NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 151:

  Neural tube defects in the fetus have been primarily associated with which deficiency in the mother?

  A. iron

  B. folic acid

  C. vitamin B12

  D. vitamin E

  Correct Answer: B

  Folic acid is essential for the development of the neural tube and might prevent the defect or failure of the tube to close (congenital anomalies).

• Question 152:

  The anemias most often associated with pregnancy are __________.

  A. folic acid and iron deficiency

  B. folic acid deficiency and thalassemia

  C. iron deficiency and thalassemia

  D. thalassemia and B12 deficiency

  Correct Answer: A

  Folic acid and iron deficiency anemia are the most common anemias, prevalent in women of childbearing

  age with 50% of pregnant women having this type of anemia. Iron deficiency anemia during pregnancy is a

  result (usually) of the increase in the plasma level during pregnancy but not in the constituent level.

  Also, if a woman has this type of anemia prepregnancy, it gets worse during pregnancy.

• Question 153:

  A nurse is caring for a client with an elevated cortisol level.

  The nurse can expect the client to exhibit symptoms of __________.

  A. urinary excess

  B. hyperpituitarism

  C. urinary deficit

  D. hyperthyroidism

  Correct Answer: C

  High levels of cortisol can produce sodium and fluid retention and potassium deficit, thus creating urinary deficit.

• Question 154:

  One of the major functions of the kidneys in maintaining normal fluid balance is __________.

  A. the manufacture of antidiuretic hormone

  B. the regulation of calcium and phosphate balance

  C. the regulation of the pH of the extracellular fluid

  D. the control of aldosterone levels

  Correct Answer: C

  Major functions of the kidneys in maintaining normal fluid balance include regulation of extracellular fluid and osmolarity by selective retention and excretion of fluids, regulation of pH of the extracellular fluid by retention of hydrogen ions, and excretion of metabolic wastes and toxic substances. ADH is manufactured by the pituitary, and the parathyroid regulates calcium and phosphate balance.

• Question 155:

  A physician orders a serum creatinine for a hospitalized client.

  The nurse should explain to the client and his family that this test __________.

  A. is normal if the level is 4.0 to 5.5 mg/dl

  B. can be elevated with increased protein intake

  C. is a better indicator of renal function than the BUN

  D. reflects the fluid volume status of a person

  Correct Answer: C

  A serum creatinine level should be 0.7 to 1.5 mg/dl, and it does not vary with increased protein intake, so it is a better indicator of renal function than the BUN.

• Question 156:

  A nurse is caring for a client with an elevated urine osmolarity. The nurse should assess the client for __________.

  A. fluid volume excess.

  B. hyperkalemia.

  C. hypercalcemia.

  D. fluid volume deficit.

  Correct Answer: D

  For a client with an elevated urine osmolarity, the nurse should assess the client for fluid volume deficit.

• Question 157:

  The chemotherapeutic agent 5-fluorourcacil (5-FU) is ordered for a client as an adjunct measure to surgery.

  Which statement about chemotherapy is true?

  A. It is a local treatment affecting only tumor cells.

  B. It is a systemic treatment affecting both tumor and normal cells.

  C. It has not yet been proved an effective treatment for cancer.

  D. It is often the drug of choice because it causes few, if any, side effects.

  Correct Answer: B

  5-FU is an antieoplastic, antimetabolic drug that inhibits DNA synthesis and interferes with cell replication.

  It is given intravenously and acts systemically. It affects all rapidly growing cells,both malignant and

  normal.

  It is used as adjuvant therapy for treating cancer of the colon, rectum, stomach, breast, and pancreas.

  This drug has many side effects, including bone marrow depression, anorexia, stomatitis, nausea, and

  vomiting.

• Question 158:

  Herbal therapy has several indications for use.

  Primarily, herbal therapy is __________.

  A. used to treat many common complaints and diseases.

  B. used to promote certain types of low-carb diets.

  C. used as an adjunct to medications.

  D. used to create a diet without salt and carbohydrates.

  Correct Answer: A

  Herbal therapy is used to treat many common complaints and diseases.

• Question 159:

  What are the implications for a client with renal insufficiency who wants to start a low-carbohydrate (CHO) diet?

  A. As long as the client eats a minimum of 30g of CHO/day, there should be no problem.

  B. The client's clinical condition is a contraindication to starting a low CHO diet.

  C. Calcium supplements should be utilized to prevent the development of osteoporosis while on a low CHO diet.

  D. As long as the client eats foods that are high biologic protein sources, a low CHO diet can be followed.

  Correct Answer: B

  A client with renal insufficiency should not start a low CHO diet because it could result in an increased

  renal solute load. Clients who have renal disease (renal failure, endstage renal disease [ESRD], dialysis,

  and transplant) or liver disease (liver failure, hepatic encephalopathy, cirrhosis, transplant, and hepatitis)

  require some form of protein control in dietary patterns to prevent complications from an inability to handle

  protein solute load. Proteins used in the diet must be of high biologic value, and protein intake is usually

  weight based, starting at 0.8 g/kg of dry weight, depending on the client's underlying clinical condition.

  Protein levels may be increased as necessary to account for metabolic response to dialysis and

  regeneration of liver tissue (1.5?.0 g/kg/day). A minimum level of CHOs are needed in the diet (50?00 g/

  day) to spare protein.

  Vitamin and mineral supplements might be indicated with clients who have liver failure.

  The dietician is instrumental in calculating specific nutrient requirements for these clients and reviewing

  fluid intake and output, medication profile, and daily weight to monitor client outcomes in conjunction with

  dialysis technicians and nurses.

• Question 160:

  The nurse should make __________ responses when questioned by a client about the role of leptin in the body.

  A. It increases food intake in clients, thereby promoting obesity.

  B. It assists in the regulation of steroids.

  C. It increases the total fat mass of people who are obese.

  D. It might decrease the total fat mass in the bodies of people who are obese.

  Correct Answer: D

  Leptin (recessive obesity gene ?protein hormone) is expressed in fat cell coding for the protein that reacts

  to the percentage of fat cells in the body. Leptin is associated with increased energy expenditure and

  decreased food intake via hypothalamic control. Obese clients might have insensitivity or resistance to the

  effects of leptin.

  Leptin can affect other body hormones such as insulin.

  Genetic factors include leptin, uncoupling proteins, and the amount of brown/white fat in the body.