Kaplan NCLEX Question of The Day

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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.

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Which medication should the nurse withhold if the client's blood pressure is 88/50?

  • A. Rosuvastatin (Crestor)
  • B. Enalapril (Vasotec)
  • C. Digoxin (Lanoxin)
  • D. Clopidogrel (Plavix)
Correct Answer: B

Rationale: Enalapril (Vasotec) is the correct answer. It is an angiotensin-converting enzyme (ACE) inhibitor that can further lower blood pressure. Given that the client's blood pressure is already low at 88/50, administering Enalapril could exacerbate hypotension and compromise perfusion to vital organs. Rosuvastatin (Crestor), Digoxin (Lanoxin), and Clopidogrel (Plavix) are not contraindicated in the context of low blood pressure and may be administered safely.

The client is undergoing progressive ambulation on the third day after a myocardial infarction. Which clinical manifestation would indicate that the client should not be advanced to the next level?

  • A. Facial flushing
  • B. A complaint of chest heaviness
  • C. Heart rate increase of 10 beats/min
  • D. Systolic blood pressure increase of 10 mm Hg
Correct Answer: B

Rationale: The correct answer is a complaint of chest heaviness. Onset of chest pain indicates myocardial ischemia, which can be life-threatening. Chest pain in a client post-myocardial infarction should be promptly evaluated, and the activity level should not be advanced. Choices A, C, and D are not the best options because facial flushing, a heart rate increase of 10 beats/min, and a systolic blood pressure increase of 10 mm Hg are not typical indicators of myocardial ischemia or necessarily contraindications for advancing activity levels in this context.

After applying oxygen using bi-nasal prongs to a client who is having chest pain, the nurse should implement which intervention?

  • A. Have the client take slow deep breaths in through their mouth and out through their nose.
  • B. Post signs indicating that oxygen is in use on the client's door and in their room
  • C. Apply Vaseline petroleum to both nares and 2 by 2 gauze around the oxygen tubing at the client's ears
  • D. Encourage the client to hyperextend the neck, take a few deep breaths and cough.
Correct Answer: A

Rationale: After applying oxygen using bi-nasal prongs to a client with chest pain, it is essential for the nurse to post signs indicating that oxygen is in use on the client's door and in their room. This safety precaution alerts healthcare providers and visitors that the client is receiving oxygen therapy, reducing the risk of accidents or misunderstandings. Choice A is incorrect because instructing the client to take slow deep breaths is not the appropriate intervention after applying oxygen. Choice C suggests applying Vaseline and gauze, which is unnecessary and not a standard practice. Choice D advising the client to hyperextend the neck, take deep breaths, and cough is not indicated after applying oxygen therapy and could potentially be harmful.

What is the preferred position for a client post liver biopsy procedure?

  • A. Fowler's
  • B. Right side
  • C. Left side
  • D. Prone
Correct Answer: B

Rationale: The correct position for a client post liver biopsy procedure is the right side. Placing the client on the right side helps apply pressure to the liver area, which can help in holding pressure and stopping bleeding. Placing the client on the left side may not be as effective in providing direct pressure on the liver. The prone position is also not ideal for post-liver biopsy care as it does not target the liver area directly. Fowler's position, a semi-sitting position, is not typically recommended post liver biopsy as it does not provide the necessary pressure on the liver site.

The nurse is caring for a client with full-thickness burns to the left arm and trunk. What is the priority for this client?

  • A. Pain management
  • B. Airway assessment
  • C. Fluid volume status monitoring
  • D. Risk for infection prevention
Correct Answer: C

Rationale: Correct! With full-thickness burns, there is a significant risk of fluid loss through the burn wound and fluid shift, leading to hypovolemia and shock. Monitoring and maintaining the client's fluid volume status is crucial to prevent complications like hypovolemic shock. Pain management (Option A) is essential but not the priority in this situation. While airway assessment (Option B) is crucial, it is typically assessed first in clients with respiratory distress. Preventing infection (Option D) is important but managing fluid volume status takes precedence in the initial care of a client with full-thickness burns.

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