NCLEX NCLEX-PN
Health Promotion and Maintenance NCLEX PN Questions
1. Which reported symptom(s) would indicate a client with Addison’s disease has received too much fludrocortisone (Florinef) replacement?
- A. Oily skin and hair
- B. Weight gain of 6 pounds in one week
- C. Loss of muscle mass in arms and legs
- D. Increased blood glucose level
Correct answer: Weight gain of 6 pounds in one week
Rationale: Fludrocortisone replacement in Addison's disease involves mimicking the action of aldosterone, a mineralocorticoid that causes the retention of sodium and water. Excessive retention of sodium and water can lead to weight gain. Therefore, a sudden increase in weight, especially a significant amount like 6 pounds in one week, can indicate an overdose of fludrocortisone. Choices A, C, and D are incorrect because oily skin and hair, loss of muscle mass, and increased blood glucose levels are not typically associated with excessive fludrocortisone replacement.
2. An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct answer: an adverse effect
Rationale: An allergic reaction is classified as an adverse effect because it is an unintended response to a medication that requires treatment. A side effect is an undesired but somewhat expected reaction to a drug that does not necessarily need intervention. Incompatibility refers to an unsuitable combination of substances that leads to an adverse effect. A therapeutic effect is the desired and intended outcome of a medication.
3. What dietary alterations should a pregnant client with congenital heart disease expect?
- A. reduced calories and reduced fat
- B. caffeine and sodium restrictions
- C. decreased protein and increased complex carbohydrates
- D. fluid restriction and reduced calories
Correct answer: caffeine and sodium restrictions
Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.
4. A client with sleep apnea has been ordered a CPAP machine. Which action could the RN delegate to a nursing assistant?
- A. Reminding the client to apply the CPAP at bedtime
- B. Obtaining every three-hour oxygen saturation levels
- C. Teaching the client how to turn on the CPAP machine
- D. Assessing for fatigue or depression caused by poor sleep
Correct answer: Reminding the client to apply the CPAP at bedtime
Rationale: The correct answer is reminding the client to apply the CPAP at bedtime. This task can be safely delegated to a nursing assistant as it involves a simple and routine reminder. Option B, obtaining oxygen saturation levels, requires a higher level of training and interpretation of results, making it more appropriate for an RN. Option C, teaching the client how to turn on the CPAP machine, involves educating the client and ensuring proper use of medical equipment, which is within the RN's scope of practice. Option D, assessing for fatigue or depression, requires a comprehensive evaluation that involves interpreting symptoms and identifying underlying causes, making it more suitable for an RN to address.
5. Support-system enhancement includes all of the following except:
- A. determining the barriers to using support systems.
- B. discussing ways to help others who are concerned.
- C. exploring life problems of the support-team members.
- D. involving spouse, family, and friends in the care and planning.
Correct answer: C: exploring life problems of the support-team members.
Rationale: Support-system enhancement involves various strategies to strengthen the support system. Determining the barriers to using support systems, discussing ways to help others who are concerned, and involving spouse, family, and friends in the care and planning are all essential aspects of enhancing the support system. However, exploring the life problems of the support-team members is not directly related to enhancing the support system. This approach could potentially invade personal boundaries and may not be necessary for improving the support system, making it the correct answer in this case. Therefore, option C is the correct answer as it does not align with the appropriate methods of support-system enhancement.
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