NCLEX Exam Practice Question of the Week - 11/30/11
Question: What will the nurse teach the client with diabetes regarding exercise in his or her treatment program?
1. During exercise the body will use carbohydrates for energy production, which in turn will decrease the need for insulin
2. With an increase in activity, the body will use more carbohydrates; therefore more insulin will be required
3. The increase in activity results in an increase in the use of insulin; therefore the client should decrease his or her carbohydrate intake
4. Exercise will improve pancreatic circulation and stimulate the islets of Langerhans to increase the production of intrinsic insulin
1. During exercise the body will use carbohydrates for energy production, which in turn will decrease the need for insulin
2. With an increase in activity, the body will use more carbohydrates; therefore more insulin will be required
3. The increase in activity results in an increase in the use of insulin; therefore the client should decrease his or her carbohydrate intake
4. Exercise will improve pancreatic circulation and stimulate the islets of Langerhans to increase the production of intrinsic insulin
Answer: 1
Rationale: As carbohydrates are used for energy, insulin needs decrease. Therefore during exercise, carbohydrate intake should be increased to cover the increased energy requirements. The beneficial effects of regular exercise may result in a decreased need for diabetic medications in order to reach target blood glucose levels. Furthermore, it may help to reduce triglycerides, LDL cholesterol levels, increase HDLs, reduce blood pressure, and improve circulation.
Rationale: As carbohydrates are used for energy, insulin needs decrease. Therefore during exercise, carbohydrate intake should be increased to cover the increased energy requirements. The beneficial effects of regular exercise may result in a decreased need for diabetic medications in order to reach target blood glucose levels. Furthermore, it may help to reduce triglycerides, LDL cholesterol levels, increase HDLs, reduce blood pressure, and improve circulation.
NCLEX Exam Practice Question of the Week - 12/7/11
Question: Which intervention is most appropriate for a client diagnosed with a schizoid personality disorder?
1. Assist the client to enter a group recreation activity.
2. Convince the client that the nursing staff is trying to be helpful.
3. Help the client learn to trust the staff through selected experiences.
4. Arrange the unit environment so that contact with other clients is limited.
1. Assist the client to enter a group recreation activity.
2. Convince the client that the nursing staff is trying to be helpful.
3. Help the client learn to trust the staff through selected experiences.
4. Arrange the unit environment so that contact with other clients is limited.
Answer: 3
Rationale: Demonstrating that the staff can be trusted is a vital initial step in the therapy for a client with a schizoid personality disorder. This is done slowly by exposing the client to experiences that demonstrate the staff’s consistent behavior. Assisting the client to enter a group recreation activity (1) may be attempted after trust is established. Convincing the client of the staff trying to be helpful (2) is less of a priority than gaining trust. Arranging the unit environment so that contact with other clients is limited (4) is an inappropriate action.
NCLEX Exam Practice Question of the Week - 12/14/11
Question: A nurse is assessing a 3-week-old infant admitted to the pediatric unit with hydrocephalus. What finding identifies a complication requiring immediate attention?
1. Tense anterior fontanel
2. Uncoordinated eye/muscle movement
3. Larger head circumference than chest circumference
4. Inability to support the head while in the prone position
1. Tense anterior fontanel
2. Uncoordinated eye/muscle movement
3. Larger head circumference than chest circumference
4. Inability to support the head while in the prone position
Answer:1
Rationale: A tense or bulging fontanel is indicative of increased intracranial pressure, which is caused by the fluid accumulation associated with hydrocephalus. Conjugate gaze does not occur until 3 to 4 months of age when eye muscles are mature. The head is the largest part of the body at this age; the head circumference should be about 1 inch larger than the chest. An infant cannot support the head before 1 to 1½ months of age.
