NCLEX NCLEX-PN
2024 PN NCLEX Questions
1. When preparing a client for surgery, the graduate nurse realizes the operative permit has not been signed. The client tells the nurse he understands the procedure but received his preoperative medication approximately 10 minutes prior. The appropriate action would be:
- A. Have the client sign the permit, as he verbalizes understanding.
- B. Witness the form after having the client sign it.
- C. Have his wife sign the form as she witnessed him saying he wants the surgery.
- D. Call the surgical area and explain the surgery will have to be cancelled.
Correct answer: Call the surgical area and explain the surgery will have to be cancelled.
Rationale: The correct action in this scenario is to call the surgical area and explain that the surgery will have to be cancelled. The client must sign the operative permit or any other legal document before receiving preoperative medication. Without the signed permit, the surgery cannot proceed to ensure the client's safety and legal compliance. Having the client sign the permit, witnessing the form after the client signs it, or having someone else sign the form are all inappropriate actions and do not address the legal requirement of the client's signature before receiving preoperative medication.
2. Which condition is associated with inadequate intake of vitamin C?
- A. rickets
- B. marasmus
- C. kwashiorkor
- D. scurvy
Correct answer: scurvy
Rationale: Scurvy is indeed associated with inadequate intake of vitamin C. Vitamin C deficiency leads to scurvy, which is characterized by weakness, anemia, gum disease, and skin hemorrhages. Choices A, B, and C are incorrect because rickets is caused by vitamin D deficiency, marasmus is due to severe malnutrition leading to wasting, and kwashiorkor is a form of severe protein-energy malnutrition.
3. Which of the following is an inappropriate item to include in planning care for a severely neutropenic client?
- A. Transfuse neutrophils (granulocytes) to prevent infection.
- B. Exclude raw vegetables from the diet.
- C. Avoid administering rectal suppositories.
- D. Prohibit vases of fresh flowers and plants in the client’s room.
Correct answer: Transfuse neutrophils (granulocytes) to prevent infection.
Rationale: The correct answer is to transfuse neutrophils (granulocytes) to prevent infection. Granulocyte transfusion is not routinely indicated to prevent infection in neutropenic clients. While neutrophils are essential in fighting infections and are beneficial in selected populations of infected, severely granulocytopenic clients who do not respond to antibiotics and are expected to experience prolonged suppression of granulocyte production, routine granulocyte transfusion is not recommended. Choices B, C, and D are appropriate interventions for a severely neutropenic client. Prohibiting fresh flowers and plants helps reduce the risk of exposure to environmental pathogens. Avoiding rectal suppositories minimizes the risk of introducing harmful bacteria. Excluding raw vegetables from the diet reduces the likelihood of foodborne infections.
4. After undergoing gastric resection, the client is informed by the nurse that which of the following meals is most likely to cause rapid emptying of the stomach?
- A. a high-protein meal
- B. a high-fat meal
- C. a large meal regardless of nutrient content
- D. a high-carbohydrate meal
Correct answer: a high-carbohydrate meal
Rationale: After gastric resection, meals high in carbohydrates are more likely to cause rapid emptying of the stomach. Carbohydrates stimulate the release of gastrin, which accelerates gastric emptying. On the other hand, high-fat and high-protein meals tend to delay gastric emptying. A large meal, regardless of nutrient content, can also delay gastric emptying due to the increased volume of food that needs to be processed.
5. The LPN is preparing a client for discharge, and the discharge medications include phenobarbital. Which of these client statements would indicate a need for reinforced teaching about this medication?
- A. “I will need to avoid eating excessive leafy greens.”
- B. “It’s best to take this medication with food.”
- C. “I can’t wait to get back to my nightly glass of wine.”
- D. “I should try to take this medication at the same time every day.”
Correct answer: “I can’t wait to get back to my nightly glass of wine.”
Rationale: The correct answer is, “I can’t wait to get back to my nightly glass of wine,” as phenobarbital should not be taken with alcohol as it is a barbiturate. Alcohol may increase the sedative effect, posing risks to the patient's safety. Choice A, “I will need to avoid eating excessive leafy greens,” is unrelated to phenobarbital and not a cause for reinforced teaching. Choice B, “It’s best to take this medication with food,” is a general instruction and not specific to phenobarbital. Choice D, “I should try to take this medication at the same time every day,” is a common recommendation for medication adherence but does not highlight a specific concern related to phenobarbital.
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