NCLEX-PN
NCLEX PN Exam Cram
1. When teaching a patient with COPD pulmonary exercises, what should be done?
- A. Teach pursed-lip breathing techniques.
- B. Encourage repetitive heavy lifting exercises to increase strength.
- C. Limit exercises due to respiratory acidosis.
- D. Take breaks every 10-20 minutes during exercises.
Correct answer: A
Rationale: The correct answer is to teach pursed-lip breathing techniques. Pursed-lip breathing helps to decrease the volume of air expelled by keeping the airways open longer, making it easier for patients with COPD to breathe out. Encouraging heavy lifting exercises (Choice B) is not suitable for patients with COPD as it can lead to increased shortness of breath. Limiting exercises due to respiratory acidosis (Choice C) is not correct; instead, exercises should be tailored to the patient's tolerance. Taking breaks every 10-20 minutes (Choice D) is not specific to the management of COPD pulmonary exercises.
2. The nurse is caring for a client with full-thickness burns to the left arm and trunk. What is the priority for this client?
- A. Pain management
- B. Airway assessment
- C. Fluid volume status monitoring
- D. Risk for infection prevention
Correct answer: C
Rationale: Correct! With full-thickness burns, there is a significant risk of fluid loss through the burn wound and fluid shift, leading to hypovolemia and shock. Monitoring and maintaining the client's fluid volume status is crucial to prevent complications like hypovolemic shock. Pain management (Option A) is essential but not the priority in this situation. While airway assessment (Option B) is crucial, it is typically assessed first in clients with respiratory distress. Preventing infection (Option D) is important but managing fluid volume status takes precedence in the initial care of a client with full-thickness burns.
3. The nurse is checking laboratory values on a patient who has crackling rales in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which of the following laboratory values does the nurse expect to be abnormal?
- A. Potassium.
- B. B-type natriuretic peptide (BNP).
- C. C-reactive protein (CRP).
- D. Platelets.
Correct answer: B
Rationale: The client's symptoms suggest heart failure. BNP is a neurohormone released from the ventricles due to increased pressure and stretch, as seen in heart failure. A BNP level greater than 51 pg/mL is often associated with mild heart failure, with higher levels indicating more severe heart failure. Potassium levels are not typically affected by heart failure. CRP is an inflammation indicator used to predict coronary artery disease risk, not directly related to heart failure in this case. The client's symptoms do not suggest bleeding or clotting abnormalities associated with platelet count issues, making platelets an unlikely abnormal value.
4. What should the nurse do while caring for a client with an eating disorder?
- A. Encourage the client to cook for others
- B. Weigh the client daily and keep a journal
- C. Restrict access to mirrors
- D. Monitor food intake and behavior for one hour after meals
Correct answer: D
Rationale: The correct answer is to monitor food intake and behavior for one hour after meals. This is crucial in caring for a client with an eating disorder as it helps in assessing any immediate risks related to the disorder. Option A is incorrect as it may trigger additional stress for the client and distract from the main focus of managing the disorder. Option B, weighing the client daily, could lead to an unhealthy focus on weight and potentially worsen the client's mental health. Option C, restricting access to mirrors, although it may be beneficial for body image concerns, does not directly address the core issue of monitoring food intake and behavior, which is essential in managing eating disorders.
5. A 15-year-old high school wrestler has been taking diuretics to lose weight to compete in a lower weight class. Which of the following medical tests is most likely to be given?
- A. Lab values of Potassium and Sodium
- B. Lab values of Glucose and Hemoglobin
- C. ECG
- D. CT scan
Correct answer: A
Rationale: Diuretics can disrupt the sodium and potassium balance, potentially leading to cardiac complications. Monitoring the lab values of potassium and sodium is crucial to assess electrolyte imbalances due to diuretic use. Testing glucose and hemoglobin levels is not directly related to diuretic use in this context. An ECG would be indicated if there were signs or symptoms of cardiac abnormalities, but it is not the primary test to monitor the effects of diuretics. A CT scan is not typically used to assess electrolyte imbalances caused by diuretics.
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