NCLEX NCLEX-PN
NCLEX PN Exam Cram
1. The factor that most determines drug distribution is:
- A. vascular perfusion of the tissue or organ.
- B. salt form.
- C. drug interactions.
- D. steady state.
Correct answer: vascular perfusion of the tissue or organ.
Rationale: The correct answer is 'vascular perfusion of the tissue or organ.' Drug distribution is primarily determined by how well the circulatory system delivers the drug to various tissues and organs. Adequate perfusion ensures proper distribution of the drug throughout the body. While the salt form (choice B), drug interactions (choice C), and steady state (choice D) can influence drug efficacy and metabolism, they are not as crucial as vascular perfusion for the initial distribution of a drug.
2. During a routine health screening for a 1-year-old child, what is the most critical topic for the nurse to discuss with the parents?
- A. the potential hazards of accidents
- B. appropriate nutrition now that the child has been weaned from breastfeeding
- C. toilet training
- D. how to purchase appropriate shoes now that the child is walking
Correct answer: the potential hazards of accidents
Rationale: During a routine health screening for a 1-year-old child, the most critical topic for the nurse to discuss with the parents is the potential hazards of accidents. Accidents are the primary source of injury in children and can be life-threatening. Discussions about appropriate nutrition should have been addressed during the weaning process, while the purchase of appropriate shoes is important but not life-threatening. Toilet training typically begins around 2 years of age, so 1 year of age is too early to discuss it. Therefore, the focus should be on educating parents about accident prevention to ensure the child's safety and well-being.
3. Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?
- A. metastatic liver cancer
- B. gram-negative septicemia
- C. pernicious anemia
- D. iron-deficiency anemia
Correct answer: pernicious anemia
Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding compared to the other conditions listed. Pernicious anemia is a condition resulting from vitamin B12 deficiency due to the absence of intrinsic factor, necessary for B12 absorption. While pernicious anemia can lead to neurological issues, it is not directly linked to an increased risk of bleeding. Metastatic liver cancer can cause liver dysfunction leading to coagulopathy, gram-negative septicemia can result in disseminated intravascular coagulation (DIC), and iron-deficiency anemia can lead to microcytic hypochromic red blood cells, increasing the risk of bleeding. Therefore, pernicious anemia is the least likely to be associated with an increased potential for bleeding out of the options provided.
4. When choosing a needle gauge for an intramuscular injection in a 12-year-old boy, which of the following gauges would you choose?
- A. 27 gauge
- B. 25 gauge
- C. 22 gauge
- D. 20 gauge
Correct answer: 22 gauge
Rationale: The correct answer is 22 gauge. A 22-gauge needle is recommended for school-age children, toddlers, and adolescents due to their muscle mass and tolerance. In infants, a smaller gauge (23-25) is preferred as their muscles are less developed and more sensitive. Choice A, 27 gauge, is too thin for an intramuscular injection in a 12-year-old boy. Choice B, 25 gauge, is more suitable for infants than for a 12-year-old. Choice D, 20 gauge, is too thick and not typically used for intramuscular injections in children.
5. How can the nurse best communicate to a client that he or she has been listening?
- A. restating the main feeling or thought the client has expressed
- B. making a judgment about the client’s problem
- C. offering a leading question such as, 'And then what happened?'
- D. saying, 'I understand what you’re saying.'
Correct answer: restating the main feeling or thought the client has expressed
Rationale: The best way for the nurse to communicate to a client that he or she has been listening is by restating the main feeling or thought the client has expressed. Restating helps the client validate the nurse’s understanding of the communication, demonstrating active listening skills. Making judgments about the client's problem, as suggested in Choice B, can hinder effective communication by introducing bias and potential misinterpretation. Offering a leading question like in Choice C is not ideal for confirming understanding; it rather seeks more information. Choice D, simply saying 'I understand what you’re saying,' may not convey active listening as effectively as restating the client's main feelings or thoughts, as it lacks the validation component present in restating.
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