Diabetes Nclex Review Question with Answer and Rationale

NCLEX Review Question

The nurse teaches the patient about diabetes including which of the following statements?

a. Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision.
b. Sugar is found only in dessert foods.

c. The only diet change needed in the treatment of diabetes is to stop eating sugar.

d. Once insulin injections are started in the treatment of Type 2 diabetes, they can never be discontinued.

Correct Answer: a.

Rationale:

a. Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision.
When blood glucose levels are well controlled, the potential for complications of diabetes is reduced.

b. Sugar is found only in dessert foods.
Several types of foods contain sugar, including cereals, sauces, salad dressing, fruit, and fruit juices.

c. The only diet change needed in the treatment of diabetes is to stop eating sugar.
It is not feasible, nor is it advisable, to remove all sources of sugar from the diet.

d. Once insulin injections are started in the treatment of Type 2 diabetes, they can never be discontinued.
If the diabetes had been well controlled without insulin prior to the period of acute stress causing the need for insulin, the patient may be able to resume previous methods for control of diabetes when the stress is resolved.

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NCLEX Question for ability of the heart to initiate an electrical impulse

NCLEX Review Question

Which term is used to describe the ability of the heart to initiate an electrical impulse?

a.Automaticity
b.Contractility
c.Conductivity
d.Excitability

Correct Answer: A
Automaticity
Rationale: Automaticity is the ability of specialized electrical cells of the cardiac conduction system to initiate an electrical impulse.

Contractility
Rationale: Contractility refers to the ability of the specialized electrical cells of the cardiac conduction system to contract in response to an electrical impulse.

Conductivity
Rationale: Conductivity refers to the ability of the specialized electrical cells of the cardiac conduction system to transmit an electrical impulse from one cell to another.

Excitability
Rationale: Excitability refers to the ability of the specialized electrical cells of the cardiac conduction system to respond to an electrical impulse.

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NCLEX Question for chest drainage tubes

NCLEX Review Question

In general, chest drainage tubes are not used for the patient undergoing

a.Pneumonectomy
b.Lobectomy
c.Wedge resection
d.Segmentectomy

Correct Answer: A
Pneumonectomy
Rationale: Usually, no drains are used for the pneumonectomy patient because the accumulation of fluid in the empty hemithorax prevents mediastinal shift.

Lobectomy
Rationale: With lobectomy, two chest tubes are usually inserted for drainage, the upper for air and the lower for fluid

Wedge resection
Rationale: With wedge resection, the pleural cavity usually is drained because of the possibility of an air or blood leak

Segmentectomy
Rationale: With segmentectomy, drains are usually used because of the possibility of an air or blood leak.

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NCLEX Question for performing endotracheal suctioning

NCLEX Review Question

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

a.10-15 seconds
b.30-35 seconds
c.20-25 seconds
d.0-5 seconds

Correct Answer: A
10-15 seconds
Rationale: In general, the nurse should apply suction no longer than 10-15 seconds because hypoxia and dysrhythmias may develop, leading to cardiac arrest.

30-35 seconds
Rationale: Applying suction for 30-35 seconds is hazardous and may result in the patient's developing hypoxia, which can lead to dysrhythmias and, ultimately, cardiac arrest.

20-25 seconds
Rationale: Applying suction for 20-25 seconds is hazardous and may result in the patient's developing hypoxia, which can lead to dysrhythmias and, ultimately, cardiac arrest.

0-5 seconds
Rationale: Applying suction for 0-5 seconds would provide too little time for effective suctioning of secretions.

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NCLEX Question for endotracheal tube cuff

NCLEX Review Question

Which of the following ranges identifies the amount of pressure within the endotracheal tube cuff that is believed to prevent both injury and aspiration?

a.20-25 mm Hg water pressure.
b.10-15 mm Hg water pressure.
c.30-35 mm Hg water pressure.
d.0-5 mm Hg water pressure

Correst Answer: A
20-25 mm Hg water pressure.
Rationale: Usually the pressure is maintained at less than 25 cm water pressure to prevent injury and at more than 20 cm water pressure to prevent aspiration.

10-15 mm Hg water pressure.
Rationale: A measure of 10--15 mm Hg water pressure would indicate that the cuff is underinflated.

30-35 mm Hg water pressure.
Rationale: A measure of 30--35 mm Hg water pressure would indicate that the cuff is overinflated.

0-5 mm Hg water pressure
Rationale: A measure of 0-5 mm Hg water pressure would indicate that the cuff is underinflated.

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NCLEX Question for high oxygen concentration

NCLEX Review Question

Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?

a.Non-rebreather mask
b.Venturi mask
c.Catheter
d.Face tent

Correst Answer: A
Non-rebreather mask
Rationale: The non-rebreather mask provides high oxygen concentration but is usually poor fitting.

Venturi mask
Rationale: The Venturi mask provides low levels of supplemental oxygen.

Catheter
Rationale: The catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention.

Face tent
Rationale: A face tent provides a fairly accurate fraction of inspired oxygen, but is bulky and uncomfortable. It would not be the device of choice to provide high oxygen concentration.

