NCLEX-PN
Quizlet NCLEX PN 2023
1. The test used to differentiate sickle cell trait from sickle cell disease is:
- A. Sickle cell preparation.
- B. Peripheral smear.
- C. Sickledex.
- D. Hemoglobin electrophoresis
Correct answer: Hemoglobin electrophoresis
Rationale: The correct test to differentiate between sickle cell trait and sickle cell disease is hemoglobin electrophoresis. This test separates different types of hemoglobin based on their electrical charge, allowing for the identification of specific hemoglobin variants like HbS in sickle cell disease. Sickle cell preparation and Sickledex are not specific tests for this differentiation. While a peripheral smear can show sickle cells, it does not provide a definitive differentiation between the trait and the disease as it doesn't identify the specific hemoglobin variant present.
2. Which of the following needs immediate medical attention and emergency intervention? The client who:
- A. complains of sharp pain upon taking a deep breath and excessive coughing.
- B. exhibits yellow, productive sputum, low-grade fever, and crackles.
- C. has a shift of the trachea to the left, with no breath sounds on the right.
- D. has asthma and complains of an inability to catch her breath after exercise.
Correct answer: has a shift of the trachea to the left, with no breath sounds on the right.
Rationale: Choice C is indicative of a tension pneumothorax, which is considered a medical emergency. The respiratory system is severely compromised, and venous return to the heart is affected. The mediastinal shift is to the unaffected side, indicating a critical situation that requires immediate intervention to prevent further deterioration. This condition can rapidly progress to a life-threatening state, necessitating prompt medical attention. Choices A, B, and D do not present with life-threatening conditions requiring emergency intervention. Choice A mentions symptoms of pleurisy, which may be painful but not immediately life-threatening. Choice B describes symptoms of bronchitis, which may require medical attention but not of an emergent nature. Choice D reflects a common complaint in asthma but does not suggest an immediate life-threatening situation unless severe respiratory distress is present.
3. During a petit mal seizure in the clinic, what should be the highest priority?
- A. Provide a safe environment free of obstructions in the immediate area
- B. Call a code
- C. Contact the patient’s physician
- D. Prevent excessive movement of the extremities
Correct answer: Provide a safe environment free of obstructions in the immediate area
Rationale: During a petit mal seizure, the highest priority is to provide a safe environment free of obstructions in the immediate area. This action aims to prevent injuries to the patient during the seizure. While calling a code or contacting the patient’s physician may be necessary at some point, immediate safety measures take precedence. Preventing excessive movement of the extremities is relevant but ensuring a safe environment is crucial to avoid harm during the seizure.
4. Which physiologic mechanism best describes the function of the sodium-potassium pump?
- A. active transport
- B. diffusion
- C. filtration
- D. osmosis
Correct answer: active transport
Rationale: Active transport is the correct answer as it accurately describes the process involved in the sodium-potassium pump. The pump utilizes energy to move ions against their concentration gradient, maintaining cellular concentrations. Diffusion (choice B) is a passive process where substances move from an area of higher concentration to lower concentration. Filtration (choice C) involves the movement of solutes based on pressure gradients. Osmosis (choice D) is the movement of water across a semipermeable membrane.
5. A nurse is caring for a patient in the step-down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?
- A. Bradycardia
- B. Increased pupil size bilaterally
- C. Change in LOC
- D. Vomiting
Correct answer: Increased pupil size bilaterally
Rationale: The correct answer is 'Increased pupil size bilaterally.' When assessing for signs of increased intracranial pressure, bilateral pupil dilation is not typically associated with this condition. Instead, unilateral pupil changes, especially one pupil becoming dilated or non-reactive while the other remains normal, are indicative of increased ICP. Bradycardia, a change in level of consciousness (LOC), and vomiting are commonly seen in patients with increased intracranial pressure due to the brain's response to the rising pressure. Therefore, the presence of bilateral pupil dilation goes against the typical pattern observed in patients with increased intracranial pressure.
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