NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 181:

  A client receiving drug therapy with furosemide and digitalis requires careful observation and care.

  In planning care for this client, the nurse should recognize that __________ electrolyte imbalances is most likely to occur.

  A. hyperkalemia

  B. hypernatremia

  C. hypokalemia

  D. hypomagnesemia

  Correct Answer: C

  Diuretics such as furosemide might deplete serum potassium. Additionally, the action of digitalis might be

  potentiated by hypokalemia.

  These drugs are not associated with hyperkalemia.

  Diuretic therapy could cause hyponatremia, not hypernatremia.

  Hypomagnesemia is generally associated with poor nutrition, alcoholism, and excessive GI or renal losses.

• Question 182:

  Laboratory tests reveal the following electrolyte values for Mr. Smith: Na 135 mEq/L, Ca 8.5 mg/dL, Cl 102 mEq/L, and K 2.0 mEq/L.

  Which of the following values should the nurse report to the physician because of its potential risk to the client?

  A. Ca

  B. K

  C. Na

  D. Cl

  Correct Answer: B

  Normal serum potassium level ranges between 3.5 and 5.5 mEq/L. The levels in choices 1, 3, and 4 are within normal ranges.

• Question 183:

  Which physiologic mechanism best describes the function of the sodium-potassium pump?

  A. active transport

  B. diffusion

  C. filtration

  D. osmosis

  Correct Answer: A

  Active transport is a process requiring energy to transport ions against a concentration gradient, as is

  needed in the sodium-potassium pump.

  Diffusion, filtration and osmosis are other regulatory mechanisms involved in fluid and electrolyte balance.

• Question 184:

  When caring for a client with a possible diagnosis of placenta previa, which of the following admission procedures should the nurse omit?

  A. perineal shave

  B. enema

  C. urine specimen collection

  D. blood specimen collection

  Correct Answer: B

  An enema could dislodge the placenta and increase bleeding.

• Question 185:

  Melissa Smith came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH.

  With which of the following statements should the nurse best respond to Melissa's complaints?

  A. "The physician will probably want to admit you for observation."

  B. "The physician will probably order bed rest at home."

  C. "These are really dangerous signs."

  D. "The physician will probably prescribe some medicine for you."

  Correct Answer: B

  Pregnancy-induced hypertension (PIH) is a hypertensive disorder of pregnancy, developing after 20 weeks

  gestation.

  It is characterized by edema, hypertension, and proteinuria (preclampsia and eclampsia). The cause is

  unknown.

  The client with advanced PIH needs rest, and home is the best place to get it. Hospitalization is not

  necessary in this situation. Medication is not indicated.

• Question 186:

  Jane Love, a 35-year old gravida III para II at 23 weeks gestation, is seen in the Emergency Department

  with painless, bright red vaginal bleeding. Jane reports that she has been feeling tired and has noticed

  ankle swelling in the evening.

  Laboratory tests reveal a hemoglobin level of 11.5 g/dL.

  After evaluating the situation, the nurse determines that Jane is at risk for placenta previa, based on which

  of the following data?

  A. anemia

  B. edema

  C. painless vaginal bleeding

  D. fatigue

  Correct Answer: C

  Placenta previa is a disorder where the placenta implants in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. The bleeding results from tearing of the placental villi from the uterine wall as the lower uterine segment contracts and dilates. It can be slight or profuse and can include bright red, painless bleeding. The abdomen might be soft, nontender, and relax between contractions.

• Question 187:

  The nurse should teach a client in the Emergency Department, who has suffered an ankle sprain, to __________.

  A. use cold applications to the sprain during the first 24-48 hours

  B. expect disability to decrease within the first 24 hours of injury

  C. expect pain to decrease within 3 hours after injury

  D. begin progressive passive and active range of motion exercises immediately

  Correct Answer: A

  Cold applications are believed to produce vasoconstriction and reduce development of edema.

  Disability and pain are anticipated to increase during the first 2-3 hours after injury.

