NCLEX NCLEX-PN
Kaplan NCLEX Question of The Day
1. The client with chronic pancreatitis should be taught how to monitor for which of the following possible additional problems associated with pancreatic disease?
- A. Hypertension
- B. Diabetes
- C. Hypothyroidism
- D. Graves' disease
Correct answer: Diabetes
Rationale: The correct answer is diabetes. In chronic pancreatitis, the pancreas may become unable to produce sufficient insulin, leading to diabetes. This connection underscores the importance of monitoring blood sugar levels and understanding the signs and symptoms of diabetes in clients with chronic pancreatitis. Choice A, hypertension, is not directly associated with pancreatic disease but rather with cardiovascular health. Choice C, hypothyroidism, and Choice D, Graves' disease, are unrelated to pancreatic disease and are endocrine disorders affecting the thyroid gland.
2. A female client complains to the nurse at the health department that she has fatigue, shortness of breath, and lightheadedness. Her history reveals no significant medical problems. She states that she is always on a fad diet without any vitamin supplements. Which tests should the nurse expect the client to have first?
- A. peptic ulcer studies
- B. complete blood count, including hematocrit and hemoglobin
- C. genetic testing
- D. hemoglobin electrophoresis
Correct answer: complete blood count, including hematocrit and hemoglobin
Rationale: The correct answer is to perform a complete blood count, including hematocrit and hemoglobin, as the initial tests to assess the client's symptoms related to fatigue, shortness of breath, and lightheadedness. These symptoms can be indicative of anemia, which can be caused by nutritional deficiencies due to fad dieting without vitamin supplements. Peptic ulcer studies, genetic testing, and hemoglobin electrophoresis are not the most appropriate initial tests for the client's presenting symptoms and history. Peptic ulcer studies are not relevant to the client's symptoms. Genetic testing is not indicated based on the client's presentation and history. Hemoglobin electrophoresis is used to diagnose specific types of anemia and is not the first-line test in this scenario. Further testing decisions should be based on the results of the initial tests, the client's history, and other relevant factors.
3. The nurse notes that a healthcare provider has documented the following prescription in a client’s record: Furosemide (Lasix) 40 mg stat once. What action should the nurse take?
- A. Administering the medication
- B. Drawing up the medication in a syringe
- C. Planning to have the nurse on the next shift administer the medication
- D. Contacting the healthcare provider
Correct answer: Contacting the healthcare provider
Rationale: The correct action for the nurse to take in this situation is to contact the healthcare provider. The prescription provided lacks crucial information such as the route of administration. Before administering any medication, the nurse must clarify any missing details with the provider, especially for a stat prescription that requires immediate administration. Drawing up or administering the medication without verifying the route of administration is unsafe and can lead to errors. Planning for the next shift nurse to administer the medication is not appropriate in this scenario as the stat order necessitates immediate action. Therefore, the best course of action is to contact the healthcare provider to obtain clarification on the prescription.
4. An advance directive is written and notarized according to law in the state of Colorado. This document is legal and binding:
- A. internationally.
- B. in the state of Colorado only.
- C. in the continental United States.
- D. in the county of origination only.
Correct answer: in the state of Colorado only.
Rationale: The correct answer is 'in the state of Colorado only.' Advance directive protocols and documents are specific to each state's laws and regulations. Choice A is incorrect as advance directives are not universally recognized internationally. Choice C is incorrect as the legal validity of an advance directive is limited to the state in which it was created. Choice D is incorrect as the legal reach of an advance directive typically extends throughout the state of origination, not just the county.
5. Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?
- A. open leg fracture
- B. open head injury
- C. stab wound to the chest
- D. traumatic amputation of a thumb
Correct answer: stab wound to the chest
Rationale: A stab wound to the chest might result in lung collapse and mediastinal shift that, if untreated, could lead to death. Treatment of an obstructed airway or a chest wound is a higher priority than hemorrhage. The principle of ABC (airway, breathing, and circulation) prioritizes care decisions. In this scenario, the stab wound to the chest poses the highest risk to the client's life as it can lead to severe complications such as lung collapse and mediastinal shift. Addressing this injury promptly is crucial to prevent further harm or potential fatality. Open leg fracture, open head injury, and traumatic amputation of a thumb, while serious, do not pose an immediate life-threatening risk compared to a stab wound to the chest.
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