NCLEX-PN Quizlet 2023

NCLEX-PN Quizlet 2023 Related

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A month after receiving a blood transfusion, an immunocompromised client develops fever, liver abnormalities, a rash, and diarrhea. The nurse should suspect this client has:

  • A. no relation to the blood transfusion.
  • B. graft-versus-host disease (GVHD).
  • C. myelosuppression.
  • D. an allergic reaction to a recent medication.
Correct Answer: B

Rationale: In this scenario, the symptoms of fever, liver abnormalities, rash, and diarrhea in an immunocompromised client a month after a blood transfusion are indicative of graft-versus-host disease (GVHD). GVHD occurs when white blood cells in donor blood attack the tissues of an immunocompromised recipient. This process can manifest within a month of the transfusion. While choices 1 and 4 are plausible, it is crucial for the nurse to consider the possibility of GVHD in immunocompromised transfusion recipients due to the significant risk. Myelosuppression, choice C, typically presents with decreased blood cell counts and is not consistent with the symptoms described. An allergic reaction to medication, choice D, would present with different manifestations such as itching, hives, or anaphylaxis, which are not described in the scenario.

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A healthcare professional is reviewing a patient's current Lithium levels. Which of the following values is outside the therapeutic range?

  • A. 1.0 mEq/L
  • B. 1.1 mEq/L
  • C. 1.2 mEq/L
  • D. 1.3 mEq/L
Correct Answer: D

Rationale: The correct answer is 1.3 mEq/L. The therapeutic range for Lithium levels typically falls between 0.6 to 1.2 mEq/L. Values below or above this range can lead to suboptimal treatment outcomes or toxicity. Choices A, B, and C are within the therapeutic range of 1.0-1.2 mEq/L, making them appropriate levels for patient care.

Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?

  • A. metastatic liver cancer
  • B. gram-negative septicemia
  • C. pernicious anemia
  • D. iron-deficiency anemia
Correct Answer: C

Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding. Pernicious anemia results from vitamin B12 deficiency due to a lack of intrinsic factor, leading to faulty absorption from the gastrointestinal tract. While pernicious anemia can lead to other health issues, bleeding tendencies are not a primary concern. Metastatic liver cancer (choice A) can cause liver dysfunction leading to decreased synthesis of clotting factors, increasing the risk of bleeding. Gram-negative septicemia (choice B) can lead to disseminated intravascular coagulation (DIC) causing excessive bleeding. Iron-deficiency anemia (choice D) can result in microcytic hypochromic red blood cells, which can impair oxygen transport and lead to tissue hypoxia, but it is not directly associated with a significant potential for bleeding.

The drug of choice to decrease uric acid levels is:

  • A. prednisone (Colisone)
  • B. allopurinol (Zyloprim)
  • C. indomethacin (Indocin)
  • D. hydrochlorothiazide (HydroDiuril)
Correct Answer: B

Rationale: The correct answer is allopurinol (Zyloprim) as it is a xanthine oxidase inhibitor that decreases uric acid formation. Allopurinol is commonly used to manage gout by lowering uric acid levels. Prednisone is a corticosteroid used to decrease inflammation, not to lower uric acid levels. Indomethacin is an analgesic, anti-inflammatory, and antipyretic agent, but it is not the drug of choice for lowering uric acid levels. Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema, not to decrease uric acid levels.

A client begins a regimen of chemotherapy. Her platelet count falls to 98,000. Which action is least likely to increase the risk of hemorrhage?

  • A. Test all excreta for occult blood.
  • B. Use a soft toothbrush or foam cleaner for oral hygiene.
  • C. Implement reverse isolation.
  • D. Avoid IM injections.
Correct Answer: C

Rationale: The correct answer is to implement reverse isolation. Reverse isolation is a protective measure used to protect patients from infections, not to affect the risk of hemorrhage. Testing all excreta for occult blood (Choice A) is important to monitor for signs of internal bleeding. Using a soft toothbrush or foam cleaner for oral hygiene (Choice B) is recommended to prevent gum bleeding. Avoiding IM injections (Choice D) is crucial to reduce the risk of bleeding in a client with a low platelet count. Therefore, among the given options, implementing reverse isolation is the least likely to increase the risk of hemorrhage.

What is appropriate care for a client with neutropenia?

  • A. Avoiding fresh fruits and vegetables.
  • B. Having a private room.
  • C. Wearing a mask when out of the room.
  • D. Practicing routine hand washing.
Correct Answer: C

Rationale: When a client has neutropenia, they have low white blood cell levels, which increases the risk of infections due to a weakened immune system. Wearing a mask when out of the room is crucial to reduce the risk of exposure to respiratory infections. Avoiding fresh fruits and vegetables is also necessary as they may contain harmful pathogens. Having a private room helps minimize exposure to pathogens and ensures that visitors are carefully screened for any signs of illness. Routine hand washing is essential to prevent the spread of infections in the healthcare setting, but the most direct measure to protect the client from potential infections is wearing a mask when out of the room.

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