  Progressive passive and active exercises may begin in 2-5 days, according to the physician's

  recommendation.

  A sprain is a traumatic injury to the tendons, muscles, or ligaments around a joint, characterized by pain,

  swelling, and discoloration of the skin over the joint. The duration and severity of the symptoms vary with

  the extent of damage to the supporting tissues.

  Treatment requires support, rest, and alternating cold and heat. X-ray pictures are often indicated to be

  certain that no fracture has occurred.

• Question 188:

  Which of the following is true concerning human immunodeficiency virus (HIV)?

  A. HIV infection involves CD4 receptor protein on the surface of helper T-cells.

  B. The presence of circulating antibodies that neutralize HIV is evidence that the individual has immunity-HIV.

  C. HIV replication occurs extracellularly.

  D. DNA replication

  Correct Answer: A

  The virus makes a DNA copy of its own RNA using the reverse transcriptase enzyme, and the DNA copy is inserted into the genetic material of the infected cell.

• Question 189:

  The sexually transmitted disease, sometimes referred to as the silent STD, that is more common than gonorrhea and a leading cause of PID is __________.

  A. genital herpes

  B. trichomoniasis

  C. syphilis

  D. chlamydia

  Correct Answer: D

  Chlamydia is a sexually transmitted genital infection and is manifested in males primarily as urethritis and in females as mucopurulent cervicitis. Clinical manifestations of urethritis are often difficult to distinguish from gonorrhea and include mucopurulent discharges of scant or moderate quantity, urethral itching, and burning on urination. Possible complications or sequelae of male urethral infections include epididymitis, infertility, and Reiter syndrome. In homosexual men, receptive anorectal intercourse might result in chlamydial proctitis. In women, the clinical manifestations might be similar to those of gonorrhea and frequently present as a mucopurulent endocervical discharge, with edema, erythema, and easily induced endocervical bleeding caused by inflammation of the endocervical columnar epithelium. However, up to 70% of sexually active women with chlamydial infections are asymptomatic. Complications and sequelae include salpingitis with subsequent risk of infertility, ectopic pregnancy, or chronic pelvic pain. Asymptomatic chronic infections of the endometrium and fallopian tubes might lead to the same outcome.

• Question 190:

  Which of the following statements is true about syphilis?

  A. The cause and mode of transmission is unclear.

  B. There is no known cure for the disease.

  C. When the primary lesion heals, the disease is cured.

  D. Syphilis can be cured with a course of antibiotic therapy.

  Correct Answer: D

  Syphilis is an acute and chronic treponemal disease characterized clinically by a primary lesion, a secondary eruption involving skin and mucous membranes, long periods of latency, and late lesions of skin, bone viscera, the CNS, and the cardiovascular system. The primary lesion (chancre) appears about three weeks after exposure as an indurated, painless ulcer with serous exudate at the site of initial invasion. Invasion of the bloodstream precedes development of the initial lesion, and a firm, nonfluctuant, painless lymph node (bubo) commonly follows. Infection might occur without a clinically evident chancre; that is, it might be in the rectum or on the cervix. After four-six weeks, even without specific treatment, the chancre begins to involute, and, in approximately one-third of untreated cases, a generalized secondary eruption appears, often accompanied by mild constitutional symptoms. This symmetrical maculopapular rash involving the palms and soles, with associated lymphadenopathy is classic. Secondary manifestations resolve spontaneously within weeks to 12 months. Again, about one-third of untreated cases of secondary syphilis become clinically latent for weeks to years. In the early years of latency, infectious lesions of the skin and mucous membranes might recur. Specific treatment includes long-acting penicillin G (benzathine penicillin), 2.4 million units given in a single IM dose on the day that primary, secondary or early latent syphilis is diagnosed. This ensures effective therapy, even if the client fails to return. Serologic testing is important to ensure adequate therapy. Tests are repeated three and six months after treatment and later as needed. In HIV-infected clients, testing should be repeated one, two, and three months after treatment, and at three-month intervals thereafter. Any fourfold titer rise indicates the need for retreatment.