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NCLEX Question for stage of COPD

NCLEX Review Question

In which stage of COPD is the forced expiratory volume (FEV1) < 30%?

a.III
b.II
c.I
d.O

Correst Answer: A
III
Rationale: Stage III patients demonstrate FEV1 < 30% with respiratory failure or clinical signs of right heart failure

II
Rationale: Stage II patients demonstrate FEV1 between > 30% and 80%

I
Rationale: Stage I is mild COPD with FEV1 < 70%.

O
Rationale: Stage O is characterized by normal spirometry

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NCLEX Question for type of chest configuration is typical of the patient with COPD

NCLEX Review Question

Which type of chest configuration is typical of the patient with COPD?

a.Barrel chest
b.Pigeon chest
c.Flail chest
d.Funnel chest

Correst Answer: A
Barrel chest
Rationale: "Barrel chest" results from fixation of the ribs in the inspiratory position.

Pigeon chest
Rationale: Pigeon chest results from a displaced sternum.

Flail chest
Rationale: Flail chest results when the ribs are fractured.

Funnel chest
Rationale: Funnel chest occurs when there is a depression in the lower portion of the sternum and is associated with Mafan's syndrome or rickets.

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NCLEX Question for risk factor for development of Chronic Obstructive Pulmonary Disease

NCLEX Review Question

Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

a.Cigarette smoking
b.Occupational exposure
c.Air pollution
d.Genetic abnormalities

Correct Answer: A
Cigarette smoking
Rationale: Pipe, cigar and other types of tobacco smoking are also risk factors.

Occupational exposure
Rationale: While a risk factor, occupational exposure is not the most important risk factor for development of COPD.

Air pollution
Rationale: Air pollution is a risk factor for development of COPD, but it is not the most important risk factor.

Genetic abnormalities
Rationale: A deficiency of alpha-antitrypsin is a risk factor for development of COPD, but it is not the most important risk factor.

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NCLEX Question for Emphysema

NCLEX Review Question

Emphysema is described as:

a.A disease of the airways characterized by destruction of the walls of overdistended alveoli.
b.A disease that results in a common clinical outcome of reversible airflow obstruction.
c.The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
d.Chronic dilatation of a bronchus or bronchi

Correct Answer: A
A disease of the airways characterized by destruction of the walls of overdistended alveoli.
Rationale: Emphysema is a category of COPD.

A disease that results in a common clinical outcome of reversible airflow obstruction.
Rationale: Asthma is the disease described.

The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
Rationale: Bronchitis is the disease described.

Chronic dilatation of a bronchus or bronchi
Rationale: Bronchiectasis is the condition described.

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NCLEX Question for carcinoma of the lung for both men and women

NCLEX Review Question

Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

a.Adenocarcinoma
b.Large cell carcinoma
c.Squamous cell carcinoma
d.Small cell carcinoma

Correct Answer: A
Adenocarcinoma
Rationale: Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.

Large cell carcinoma
Rationale: Large cell carcinoma is a fast-growing tumor that tends to arise peripherally.

Squamous cell carcinoma
Rationale: Squamous cell carcinoma is more centrally located and arises more commonly in the segmental and subsegmental bronchi in response to repetitive carcinogenic exposures.

Small cell carcinoma
Rationale: Small cell carcinomas arise primarily as proximal lesions, but may arise in any part of the tracheobronchial tree.
for air bubbles is not a reliable method for determining nasogastric tube placement in the stomach.

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NCLEX Question for the best method for determining nasogastric tube placement in the stomach

NCLEX Review Question

Which of the following methods is the best method for determining nasogastric tube placement in the stomach?

a.X-ray
b.Observation of gastric aspirate
c.Testing of pH of gastric aspirate
d.Placement of external end of tube under water

Correct Answer: A
X-ray
Rationale: Radiologic identification of tube placement in the stomach is most reliable.

Observation of gastric aspirate
Rationale: Gastric fluid may be grassy green, brown, clear, or odorless while an aspirate from the lungs may be off-white or tan. Hence, checking aspirate is not the best method of determining nasogastric tube placement in the stomach.

Testing of pH of gastric aspirate
Rationale: Gastric pH values are typically lower or more acidic than that of the intestinal or respiractory tract, but not always.

Placement of external end of tube under water
Rationale: Placement of external end of tube under water and watching

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NCLEX Question for types of lung cancer is characterized as fast growing and tending to arise peripherally

NCLEX Review Question

Which of the following types of lung cancer is characterized as fast growing and tending to arise peripherally?

a.Large cell carcinoma
b.Bronchioalveolar carcinoma
c.Adenocarcinoma
d.Squamous cell carcinoma

Correct Answer: A
Large cell carcinoma
Rationale: Large cell carcinoma is a fast-growing tumor that tends to arise peripherally.

Bronchioalveolar carcinoma
Rationale: Bronchioalveolar cell cancer arises from the terminal bronchus and alveoli and is usually slow-growing.

Adenocarcinoma
Rationale: Adenocarcinoma presents as peripheral masses or nodules and often metastasizes.

