NCLEX-PN
Kaplan NCLEX Question of The Day
1. Which hormone is responsible for amenorrhea in the pregnant woman?
- A. Progesterone
- B. Estrogen
- C. Follicle-stimulating hormone (FSH)
- D. Human chorionic gonadotropin (hCG)
Correct answer: Progesterone
Rationale: Correct! Progesterone is the hormone responsible for amenorrhea in pregnant women. Progesterone plays a crucial role in maintaining the uterine lining for implantation and supporting early pregnancy. High levels of progesterone during pregnancy suppress the normal menstrual cycle, leading to amenorrhea. Estrogen, FSH, and hCG do not directly cause amenorrhea in pregnant women. Estrogen is involved in the development of female secondary sexual characteristics, FSH is involved in the growth and maturation of ovarian follicles, and hCG is produced by the placenta to support the production of progesterone during pregnancy.
2. The charge nurse is observing a student nurse caring for a 4-month-old infant in isolation diagnosed with RSV. Which of the following would indicate to the charge nurse that the student nurse needs further instruction on isolation standards?
- A. Donning clean gloves each time she goes in the room.
- B. Wearing a clean mask each time she goes in the room.
- C. Labeling the door so staff will use Airborne Precautions.
- D. Wearing a gown when she goes in the room to administer medication.
Correct answer: A: Donning clean gloves each time she goes in the room.
Rationale: The correct answer is 'Donning clean gloves each time she goes in the room.' Sterile gloves are not necessary for standard isolation precautions; clean gloves are sufficient. The student nurse should be instructed to use clean gloves to reduce the risk of spreading infections. Wearing a clean mask each time she goes in the room is a good practice to prevent the spread of respiratory infections like RSV. Labeling the door for Airborne Precautions is appropriate for RSV. Wearing a gown when entering the room to administer medication helps prevent the transmission of infectious agents.
3. Elderly persons with pernicious anemia should be instructed:
- A. to increase their dietary intake of foods high in B12.
- B. that they do not need to return for follow-up for at least a month after initiation of treatment.
- C. that oral B12 is safer and less expensive than parenteral replacement.
- D. that diarrhea can be a transient side effect of B12 injections.
Correct answer: that diarrhea can be a transient side effect of B12 injections.
Rationale: Elderly persons with pernicious anemia, a condition characterized by vitamin B12 deficiency due to lack of intrinsic factor, should be informed about the potential side effects of B12 injections. Diarrhea is a known transient side effect of B12 injections, along with pain and burning at the injection site, and peripheral vascular thrombosis. Increasing dietary intake of B12-rich foods would not be sufficient due to the malabsorption issue in pernicious anemia. Follow-up is essential in managing pernicious anemia, so instructing patients they do not need to return for follow-up is incorrect. While oral B12 may be a suitable option for some cases, it is not the preferred choice for pernicious anemia where malabsorption is the primary issue.
4. The nurse observes a nursing assistant performing AM care for a client with a new leg cast. Which action by the assistant will the nurse intervene?
- A. Lifting the affected leg with the palms of the hands
- B. Covering the affected leg with a blanket to avoid chills
- C. Placing plastic over the groin prior to bathing
- D. Elevating the casted leg on two pillows
Correct answer: Covering the affected leg with a blanket to avoid chills
Rationale: The correct answer is to intervene when the assistant covers the affected leg with a blanket to avoid chills. A new cast should not be covered to allow the heat from the cast to evaporate, preventing complications. Lifting the affected leg with the palms of the hands is appropriate for proper handling. Placing plastic over the groin prior to bathing is a standard practice to protect the client's privacy and maintain hygiene. Elevating the casted leg on two pillows helps reduce swelling and promote circulation, making it a suitable action.
5. A central venous pressure reading of 11cm/H(2)O of an IV of normal saline is determined by the nurse caring for the patient. The patient has a diagnosis of pericarditis. Which of the following is the most applicable?
- A. The patient has a condition of hypovolemia.
- B. Not enough fluid has been given to the patient.
- C. Pericarditis may cause pressures greater than 10cm/H(2)O with testing of CVP.
- D. The patient may have a condition of arteriosclerosis.
Correct answer: Pericarditis may cause pressures greater than 10cm/H(2)O with testing of CVP.
Rationale: A central venous pressure reading above 10cm/H(2)O may indicate a condition of pericarditis, as the inflammation and fluid accumulation around the heart can lead to elevated pressures. Choices A, B, and D are incorrect. Hypovolemia would typically result in lower CVP readings, not higher. Not enough fluid given would also lead to lower CVP levels. Arteriosclerosis is not directly related to CVP readings in the context of pericarditis.
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