/hr is incorrect because it is way more than the correct milliliter to be infused. 3. 3. Question A 76-year-old male client had a thromboembolic right stroke; his left arm is swollen. Which of the following conditions may cause swelling after a stroke? • A. Elbow contracture secondary to spasticity. • B. Loss of muscle contraction decreasing venous return. • C. Deep vein thrombosis (DVT) due to immobility of the ipsilateral side. • D. Hypoalbuminemia due to protein escaping from an inflamed glomerulus. Incorrect Correct Answer: B. Loss of muscle contraction decreasing venous return In clients with hemiplegia or hemiparesis, loss of muscle contraction decreases venous return and may cause swelling of the affected extremity. • Option A: Contractures or bony calcifications may occur with a stroke, but don’t appear with swelling. • Option C: DVT may develop in clients with a stroke but is more likely to occur in the lower extremities. • Option D: A stroke isn’t linked to protein loss. Higher levels of protein were associated with a lower risk of stroke. According to a study, for every 20 grams of protein people ate per day, there is a 26 percent lower risk of stroke. 4. 4. Question Heberden’s nodes are a common sign of osteoarthritis. Which of the following statements is correct about this deformity? • A. It appears only in men. • B. It appears on the distal interphalangeal joint. • C. It appears on the proximal interphalangeal joint. • D. It appears on the dorsolateral aspect of the interphalangeal joint. Incorrect Correct Answer: B. It appears on the distal interphalangeal joint. Heberden’s nodes appear on the distal interphalangeal joint on both men and women. • Option A: It appears on both men and women. They are hard bony lumps in the joints of the fingers. • Option C: It does not appear on the proximal, rather, on the distal interphalangeal joint. • Option D: Bouchard’s node appears on the dorsolateral aspect of the proximal interphalangeal joint. 5. 5. Question Which of the following statements explains the main difference between rheumatoid arthritis and osteoarthritis? • A. Osteoarthritis is gender-specific, rheumatoid arthritis isn’t. • B. Osteoarthritis is a localized disease rheumatoid arthritis is systemic. • C. Osteoarthritis is a systemic disease, rheumatoid arthritis is localized. • D. Osteoarthritis has dislocations and subluxations, rheumatoid arthritis doesn’t. Incorrect Correct Answer: B. Osteoarthritis is a localized disease; rheumatoid arthritis is systemic Osteoarthritis is a localized disease, rheumatoid arthritis is systemic. • Option A: Osteoarthritis isn’t gender-specific, but rheumatoid arthritis is. • Option C: Osteoarthritis is localized while rheumatoid arthritis is systemic. • Option D: Clients have dislocations and subluxations in both disorders. 6. 6. Question Mrs. Cruz uses a cane for assistance in walking. Which of the following statements is true about a cane or other assistive devices? • A. A walker is a better choice than a cane. • B. The cane should be used on the affected side. • C. The cane should be used on the unaffected side. • D. A client with osteoarthritis should be encouraged to ambulate without the cane. Incorrect Correct Answer: C. The cane should be used on the unaffected side A cane should be used on the unaffected side. A client with osteoarthritis should be encouraged to ambulate with a cane, walker, or other assistive device as needed; their use takes weight and stress off joints. • Option A: If a single assisting hand helps to walk, then logically a cane might be of potential benefit. • Option B: A cane should be used on the unaffected side of the client. • Option D: The use of a cane is important to prevent further injury or falls. 7. 7. Question A male client with type 1 diabetes is scheduled to receive 30 U of 70/30 insulin. There is no 70/30 insulin available. As a substitution, the nurse may give the client: • A. 9 U regular insulin and 21 U neutral protamine Hagedorn (NPH). • B. 21 U regular insulin and 9 U NPH. • C. 10 U regular insulin and 20 U NPH. • D. 20 U regular insulin and 10 U NPH. Incorrect Correct Answer: A. 9 U regular insulin and 21 U neutral protamine Hagedorn (NPH). A 70/30 insulin preparation is 70% NPH and 30% regular insulin. Therefore, a correct substitution requires mixing 21 U of NPH and 9 U of regular insulin. • Option B: Using this dosage would be incorrect and may produce no effect on the client’s blood sugar level. • Option C: This is an incorrect insulin dose. Incorrect administration can result in transient and serious hypoglycemia and hyperglycemia, wide glycemic excursions, and diabetic ketoacidosis. • Option D: This is an incorrect dosage for the prescribed insulin. Glycemic control is poorer in those who lacked confidence in their ability to choose correct doses. 8. 8. Question Nurse Len should expect to administer which medication to a client with gout? • A. Aspirin • B. Furosemide (Lasix) • C. Colchicines • D. Calcium gluconate (Kalcinate) Incorrect Correct Answer: C. Colchicines A disease characterized by joint inflammation (especially in the great toe), gout is caused by urate crystal deposits in the joints. The physician prescribes colchicine to reduce these deposits and thus ease joint inflammation. • Option A: Although aspirin is used to reduce joint inflammation and pain in clients with osteoarthritis and rheumatoid arthritis, it isn’t indicated for gout because it has no effect on urate crystal formation. • Option B: Furosemide, a diuretic, doesn’t relieve gout. It is a loop diuretic that prevents the body from absorbing too much salt. This allows the salt to be passed in the urine. • Option D: Calcium gluconate is used [Show Less]