NCLEX-RN
NCLEX RN Practice Questions Exam Cram
1. The nurse is caring for a 2-year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
- A. Neurotoxicity
- B. Hepatomegaly
- C. Nephrotoxicity
- D. Ototoxicity
Correct answer: C
Rationale: The correct answer is nephrotoxicity. Calcium disodium edetate, used in chelation therapy for lead poisoning, can lead to kidney toxicity. This is an important side effect to monitor in patients undergoing this treatment. Choices A, B, and D are incorrect. Neurotoxicity, hepatomegaly, and ototoxicity are not typically associated with calcium disodium edetate therapy for lead poisoning.
2. Which of the following factors may alter the level of consciousness in a patient?
- A. Alcohol
- B. Electrolytes
- C. Infection
- D. All of the above may cause altered level of consciousness
Correct answer: D
Rationale: Various factors can lead to altered levels of consciousness in a patient. Alcohol consumption can depress the central nervous system and cause changes in consciousness. Electrolyte imbalances, such as hyponatremia or hypernatremia, can disrupt brain function and affect consciousness. Infections, especially those affecting the brain like encephalitis, can also lead to alterations in consciousness. Therefore, all of the choices provided - Alcohol, Electrolytes, and Infection - can potentially cause changes in the level of consciousness. Remember the acronym AEIOU-TIPPS to recall common causes of decreased level of consciousness, including Alcohol, Electrolytes, and Infection, among others.
3. After repair of an inguinal hernia, the infant is being cared for. Which assessment finding indicates that the surgical repair was effective?
- A. A clean, dry incision
- B. Abdominal distension
- C. An adequate flow of urine
- D. Absence of inguinal swelling with crying
Correct answer: D
Rationale: The absence of inguinal swelling when the infant cries or strains indicates that the surgical repair of the inguinal hernia was effective. Inguinal swelling typically occurs with crying or straining in cases of this condition. A clean, dry incision signifies the absence of wound infection post-surgery but does not directly indicate the effectiveness of the hernia repair. Abdominal distension suggests a gastrointestinal issue unrelated to the hernia repair. An adequate flow of urine is not specific to evaluating the success of inguinal hernia repair.
4. A pregnant woman who is 36 weeks' pregnant and has hepatitis B is being informed by a nurse. Which of the following statements from the client indicates understanding of this condition?
- A. Now I know my baby will need a cesarean section.
- B. My baby will need two shots soon after birth.
- C. I will not be able to breastfeed.
- D. My baby's father does not need testing; I know I am the one with hepatitis.
Correct answer: B
Rationale: The correct answer is 'My baby will need two shots soon after birth.' A baby born to a mother with hepatitis B should receive two injections soon after birth to reduce the risk of contracting the disease. Within the first 12 hours post-birth, the baby should receive the first hepatitis B vaccine and hepatitis B immune globulin (HBIG) for additional protection. Option A is incorrect because the need for a cesarean section is not directly related to the mother's hepatitis B status. Option C is incorrect as breastfeeding can be safe if managed properly. Option D is incorrect as the baby's father should also be tested for hepatitis B to prevent transmission to the newborn.
5. Using the illustrated technique, the healthcare provider is assessing for which finding in a patient with chronic obstructive pulmonary disease (COPD)?
- A. Hyperresonance
- B. Tripod positioning
- C. Accessory muscle use
- D. Reduced chest expansion
Correct answer: D
Rationale: The technique for palpation for chest expansion is shown in the illustrated technique. Reduced chest expansion would be noted on palpation of a patient's chest with COPD. Hyperresonance would be assessed through percussion, not palpation. Accessory muscle use and tripod positioning would be assessed by inspection, not palpation.
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