NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 171:

  In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?

  A. Use a soft toothbrush.

  B. Use dental floss daily.

  C. Hold pressure on any scrapes for 1-2 minutes.

  D. Use a triple-edged razor.

  Correct Answer: A

  A soft toothbrush is less likely to cause the gums to bleed than a stiff one. So many white cells are

  produced in clients with leukemias that other cell types (like platelets) are crowded out, putting the client at

  risk for bleeding.

  To use dental floss daily is incorrect because dental floss is contraindicated; it can make the gums bleed.

  To hold pressure on any scrapes for 1-2 minutes is incorrect because when clotting is impaired, pressure

  should be held for 5-10 minutes or longer, until the bleeding stops.

  To use a triple-edged razor is incorrect because an electric razor should be used to prevent small cuts.

• Question 172:

  The best lab test to diagnose disseminated intravascular coagulation (DIC) is ___________.

  A. platelet count

  B. protime (PT)

  C. partial thromboplastin time (PTT)

  D. D-dimer

  Correct Answer: D

  In DIC, many small clots form throughout the body and are immediately broken down.

  D-dimer measures a specific fibrin split (or degradation) product and is the most specific test for DIC.

  Platelet count is incorrect because platelets are consumed in DIC, but this is not specific.

  Partial thromboplastin time (PTT) and D-dimer are both elevated (because clotting factors have been used

  up) but, again, are not specific.

• Question 173:

  When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize ___________.

  A. when started, therapy must not be interrupted to prevent viral resistance

  B. when started, therapy must not be interrupted to prevent opportunistic infection

  C. therapy should be interrupted for one day each month to prevent toxicity

  D. therapy should be interrupted for one week every three months to prevent toxicity

  Correct Answer: A

  HIV mutates very rapidly, and any interruption of therapy can allow viral resistance to emerge ?even taking

  a dose late.

  Choice "when started, therapy must not be interrupted to prevent opportunistic infection" is incorrect

  because, when the virus is kept in check with anti-retrovirals, the client's own immune system is able to

  keep opportunistic infections at bay. Choices "therapy should be interrupted for one day each month to

  prevent toxicity" and "therapy should be interrupted for one week every three months to prevent toxicity"

  are incorrect because therapy should not be interrupted for any reason.

  If the client develops toxicity, another anti-retroviral drug might be prescribed.

• Question 174:

  A client with sickle cell disease is worried about passing the disease on to children.

  Which of the following statements by the PN is most appropriate for this client?

  A. "You should discuss this with your physician."

  B. "Sickle cell disease is genetically based and might be passed on to children."

  C. "Sickle cell disease is genetically based and is not passed on to children."

  D. "Sickle cell disease is caused by an infection and cannot be passed on to children."

  Correct Answer: B

  A client with sickle cell disease passes on the least sickle cell trait and possibly sickle cell disease,

  depending on the sickle status of the other parent.

  Choice "You should discuss this with your physician." is not helpful to the client.

  Choices "Sickle cell disease is genetically based and is not passed on to children." and "Sickle cell disease

  is caused by an infection and cannot be passed on to children." are not true.

• Question 175:

  Which type of hepatitis is transmitted via the fecal-oral route?

  A. A

  B. B

  C. C

  D. D

  Correct Answer: A

  Type A hepatitis is transmitted via the fecal-oral route. The remaining types have other modes of transmission.

• Question 176:

  A client with jaundice has which skin color?

  A. pale

  B. ruddy

  C. yellow

  D. pink

  Correct Answer: C

  Jaundice turns the skin yellow.

  The other skin colors are not symptoms of jaundice.

• Question 177:

  A client had a colostomy done one day ago.

  Which of the following is an abnormal finding when assessing the stoma?

  A. mild edema

  B. minimal bleeding

  C. rose color

  D. dark red color

  Correct Answer: D

  A dark red color is an abnormal finding when assessing the stoma. It indicates inadequate blood supply. The other findings are normal one day postoperatively.

• Question 178:

  Which of the following procedures describes an opening between the colon and abdominal wall?

  A. ileostomy

  B. jejunostomy

  C. colostomy

  D. cecostomy

  Correct Answer: C

  A colostomy is an opening between the colon and abdominal wall. The remaining terms describe other types of ostomies.

• Question 179:

  Which is the most common microorganism associated with gastritis?

  A. syphilis

  B. cytomegalovirus

  C. H. pylori

  D. mycobacterium

  Correct Answer: C

  H. pylori is the most common microorganism associated with gastritis.

  The other microorganisms listed might be associated with gastritis but to a lesser degree.

• Question 180:

  Which statement best describes electrolytes in intracellular and extracellular fluid?

  A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.

  B. There is an equal concentration of sodium and potassium in extracellular fluid.

  C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid.

  D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid.

  Correct Answer: A

  There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.