NCLEX-PN
Best NCLEX Next Gen Prep
1. When assisting the physician in performing transillumination of a client's scrotum, how should the nurse prepare for this procedure?
- A. Obtaining a flashlight and darkening the room
- B. Instructing the client to drink three glasses of water
- C. Instructing the client to take several deep breaths and bear down
- D. Telling the client that the procedure is very uncomfortable but that the discomfort will only last for a few moments
Correct answer: A
Rationale: When preparing for transillumination of the scrotum, the nurse should obtain a flashlight and darken the room. This is done to allow the strong flashlight to be shined from behind the scrotal contents. Normal scrotal contents do not appear on transillumination. Instructing the client to drink fluids or to take deep breaths and bear down is not part of the preparation for this procedure. Additionally, it is not necessary to inform the client that the procedure is uncomfortable as transillumination is a painless procedure.
2. What is the therapeutic range for carbamazepine (Tegretol)?
- A. 7-12 mcg/mL
- B. 4-10 mcg/mL
- C. 10-14 mcg/mL
- D. 1-5 mcg/mL
Correct answer: B
Rationale: The therapeutic range for carbamazepine (Tegretol) is 4-10 mcg/mL. This range is established based on the optimal balance between effectiveness and safety. Choices A, C, and D are outside the therapeutic range for carbamazepine, which could lead to suboptimal treatment outcomes or increased risk of toxicity. Choice B (4-10 mcg/mL) is the correct range recommended for therapeutic efficacy while minimizing adverse effects.
3. In the context of diagnostic genetic counseling, which of the following choices is typically not made by clients?
- A. Terminating the pregnancy.
- B. Preparing for the birth of a child with special needs.
- C. Accessing support services before the birth.
- D. Completing the grieving process before the birth.
Correct answer: D
Rationale: In diagnostic genetic counseling, clients may face difficult decisions based on test results. Terminating the pregnancy is a choice some clients may consider if severe abnormalities are detected. Preparing for the birth of a child with special needs involves getting ready to care for a child who may require extra attention and support. Accessing support services before the birth can help clients connect with resources and professionals for assistance during and after the pregnancy. Completing the grieving process before birth is not typically a choice made in the context of genetic counseling. The grieving process often starts or continues after distressing results and can extend beyond the birth of the child. Therefore, the correct answer is completing the grieving process before the birth.
4. Which of the following methods of contraception is able to reduce the transmission of HIV and other STDs?
- A. intrauterine device (IUD)
- B. Norplant
- C. oral contraceptives
- D. vaginal sponge
Correct answer: D
Rationale: The correct answer is the vaginal sponge. The vaginal sponge is a barrier method of contraception that, when used with foam or jelly contraception, reduces the transmission of HIV and other STDs, as well as reducing the risk of pregnancy. Intrauterine devices (IUDs), Norplant, and oral contraceptives can prevent pregnancy but not the transmission of HIV and STDs. Clients using the contraceptive methods in Choices A, B, and C should be counseled to use a chemical or barrier contraceptive to decrease the transmission of HIV or STDs.
5. A client is scheduled to undergo a Papanicolaou (Pap) test in 1 week. Which statement does the nurse make to the client?
- A. 'If you are menstruating, use pads instead of a tampon.'
- B. 'Avoid intercourse for 24 hours before the scheduled examination.'
- C. 'Get a douching kit from the pharmacy and douche 2 hours before the examination.'
- D. 'If you are having a vaginal discharge, obtain a sample of the discharge for inspection.'
Correct answer: B
Rationale: The correct answer is to 'Avoid intercourse for 24 hours before the scheduled examination.' The Pap test is used to screen for cervical cancer. It is not performed during menstruation or if a heavy infectious discharge is present. Before the test, the client should not douche, have intercourse, or insert anything into the vagina within 24 hours. Instructing the client to use pads instead of a tampon when menstruating can interfere with the test results due to the presence of blood. Douching before the exam is discouraged as it can alter the cervical cells' appearance, affecting the test's accuracy. Obtaining a sample of vaginal discharge for inspection is not a standard pre-Pap test instruction and is unnecessary for the test.
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