NCLEX-PN
NCLEX PN Exam Cram
1. When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize:
- A. When started, therapy must not be interrupted to prevent viral resistance.
- B. When started, therapy must not be interrupted to prevent opportunistic infection.
- C. Therapy should not be interrupted for one day each month to prevent toxicity.
- D. Therapy should not be interrupted for one week every three months to prevent toxicity.
Correct answer: A
Rationale: When teaching a client about anti-retroviral therapy for HIV, it is crucial to emphasize that therapy must not be interrupted to prevent viral resistance. HIV mutates rapidly, and any interruption can lead to the emergence of resistant strains, compromising treatment effectiveness. Choice B is incorrect because keeping the virus in check with anti-retrovirals helps the client's immune system fight off opportunistic infections. Choices C and D are incorrect because therapy should not be interrupted for any reason. If toxicity occurs, the healthcare provider may adjust the treatment regimen by prescribing alternative anti-retroviral drugs.
2. Which of the following food selections would need to be removed from a tray for a client recovering from thyroidectomy?
- A. Fresh apple
- B. V8 juice
- C. Mustard greens
- D. Ice cream
Correct answer: A
Rationale: The correct answer is a fresh apple. After a thyroidectomy, it is important to avoid hard and crunchy foods like apples due to the proximity of the esophagus to the surgical site. Apples can be difficult to chew and swallow, posing a risk of injury or discomfort to the patient. V8 juice, mustard greens, and ice cream are softer options that would be more suitable for a client recovering from thyroidectomy.
3. A client is going to have an endoscopy performed. Which of the following is not a probable reason for an endoscopy procedure?
- A. Aspiration noted on a honey-thick diet
- B. Pain felt during a bowel movement
- C. Pain felt in the left upper quadrant
- D. Right shoulder pain
Correct answer: B
Rationale: The correct answer is 'Pain felt during a bowel movement.' Endoscopy is used to examine the upper gastrointestinal tract, which includes the esophagus, stomach, and duodenum. Pain during a bowel movement would suggest an issue in the lower gastrointestinal tract, which is typically examined with a colonoscopy. Choices A, C, and D are not probable reasons for an endoscopy procedure as they relate to symptoms in the upper gastrointestinal tract or are not specific to gastrointestinal issues. Aspiration noted on a honey-thick diet could indicate a risk of aspiration pneumonia related to swallowing difficulties, which can be assessed through an endoscopy. Pain felt in the left upper quadrant may be related to conditions like gastritis or peptic ulcers that can be investigated using an endoscopy. Right shoulder pain can be a referred pain from conditions like gallbladder disease that can also be evaluated with an endoscopy.
4. Which of the following procedures describes an opening between the colon and abdominal wall?
- A. ileostomy
- B. jejunostomy
- C. colostomy
- D. cecostomy
Correct answer: C
Rationale: A colostomy is an opening between the colon and abdominal wall. An ileostomy is an opening between the ileum and abdominal wall, not the colon. Jejunostomy is an opening between the jejunum and abdominal wall, and cecostomy is an opening into the cecum. The term 'colostomy' specifically refers to the surgical procedure where a part of the colon is brought through the abdominal wall to create a stoma, allowing feces to leave the body. Therefore, the correct answer is colostomy as it accurately describes the opening between the colon and the abdominal wall, distinct from the other options.
5. Which type of exercises might be prescribed to strengthen the pelvic floor muscles of a client with urinary incontinence?
- A. Kegel
- B. resistance
- C. passive
- D. stretching
Correct answer: A
Rationale: The correct answer is Kegel. Kegel exercises are specifically designed to strengthen the pelvic floor muscles, making them an effective treatment for urinary incontinence. These exercises involve contracting and relaxing the pelvic floor muscles, which helps to improve muscle tone and control. Choice B, resistance exercises, may not directly target the pelvic floor muscles as effectively as Kegel exercises. Passive exercises (Choice C) do not actively engage the muscles and are unlikely to strengthen the pelvic floor. Stretching exercises (Choice D) focus on increasing flexibility rather than muscle strength, so they are not the most appropriate for strengthening the pelvic floor muscles in the context of urinary incontinence.
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