NCLEX-PN
NCLEX PN 2023 Quizlet
1. The client seeks advice from the nurse regarding issues with flatus due to colostomy. Which food should the nurse recommend?
- A. High-fiber foods, such as bran.
- B. Cruciferous vegetables, such as cabbage, broccoli, and kale.
- C. Carbonated beverages.
- D. Yogurt.
Correct answer: D
Rationale: The correct answer is yogurt. Yogurt can help reduce gas formation in clients with a colostomy. High-fiber foods like bran can stimulate peristalsis and increase flatulence, which is not helpful in this situation. Cruciferous vegetables, such as cabbage, broccoli, and kale, and beans tend to increase gas formation. Carbonated beverages, along with smoking, chewing gum, and drinking fluids with a straw, can also increase gas formation. Therefore, the nurse should recommend yogurt to help alleviate the client's issues with flatus.
2. A 62-year-old female is being seen on a home visit by a nurse. The patient reports she has been taking Premarin for years. Which of the following would indicate an overdose?
- A. Lower extremity edema
- B. Sensory changes in the upper extremities
- C. Increased occurrence of fractures
- D. Decreased peripheral blood flow
Correct answer: A
Rationale: Lower extremity edema can indicate an overdose of Premarin. Premarin, an estrogen hormone replacement therapy, can cause fluid retention leading to edema in the lower extremities. Sensory changes in the upper extremities, increased occurrence of fractures, and decreased peripheral blood flow are not typically associated with an overdose of Premarin.
3. A patient has been diagnosed with Guillain-Barre Syndrome. Which of the following statements is the most applicable when discussing the impairments with Guillain-Barre Syndrome with the patient?
- A. Guillain-Barre Syndrome improves in almost all cases within 5 years.
- B. Guillain-Barre Syndrome causes limited sensation in the abdominal region.
- C. Guillain-Barre Syndrome causes muscle weakness in the legs.
- D. Guillain-Barre Syndrome affects breathing in severe cases.
Correct answer: C
Rationale: The correct statement is that Guillain-Barre Syndrome causes muscle weakness in the legs. This muscle weakness typically starts in the legs and can progress to the upper body. Choice A is incorrect as while most cases do improve, the recovery time can vary. Choice B is incorrect as Guillain-Barre Syndrome primarily affects muscle weakness rather than sensation. Choice D is incorrect as severe cases of Guillain-Barre Syndrome can lead to respiratory muscle weakness, impacting breathing.
4. A child with newly diagnosed leukemia is receiving chemotherapy. Which would be included in his plan of care by the nurse?
- A. Place the child in a negative pressure isolation room
- B. Administer prophylactic IV antibiotics
- C. Avoid high protein food intake
- D. Teach family and visitors handwashing techniques
Correct answer: D
Rationale: The correct answer is to teach family and visitors handwashing techniques. Any client on chemotherapy should have good infection control measures in place, such as handwashing by all who they encounter. Placing the child in a negative pressure isolation room (Choice A) is not necessary unless specifically indicated for a certain condition. Administering prophylactic IV antibiotics (Choice B) may not be part of the standard care plan for a child with leukemia receiving chemotherapy. Avoiding high protein food intake (Choice C) is not directly related to infection control and may not be necessary unless there are specific dietary restrictions.
5. A homeless person has been admitted to the medical unit and placed on airborne precautions for suspected active TB infection. The nurse will assess for these signs and symptoms (Select one that doesn't apply).
- A. Weight gain
- B. Fatigue
- C. Bloody sputum
- D. Diaphoresis during sleep
Correct answer: A
Rationale: The correct answer is 'Weight gain.' When assessing for signs and symptoms of active TB infection, weight loss is typically observed rather than weight gain. Other common signs and symptoms include fatigue, bloody sputum, and diaphoresis during sleep. Fatigue, bloody sputum, and diaphoresis during sleep are all associated with active TB infection. Weight gain is not typically seen in active TB; instead, patients usually experience weight loss due to the impact of the infection on their overall health.
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