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NCLEX NCLEX-RN Exam
National Council Licensure Examination - NCLEX-RN (Page 48 )

Updated On: 12-Jan-2026
Page 48 of 345
PDF with 862 Questions

Assessment of the client with pericarditis may reveal which of the following?

  1. Ventricular gallop and substernal chest pain
  2. Narrowed pulse pressure and shortness of breath
  3. Pericardial friction rub and pain on deep inspiration
  4. Pericardial tamponade and widened pulse pressure

Answer(s): C

Explanation:

(A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.



To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?

  1. Positive inotropic therapy
  2. Negative chronotropic therapy
  3. Increase in balance of myocardial O2 supply and demand
  4. Afterload reduction therapy

Answer(s): A

Explanation:

(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand. (B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand.



The nurse should know that according to current thinking, the most important prognostic factor for a client with breast cancer is:

  1. Tumor size
  2. Axillary node status
  3. Client's previous history of disease
  4. Client's level of estrogen-progesterone receptor assays

Answer(s): B

Explanation:

(A) Although tumor size is a factor in classification of cancer growth, it is not an indicator of lymph node spread. (B) Axillary node status is the most important indicator for predicting how far the cancer has spread. If the lymph nodes are positive for cancer cells, the prognosis is poorer. (C) The client's previous history of cancer puts her at an increased risk for breast cancer recurrence, especially if the cancer occurred in the other breast. It does not predict prognosis, however. (D) The estrogen-progesterone assay test is used to identify present tumors being fedfrom an estrogen site within the body. Some breast cancers grow rapidly as long as there is an estrogen supply such as from the ovaries. The estrogen-progesterone assay test does not indicate the prognosis.



Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client's history?

  1. Menarche after age 13
  2. Nulliparity
  3. Maternal family history of breast cancer
  4. Early menopause

Answer(s): C

Explanation:

(A) Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. (B) Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. (C) A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. (D) Early menopause decreases the risk of developing breast cancer.



A pregnant woman at 36 weeks' gestation is followed for PIH and develops proteinuria. To increase protein in her diet, which of the following foods will provide the greatest amount of protein when added to her intake of 100 mL of milk?

  1. Fifty milliliters light cream and 2 tbsp corn syrup
  2. Thirty grams powdered skim milk and 1 egg
  3. One small scoop (90 g) vanilla ice cream and 1 tbsp chocolate syrup
  4. One package vitamin-fortified gelatin drink

Answer(s): B

Explanation:

(A) This choice would provide more unwanted fat and sugar than protein. (B) Skim milk would add protein. Eggs are good sources of protein while low in fat and calories. (C) The benefit of protein from ice cream would be outweighed by the fat content. Chocolate syrup has caffeine, which is contraindicated or limited in pregnancy. (D) Although most animal proteins are higher in protein than plant proteins, gelatin is not. It loses protein during the processing for food consumption.



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