NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 201:

  A client begins a regimen of chemotherapy. Her platelet counts fall to 98,000. Which action is least likely to increase the risk of hemorrhage?

  A. Test all excreta for occult blood.

  B. Use a soft toothbrush or foam cleaner for oral hygiene.

  C. Implement reverse isolation.

  D. Avoid IM injections.

  Correct Answer: C

  Reverse isolation does not affect the risk of hemorrhage.

• Question 202:

  High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by __________.

  A. the inability of the kidneys to excrete the drug metabolites

  B. rapid cell catabolism

  C. toxic effects of the prophylactic antibiotics that are given concurrently

  D. the altered blood pH from the acid medium of the drugs

  Correct Answer: B

  Chemotherapy causes damage to cells, and uric acid is a cell metabolite.

• Question 203:

  A client with asthma develops respiratory acidosis.

  Based on this diagnosis, what should the nurse expect the client's serum potassium level to be?

  A. normal

  B. elevated

  C. low

  D. unrelated to the pH

  Correct Answer: B

  Hyperkalemia occurs in a state of acidosis because potassium moves from injured cells into the bloodstream.

• Question 204:

  A client goes to the Emergency Department with acute respiratory distress and the following arterial blood gases (ABGs): pH 7.35, PCO2 40 mmHg, PO2 63 mmHg, HCO3 23, and oxygenation saturation (SaO2) 93%.

  Which of the following represents the best analysis of the etiology of these ABGs?

  A. tuberculosis (TB)

  B. pneumonia

  C. pleural effusion

  D. hypoxia

  Correct Answer: D

  A combined low PO2 and low SaO2 indicates hypoxia. The pH, PCO2, and HCO3 are normal.

  ABGs are not necessarily altered in TB or pleural effusion.

  Depending on the degree of the pneumonia, the PO2 and PCO2 might be low because hypoxia stimulates

  hyperventilation.

• Question 205:

  A client has chronic respiratory acidosis caused by end-stage chronic obstructive pulmonary disease (COPD). Oxygen is delivered at 1 L/min per nasal cannula.

  The nurse teaches the family that the reason for this is to avoid respiratory depression, based on which of the following explanations?

  A. COPD clients are stimulated to breathe by hypoxia.

  B. COPD clients depend on a low carbon dioxide level.

  C. COPD clients tend to retain hydrogen ions if they are given high doses of oxygen.

  D. COPD clients thrive on a high oxygen level.

  Correct Answer: A

  COPD clients are compensating for low oxygen and high carbon dioxide levels. Hypoxia is the main stimulus to breathe in persons with chronic hypercapnia. Increasing the level of oxygen decreases the stimulus to breathe.

• Question 206:

  Which of the following observations is most important when assessing a client's breathing?

  A. presence of breathing and pulse rate

  B. breathing pattern and adequacy of breathing

  C. presence of breathing and adequacy of breathing

  D. patient position and adequacy of breathing

  Correct Answer: C

  It is not enough to simply make sure the client is breathing. The client must be breathing adequately.

• Question 207:

  Signs of impaired breathing in infants and children include all of the following except __________.

  A. nasal flaring

  B. grunting

  C. seesaw breathing

  D. quivering lips

  Correct Answer: D

  Lip quivering is a distracter.

  Signs of impaired breathing in infants and children include all the other options.

• Question 208:

  Erythropoietin used to treat anemia in clients with renal failure should be given in conjunction with __________.

  A. iron, folic acid, and B12

  B. an increase of protein in the diet

  C. vitamins A and C

  D. an increase of calcium in the diet

  Correct Answer: A

  The kidneys of a client in renal failure produce no erythropoietin, a hormone necessary for RBC

  production. Erythropoietin can be given as replacement, but the client needs adequate iron, folate, and

  B12 to increase the effectiveness of EPO.

  Choice "an increase of protein in the diet" is not necessary for RBC production and can increase uremia.

  Choices "vitamins A and C" and "an increase of calcium in the diet" are not necessary for RBC production.

• Question 209:

  An appropriate intervention for the client with suspected genitourinary trauma and visible blood at the urethral meatus is __________.

  A. insertion of a Foley catheter

  B. in and out catheter specimen for urinalysis

  C. a voided urine specimen for urinalysis

  D. a urologist consult

  Correct Answer: D

  A urologist consult is appropriate for a client with visible blood at the urethral meatus and suspected

  trauma.

  Choices "insertion of a Foley catheter" and "in and out catheter specimen for urinalysis" are

  contraindicated.

  A urinalysis might be ordered by the physician, but the question does not provide enough information to

  make "a voided urine specimen for urinalysis" the correct answer.

• Question 210:

  A client with stress incontinence should be advised __________.

  A. to purchase absorbent undergarments

  B. that Kegel exercises might help

  C. that effective surgical treatments are nonexistent

  D. that behavioral therapy is ineffective

  Correct Answer: B

  Kegel exercises, tightening and releasing the pelvic floor muscles, might improve stress incontinence.

  To purchase absorbent undergarments is not an appropriate treatment for stress incontinence.

  Several effective surgical treatments exist.

  Lifestyle and dietary modifications can also be helpful.