Squamous cell carcinoma
Rationale: Squamous cell carcinoma arises from the bronchial epithelium and is more centrally located.

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NCLEX Question for subcutaneous emphysema

NCLEX Review Question

Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

a.Record the observation.
b.Apply a compression dressing to the area.
c.Measure the patient's pulse oximetry.
d.Report the finding to the physician immediately.

Correct Answer: A
Record the observation.
Rationale:
Subcutaneous emphysema occurs after chest surgery as the air that is located within the pleural cavity is expelled through the tissue opening created by the surgical procedure.

Apply a compression dressing to the area.
Rationale: Subcutaneous emphysema is a typical post-operative finding in the patient after chest surgery.

Measure the patient's pulse oximetry.
Rationale: Subcutaneous emphysema is absorbed by the body spontaneously after the underlying leak is treated or halted.

Report the finding to the physician immediately.
Rationale: Subcutaneous emphysema results from air entering the tissue planes.

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NCLEX Question Mantoux test

NCLEX Review Question

When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows

a.redness and induration.
b.drainage.
c.tissue sloughing.
d.bruising.

Correct Answer: A
redness and induration.
Rationale: The site is inspected for redness and palpated for hardening.

drainage.
Rationale: Drainage at the site does not indicate a reaction to the tubercle bacillus.

tissue sloughing.
Rationale: Sloughing of tissue at the site of injection does not indicate a reaction to the tubercle bacillus.

bruising.
Rationale: Bruising of tissue at the site may occur from the injection, but does not indicate a reaction to the tubercle bacillus.

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NCLEX Question for community-acquired pneumonias

NCLEX Review Question

Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

a.Legionnaires' disease
b.Streptococcal (pneumococcal) pneumonia
c.Mycoplasma pneumonia
d.Viral pneumonia

Correct Answer: A
Legionnaires' disease
Rationale: Legionnaires' disease accounts for 15% of community-acquired pneumonias.

Streptococcal (pneumococcal) pneumonia
Rationale: Streptococcal pneumonia demonstrates the highest occurrence in winter months.

Mycoplasma pneumonia
Rationale: Mycoplasma pneumonia demonstrates the highest occurrence in fall and early winter.

Viral pneumonia
Rationale: Viral pneumonia demonstrates the greatest incidence during winter months.

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NCLEX Question for collapse of alveoli or infectious process

NCLEX Review Question

Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or infectious process?

a.Consolidation
b.Atelectasis
c.Bronchiectasis
d.Empyema

Correct Answer: A
Consolidation
Rationale: Consolidation occurs during an infectious process such as pneumonia.

Atelectasis
Rationale: Atelectasis refers to collapse or airless condition of the alveoli caused by hypoventilation, obstruction to the airways, or compression.

Bronchiectasis
Rationale: Bronchiectasis refers to chronic dilation of a bronchi or bronchi in which the dilated airway becomes saccular and a medium for chronic infection.

Empyema
Rationale: Empyema refers to accumulation of purulent material in the pleural space.

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NCLEX Question for laryngectomy

NCLEX Review Question

When the patient who has undergone laryngectomy suffers wound breakdown, the nurse monitors him very carefully because he is identified as being at high risk for

a.carotid artery hemorrhage.
b.pulmonary embolism.
c.dehydration.
d.pneumonia.

Correct Answer: A
carotid artery hemorrhage.
Rationale: The carotid artery lies close to the stoma and may rupture from erosion if the wound does not heal properly.

pulmonary embolism.
Rationale: Pulmonary embolism is associated with immobility.

dehydration.
Rationale: Dehydration may lead to poor wound healing and breakdown.

pneumonia.
Rationale: Pneumonia is a risk for any postoperative patient.

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NCLEX Question for sleep apnea

NCLEX Review Question
Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

a.Obstructive
b.Simple
c.Mixed
d.Central

Correct Answer: A
Obstructive
Rationale: Obstructive sleep apnea occurs usually in men, especially those who are older and overweight.

Simple
Rationale: Types of sleep apnea do not include a simple characterization.

Mixed
Rationale: Mixed sleep apnea is a combination of central and obstructive apnea with one apneic episode.

Central
Rationale: In central sleep apnea, the patient demonstrates simultaneous cessation of both airflow and respiratory movements.

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NCLEX Question for clergyman's sore throat

NCLEX Review Question

Another term for clergyman's sore throat is

a.chronic granular pharyngitis.
b.aphonia.
c.atrophic pharyngitis.
d.hypertrophic pharyngitis.

Correct Answer: A
chronic granular pharyngitis.
Rationale: In clergyman's sore throat, the pharynx is characterized by numerous swollen lymph follicles.

aphonia.
Rationale: Aphonia refers to the inability to use one's voice.

atrophic pharyngitis.
Rationale: Atrophic pharyngitis is characterized by a membrane that is thin, white, glistening, and at times wrinkled.

hypertrophic pharyngitis.
Rationale: Hypertrophic pharyngitis is characterized by general thickening and congestion of the pharyngeal mucous membrane.

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