Clinical Area: Child Health Nursing
Rationale: A tense or bulging fontanel is indicative of increased intracranial pressure, which is caused by the fluid accumulation associated with hydrocephalus. Conjugate gaze does not occur until 3 to 4 months of age when eye muscles are mature. The head is the largest part of the body at this age; the head circumference should be about 1 inch larger than the chest. An infant cannot support the head before 1 to 1½ months of age.
Clinical Area: Child Health Nursing
NCLEX Exam Practice Question of the Week - 12/21/11
Question: The mother of a 15-month-old child who is immunosuppressed asks about continuation of the childhood vaccines. Which immunizations are not recommended to be given to the child during immunosuppression?
1 Diphtheria, tetanus, and pertussis (DTaP); hepatitis B
2 Haemophilus influenzae B
3 Varicella; measles, mumps, and rubella (MMR)
4 Inactivated polio; diphtheria, tetanus, and pertussis (DTaP)
1 Diphtheria, tetanus, and pertussis (DTaP); hepatitis B
2 Haemophilus influenzae B
3 Varicella; measles, mumps, and rubella (MMR)
4 Inactivated polio; diphtheria, tetanus, and pertussis (DTaP)
Answer: 3
Rationale: Live viruses are usually not administered when a client is immunosuppressed. Frequently, measles-mumps-rubella vaccine and varicella vaccine are not given to the immunocompromised client; they may be administered when the client has a more competent immune system. Childhood vaccinations are encouraged when the client is not immunocompromised (in remission or not on immunosuppressant medications).
Rationale: Live viruses are usually not administered when a client is immunosuppressed. Frequently, measles-mumps-rubella vaccine and varicella vaccine are not given to the immunocompromised client; they may be administered when the client has a more competent immune system. Childhood vaccinations are encouraged when the client is not immunocompromised (in remission or not on immunosuppressant medications).
NCLEX Exam Practice Question of the Week - 12/28/11
Question: A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. The nurse would document the GTPAL for this client as:
1. G = 3, T = 2, P = 0, A = 0, L = 1
2. G = 2, T = 1, P = 0, A = 0, L = 1
3. G = 1, T = 1, P = 1, A = 0, L = 1
4. G = 2, T = 0, P = 0, A = 0, L = 1
1. G = 3, T = 2, P = 0, A = 0, L = 1
2. G = 2, T = 1, P = 0, A = 0, L = 1
3. G = 1, T = 1, P = 1, A = 0, L = 1
4. G = 2, T = 0, P = 0, A = 0, L = 1
Answer:2
Rationale: Pregnancy outcomes can be described with the acronym GTPAL. G is gravidity, the number of pregnancies; T is term births, the number born at term (longer than 37 weeks); P is preterm births, the number born before 37 weeks’ gestation; A is abortions or miscarriages, the number of abortions or miscarriages (included in gravida if before 20 weeks’ gestation; included in parity [number of births] if past 20 weeks’ gestation); and L is the number of current living children. A woman who is pregnant with twins and has a child has a gravida of 2. Because the child was delivered at 38 weeks, the number of term births is 1, and the number of preterm births is 0. The number of abortions is 0, and the number of living children is 1.
NCLEX Exam Practice Question of the Week - 1/4/12
Question: A male client with a fracture of the femur has his extremity in skeletal traction and is encouraged to use an overhead trapeze apparatus. What is the purpose of the overhead trapeze?
1. Assist with stump exercises
2. Enhance breathing and lung expansion
3. Promote circulation throughout the body
4. Facilitate independent movement while in bed
1. Assist with stump exercises
2. Enhance breathing and lung expansion
3. Promote circulation throughout the body
4. Facilitate independent movement while in bed
Answer: 4
Rationale: An overhead trapeze will facilitate independent movement in bed. It also maintains range of motion of the upper extremities and strengthens the biceps. Assisting with stump exercises (1), enhancing breathing and lung expansion (2), and promoting circulation throughout the body (3) are secondary benefits to using an overhead trapeze but are not the primary purpose.
