the nurse is performing an assessment on a client with possible pernicious anemia which data would support this diagnosis
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PN Nclex Questions 2024

1. The client is being assessed for possible pernicious anemia. Which finding would support this diagnosis?

Correct answer: C

Rationale: The correct answer is a red, beefy tongue, which is characteristic of pernicious anemia due to the atrophy of the papillae on the tongue. This finding is known as glossitis. A red, beefy tongue is a classic sign of pernicious anemia. Choice A, weight loss of 10 pounds in 2 weeks, is non-specific and not a typical finding in pernicious anemia. Choice B, complaints of numbness and tingling in the extremities, are more indicative of peripheral neuropathy, a common symptom of vitamin B12 deficiency, which can be seen in pernicious anemia. Choice D, a hemoglobin level of 12.0 g/dL, falls within the normal range and does not specifically point towards pernicious anemia, which is characterized by low hemoglobin levels due to impaired absorption of vitamin B12.

2. Which of the following statements is correct regarding rape?

Correct answer: B

Rationale: The correct statement is that legally, a woman can be raped by her spouse. Rape is defined as sexual intercourse against someone's will, and it can occur between any two persons regardless of their relationship, including spouses. Choice A is incorrect as most rapes are not reported due to various reasons like fear, shame, or distrust in the legal system. Choice C is incorrect as prosecuting and convicting for rape can be challenging due to factors like lack of evidence, societal biases, and victim blaming. Choice D is incorrect as the most common location of rape is not necessarily the victim's own home; it can happen in various settings such as public places, workplaces, or social gatherings.

3. The licensed practical nurse is working with a registered nurse and a patient care assistant. Which of the following clients should be cared for by the registered nurse?

Correct answer: D

Rationale: The correct answer is a client 2 days post-thoracotomy because this client is the most critical and requires the expertise of a registered nurse. Clients A and B are stable and ready for discharge after their respective surgeries (appendectomy and thyroidectomy). Client C, who is 3 days post-splenectomy, is also stable enough to be cared for by a licensed practical nurse as they are in a stable condition and do not have immediate critical needs. Therefore, the registered nurse should care for the client 2 days post-thoracotomy due to the critical nature of the procedure and the immediate postoperative care required.

4. Which information should be reported to the state Board of Nursing?

Correct answer: B

Rationale: The correct answer is 'The narcotic count has been incorrect on the unit for the past 3 days.' This information should be reported to the state Board of Nursing as it involves medication errors and potential drug diversion, which are serious issues that fall under the jurisdiction of the Board. Reporting medication discrepancies and errors in narcotic counts is crucial for patient safety and regulatory compliance. Choices A, C, and D involve different types of issues that are not within the direct purview of the Board of Nursing. Providing literature in multiple languages (Choice A), addressing billing practices (Choice C), and resolving staff performance issues (Choice D) should be handled internally or reported to the appropriate departments or authorities, such as the Joint Commission or the charge nurse.

5. Which of the following clients should refrain from therapy with the thiazide diuretic hydrochlorothiazide?

Correct answer: C

Rationale: The correct answer is a client with diabetes mellitus, type II. Thiazide diuretics like hydrochlorothiazide can cause metabolic abnormalities, including elevated blood glucose levels. This increase is linked to diuretic-induced potassium deficiency, which reduces insulin secretion, leading to higher plasma glucose levels. Thiazides are commonly used in clients with renal impairment and hypertension. Moreover, thiazides decrease calcium excretion, reducing the risk of renal calculi, so it is not contraindicated for clients with kidney stones. Therefore, clients with diabetes mellitus, type II should avoid therapy with hydrochlorothiazide due to the potential adverse effects on blood glucose levels.

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