NCLEX-PN
Quizlet NCLEX PN 2023
1. During a screening on a patient with a recent cast on the left lower extremity, which of the following statements should the nurse be most concerned about?
- A. The patient reports, "I didn't keep my extremity elevated as the doctor asked me to."?
- B. The patient reports, "I have been having pain in my left calf."?
- C. The patient reports, "My left leg has really been itching."?
- D. The patient reports, "The arthritis in my wrists is flaring up when I put weight on my crutches."?
Correct answer: B
Rationale: The correct answer is B because pain in the left calf could indicate a potential neurovascular complication related to the casted extremity. It could suggest issues such as compartment syndrome or impaired circulation. Option A is not as concerning since not elevating the extremity may lead to swelling but is not an immediate concern. Option C indicates itching, which is common with casts and not as concerning as potential neurovascular issues. Option D, regarding arthritis in the wrists, is unrelated to the lower extremity issue being screened for.
2. When 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
Rationale: The correct answer is to 'Use a soft toothbrush.' A soft toothbrush is recommended because it is less likely to cause the gums to bleed in clients with leukemia, who are at risk of bleeding due to overcrowding of white cells at the expense of other cell types like platelets. Choice B, 'Use dental floss daily,' is incorrect because dental floss is contraindicated and can make the gums bleed in clients with leukemia. Choice C, '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. Choice D, 'Use a triple-edged razor,' is incorrect because an electric razor should be used instead of a triple-edged razor to prevent small cuts and bleeding in clients with leukemia.
3. Which microorganism is most commonly associated with gastritis?
- A. Syphilis
- B. Cytomegalovirus
- C. H. pylori
- D. Mycobacterium
Correct answer: C
Rationale: H. pylori is the most common microorganism associated with gastritis, present in over 80% of cases. While syphilis, cytomegalovirus, and mycobacterium can also cause gastritis, they are much less prevalent compared to H. pylori. Therefore, the correct answer is H. pylori.
4. What is the best lab test to diagnose disseminated intravascular coagulation (DIC)?
- A. platelet count
- B. prothrombin time (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct answer: D
Rationale: The best lab test to diagnose disseminated intravascular coagulation (DIC) is the D-dimer test. In DIC, numerous small clots form throughout the body and are rapidly broken down. D-dimer measures a specific fibrin split product and is the most specific test for DIC. Platelet count (Choice A) is decreased in DIC due to consumption, but it is not specific for diagnosing DIC. Prothrombin time (PT - Choice B) and partial thromboplastin time (PTT - Choice C) are both elevated in DIC because clotting factors have been used up, but they are not specific for DIC as they can be elevated in other conditions as well.
5. If your patient is acutely psychotic, which of the following independent nursing interventions would not be appropriate?
- A. Conveying calmness through one-on-one interaction
- B. Recognizing and managing your own feelings to prevent escalation of the patient's anxiety level
- C. Encouraging client participation in group therapy
- D. Listening and identifying causes of their behavior
Correct answer: C
Rationale: When a patient is acutely psychotic, they may not be able to effectively participate in group therapy due to their altered mental state. Group settings can be overwhelming and may exacerbate the patient's symptoms. Choices A, B, and D are appropriate interventions. Choice A is correct as providing calmness through one-on-one interaction can be beneficial in establishing trust and reducing anxiety. Choice B is also important as recognizing and managing the nurse's feelings can prevent further escalation of the patient's symptoms. Choice D is relevant as listening and identifying causes of the patient's behavior can aid in understanding and providing appropriate care tailored to the patient's needs.
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