Rationale: An overhead trapeze will facilitate independent movement in bed. It also maintains range of motion of the upper extremities and strengthens the biceps. Assisting with stump exercises (1), enhancing breathing and lung expansion (2), and promoting circulation throughout the body (3) are secondary benefits to using an overhead trapeze but are not the primary purpose.
NCLEX Exam Practice Question of the Week - 1/11/12
Question: At a client’s first visit to the prenatal clinic, the nurse asks the client when she had her last menstrual period so the estimated date of birth (EDB) can be determined. The client responds, “January 21.” Using Nägele’s rule, what is the month and day of the client’s EDB?
1. October 21
2. October 28
3. November 21
4. November 28
1. October 21
2. October 28
3. November 21
4. November 28
Answer: 2
Rationale: Nägele’s rule for determining the estimated date of birth (EDB) is to subtract 3 months from the first day of the last menstrual period and add 7 days and 1 year. According to Nägele’s rule, October 21 is too early and November 21 and 28 are too late.
NCLEX Exam Practice Question of the Week - 1/18/12
Question: A client is experiencing a sickle cell crisis during labor and delivery. What is the best nursing action?
1 Maintain IV fluid infusion and assess adequacy of hydration.
2 Administer a high concentration of oxygen.
3 Insert a Foley catheter and monitor hourly urine output.
4 Provide continuous sedation for pain relief.
1 Maintain IV fluid infusion and assess adequacy of hydration.
2 Administer a high concentration of oxygen.
3 Insert a Foley catheter and monitor hourly urine output.
4 Provide continuous sedation for pain relief.
Answer: 1
Rationale: Adequate hydration is critical during stress periods for the client with sickle cell disease, and this is particularly true of a client in labor. Oxygen may or may not be ordered in low concentrations. A urinary retention catheter is not necessary at this time and would be a potential cause of infection. Although pain relief is important for both the sickling issues and the labor pains, continuous sedation would not be indicated, as this would be detrimental to the fetus.
NCLEX Exam Practice Question of the Week - 1/25/12
Question: Tamoxifen (Nolvadex) is prescribed for the client with metastatic breast carcinoma. The nurse administering the medication understands that the primary action of this medication is to:
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.
4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.
4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Answer: 4
Rationale:Tamoxifen (Nolvadex) is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
Rationale:Tamoxifen (Nolvadex) is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
NCLEX Exam Practice Question of the Week - 2/1/12
Question:What is the primary concern of the nurse administering narcotics and sedatives to a client with cirrhosis?
1. The kidneys cannot excrete the drug.
2. The liver cannot metabolize drugs effectively.
3. Hepatic enzymes potentiate these drugs to high levels.
4. Narcotics and sedatives are contraindicated in clients with cirrhosis.
1. The kidneys cannot excrete the drug.
2. The liver cannot metabolize drugs effectively.
3. Hepatic enzymes potentiate these drugs to high levels.
4. Narcotics and sedatives are contraindicated in clients with cirrhosis.
Answer: 2
Rationale: Liver diseases, such as cirrhosis, impede the effective metabolism of drugs. Drug levels may even build to dangerous levels in the blood. Narcotics and sedatives are metabolized in the liver, not the kidneys (1). Hepatic enzymes do not potentiate these drugs to high levels (3). Answer option 4, although a true statement itself, is not the rationale for cautious administration of narcotics and sedatives in the cirrhosis client.
Rationale: Liver diseases, such as cirrhosis, impede the effective metabolism of drugs. Drug levels may even build to dangerous levels in the blood. Narcotics and sedatives are metabolized in the liver, not the kidneys (1). Hepatic enzymes do not potentiate these drugs to high levels (3). Answer option 4, although a true statement itself, is not the rationale for cautious administration of narcotics and sedatives in the cirrhosis client.
Source: http://elsevierstudentlife.tumblr.com/tagged/NCLEXQuestion/page/4
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