NCLEX-PN
NCLEX PN Exam Cram
1. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?
- A. "This diet can be used when there is close medical supervision."?
- B. "This is a long-term treatment measure that assists obese people who can't lose weight."?
- C. "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."?
- D. "A VLCD contains very little protein."?
Correct answer: A
Rationale: The correct answer is, "This diet can be used when there is close medical supervision."? Very low-calorie diets (VLCDs) are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis. Choice B is incorrect because VLCDs are typically short-term interventions. Choice C is incorrect because VLCDs usually consist of nutritionally complete liquid formulations, not solid food items that are pureed. Choice D is incorrect because VLCDs actually contain a high quality of protein, although the overall caloric content is very low.
2. Which type of hepatitis is transmitted via the fecal-oral route?
- A. Hepatitis A
- B. Hepatitis B
- C. Hepatitis C
- D. Hepatitis D
Correct answer: A
Rationale: Hepatitis A is the correct answer because it is transmitted via the fecal-oral route, often through contaminated food or water. Hepatitis B is transmitted through exposure to infectious blood, semen, and other body fluids, not through the fecal-oral route. Hepatitis C is transmitted through blood-to-blood contact, not via the fecal-oral route. Hepatitis D occurs only in individuals infected with Hepatitis B. Therefore, the correct choice for the type of hepatitis transmitted via the fecal-oral route is Hepatitis A.
3. A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with an overdose?
- A. Memory loss and lack of appetite
- B. Confusion and fatigue
- C. Heightened reflexes
- D. Tinnitus and spasticity
Correct answer: B
Rationale: The correct answer is 'Confusion and fatigue.' Lidocaine Hydrochloride, when taken in excess, can lead to symptoms such as confusion and fatigue. It affects the central nervous system, leading to these cognitive and physical impairments. Choice A ('Memory loss and lack of appetite') is incorrect because memory loss is not a common symptom of Lidocaine Hydrochloride overdose, and lack of appetite is not a typical effect. Choice C ('Heightened reflexes') is incorrect as Lidocaine Hydrochloride overdose usually depresses reflexes rather than heightening them. Choice D ('Tinnitus and spasticity') is incorrect as tinnitus and spasticity are not commonly associated with Lidocaine Hydrochloride overdose.
4. When teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?
- A. Use a soft toothbrush.
- B. Use dental floss daily.
- C. Hold pressure on any scrapes for 1-2 minutes.
- D. Use a triple-edged razor.
Correct answer: A
Rationale: The correct answer is to 'Use a soft toothbrush.' A soft toothbrush is recommended because it is less likely to cause the gums to bleed in clients with leukemia, who are at risk of bleeding due to overcrowding of white cells at the expense of other cell types like platelets. Choice B, 'Use dental floss daily,' is incorrect because dental floss is contraindicated and can make the gums bleed in clients with leukemia. Choice C, 'Hold pressure on any scrapes for 1-2 minutes,' is incorrect because when clotting is impaired, pressure should be held for 5-10 minutes or longer until the bleeding stops. Choice D, 'Use a triple-edged razor,' is incorrect because an electric razor should be used instead of a triple-edged razor to prevent small cuts and bleeding in clients with leukemia.
5. A client comes to the clinic for assessment of his physical status and guidelines for starting a weight-reduction diet. The client's weight is 216 pounds and his height is 66 inches. The nurse identifies the BMI (body mass index) as:
- A. within normal limits, so a weight-reduction diet is unnecessary
- B. lower than normal, so education about nutrient-dense foods is needed
- C. indicating obesity because the BMI is 35
- D. indicating overweight status because the BMI is 27
Correct answer: C
Rationale: Obesity is defined by a BMI of 30 or more with no co-morbid conditions. It is calculated by utilizing a chart or nomogram that plots height and weight. This client's BMI is 35, indicating obesity. Choices A, B, and D are incorrect because the client's BMI is above 30, which falls under the obesity category. Therefore, a weight-reduction diet and increased physical activity are necessary to address the client's weight status and promote overall health.
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