NCLEX-PN
NCLEX PN Exam Cram
1. In hanging a parenteral IV fluid that is to be infused by gravity, rather than with an infusion pump, the nurse notes that the IV tubing is available in different drop factors. Which tubing is a microdrop set?
- A. 15 drops per milliliter
- B. 60 drops per milliliter
- C. 20 drops per milliliter
- D. 10 drops per milliliter
Correct answer: B
Rationale: A microdrop set delivers 60 drops per milliliter of IV fluid. This allows for a more precise control of the infusion rate. The correct choice is B because it provides the desired microdrop rate. Choices A, C, and D are incorrect. A delivers 15 drops per milliliter, which is a macrodrop set. C delivers 20 drops per milliliter, also a macrodrop set. D delivers 10 drops per milliliter, another macrodrop set. Therefore, the correct choice for a microdrop set is B.
2. A healthcare professional is reviewing a patient's arterial blood gas values. Which of the following conditions apply under the following values? pH- 7.49 Bicarbonate ion 24 mEq/dl PaCO2 - 31 mmHg PaO2 - 52 mmHg FiO2 - 0.22
- A. respiratory acidosis
- B. respiratory alkalosis
- C. metabolic acidosis
- D. metabolic alkalosis
Correct answer: B
Rationale: The given blood gas values indicate respiratory alkalosis. A high pH and low PaCO2 level are consistent with respiratory alkalosis. In this scenario, no compensation for the alkalosis is noted, ruling out metabolic acidosis or alkalosis. Metabolic conditions would usually involve changes in bicarbonate levels, which remain within the normal range in this case.
3. For which adverse effect of the block does the postpartum nurse monitor the woman after receiving a subarachnoid (spinal) block for a cesarean delivery?
- A. Headache
- B. Pruritus
- C. Vomiting
- D. Hypertension
Correct answer: A
Rationale: The correct answer is 'Headache.' Postdural headache is a common adverse effect associated with a subarachnoid block due to cerebrospinal fluid leakage at the site of dural puncture. This headache worsens when the woman is upright and may improve when she lies flat. To manage this headache, bed rest and adequate hydration are recommended. Pruritus, vomiting, and hypertension are not typically associated with subarachnoid blocks. Pruritus, nausea, and vomiting are more commonly linked to the use of intrathecal opioids.
4. Which of the following lab values would indicate symptomatic AIDS in the medical chart? (T4 cell count per deciliter)
- A. Greater than 1000 cells per deciliter
- B. Less than 500 cells per deciliter
- C. Greater than 2000 cells per deciliter
- D. Less than 200 cells per deciliter
Correct answer: D
Rationale: A T4 cell count of less than 200 cells per deciliter indicates symptomatic AIDS. This severe depletion of T4 cells signifies advanced HIV infection and a significantly compromised immune system. Choices A, B, and C are incorrect because T4 cell counts above 2000, above 1000, or below 500 cells per deciliter, respectively, are not indicative of symptomatic AIDS.
5. For a client with suspected appendicitis, in which quadrant should the nurse expect to find abdominal tenderness?
- A. upper right
- B. upper left
- C. lower right
- D. lower left
Correct answer: C
Rationale: The correct answer is C: lower right. Abdominal tenderness in the lower-right quadrant is a classic sign of appendicitis. The appendix is located in the lower right abdomen, so inflammation of the appendix typically causes tenderness in this specific area. Choices A, B, and D are incorrect because tenderness in the upper right, upper left, and lower left quadrants, respectively, is not typical in appendicitis cases. Therefore, the nurse should focus on assessing the lower right quadrant for tenderness when suspecting appendicitis.
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