NCLEX PN 2023 Quizlet

NCLEX PN 2023 Quizlet Related

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A client was involved in a motor vehicle accident in which the seat belt was not worn. The client is exhibiting crepitus, decreased breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34/min. Which of the following assessment findings should concern the nurse the most?

  • A. temperature of 102°F and a productive cough
  • B. arterial blood gases (ABGs) with a PaO2 of 92 mmHg and PaCO2 of 40 mmHg
  • C. trachea deviating to the right
  • D. barrel-chested appearance
Correct Answer: C

Rationale: The correct answer is 'trachea deviating to the right.' A mediastinal shift is indicative of a tension pneumothorax, which is a dangerous complication seen in trauma patients with symptoms like crepitus, decreased breath sounds, shortness of breath, and tachypnea. Assessing for acute traumatic injuries is crucial in this context. Choice A, a temperature of 102°F and a productive cough, is common in pneumonia cases and not as concerning as a mediastinal shift. Choice B, ABGs with a PaO2 of 92 mmHg and PaCO2 of 40 mmHg, shows values within normal limits and does not suggest a tension pneumothorax. Choice D, a barrel-chested appearance, is typical of COPD and not directly related to the acute traumatic injury described. A tension pneumothorax is a medical emergency where air cannot escape the pleural cavity, leading to lung collapse and a mediastinal shift to the unaffected side with a downward displacement of the diaphragm.

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When discussing possible complications of pregnancy with a client, the nurse should explain that all of the following are symptoms of urinary tract infection (UTI). Which of the following is least indicative of UTI during pregnancy?

  • A. low back pain
  • B. urinary frequency
  • C. GI distress
  • D. malaise
Correct Answer: B

Rationale: Urinary frequency is least indicative of UTI during pregnancy. It is a common minor discomfort of pregnancy caused by pressure of the growing uterus on the bladder. As the uterus rises in the second trimester, there are usually no problems. Frequency may return in the third trimester when the uterus drops into the pelvic cavity. UTI symptoms include low back pain, suprapubic discomfort, and malaise, and are confirmed by laboratory findings. Low back pain, GI distress, and malaise are more closely associated with UTI during pregnancy compared to urinary frequency.

Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?

  • A. metoclopramide (Reglan)
  • B. ondansetron (Zofran)
  • C. hydroxyzine (Vistaril)
  • D. prochlorperazine (Compazine)
Correct Answer: B

Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. Ondansetron (Zofran) works by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract. This action helps reduce nausea and vomiting. Metoclopramide (Reglan) works as a dopamine antagonist and also has prokinetic effects, making it effective for different conditions. Hydroxyzine (Vistaril) is an antihistamine with antiemetic properties, but it does not act as a serotonin antagonist. Prochlorperazine (Compazine) is a dopamine antagonist that is also used to treat nausea and vomiting, but not as a serotonin antagonist like ondansetron.

A high school nurse observes a 14-year-old female rubbing her scalp excessively in the gym. What is the most appropriate course of action for the nurse?

  • A. Request the female’s parents for a private evaluation of her scalp
  • B. Contact the female’s parents regarding the observations
  • C. Observe the hairline and scalp for possible signs of lice
  • D. Inform the student’s physician about the situation
Correct Answer: C

Rationale: The most appropriate course of action for the nurse is to observe the hairline and scalp for possible signs of lice. The student's behavior of excessively rubbing her scalp raises concerns about a potential infestation, making it necessary to look for signs firsthand. Contacting the parents or the physician should be considered after observing for signs of lice to provide more information and take appropriate action. Requesting a private evaluation from the parents may not be required initially, as lice infestation is a common concern among children and observing for signs is the immediate step to address the situation.

A client with urinary tract calculi needs to avoid which of the following foods?

  • A. lettuce
  • B. cheese
  • C. apples
  • D. broccoli
Correct Answer: B

Rationale: A client with urinary tract calculi needs to avoid foods high in calcium to prevent the formation of more stones. Cheese is high in calcium, so it should be avoided. Lettuce, apples, and broccoli are not typically associated with high calcium content and are safe options for individuals with urinary tract calculi. Therefore, the correct answer is cheese. Choices A, C, and D are not high in calcium and are safe for consumption by individuals with urinary tract calculi.

When treating anemia in clients with renal failure, erythropoietin should be given in conjunction with:

  • A. iron, folic acid, and B12.
  • B. an increase in protein in the diet.
  • C. vitamins A and C.
  • D. an increase in calcium in the diet.
Correct Answer: A

Rationale: Erythropoietin is used to stimulate red blood cell production in clients with renal failure. To effectively increase red blood cell production, adequate levels of iron, folic acid, and B12 are necessary. These nutrients play crucial roles in erythropoiesis. Choices B, an increase in protein in the diet, is not directly related to enhanced erythropoiesis and can potentially worsen uremia. Choices C and D, vitamins A and C, and an increase in calcium in the diet, are not directly involved in red blood cell production and are not essential in this context.

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