NCLEX Chronic Illness Practice Questions

NCLEX Chronic Illness Practice Questions Related

Review NCLEX Chronic Illness Practice Questions related questions and content

Four clients are receiving tyrosine kinase inhibitors (TKIs). Which of these four clients should the nurse assess first?

  • A. Client with dry, itchy, peeling skin
  • B. Client with a serum calcium of $9.2 mg/dL
  • C. Client with a serum potassium of $2.8 mEq/L
  • D. Client with a weight gain of 0.5 pound (1.1 kg) in 1 day
Correct Answer: C

Rationale: Tyrosine kinase inhibitors (TKIs) target cancer cell signaling pathways but can cause electrolyte imbalances, among other side effects. A serum potassium of 2.8 mEq/L (normal 3.5-5.0 mEq/L) is critically low, risking cardiac arrhythmias or muscle dysfunction, making this client the priority for immediate assessment. Dry, itchy, peeling skin is a common TKI side effect, uncomfortable but not immediately life-threatening, warranting later attention for infection risk. A calcium level of 9.2 mg/dL is normal (8.5-10.2 mg/dL), requiring no urgent action. A 0.5-pound weight gain in a day is minor and less critical unless part of a pattern suggesting fluid retention. The nurse prioritizes the potassium imbalance due to its potential for rapid, severe consequences, reflecting oncology's emphasis on addressing physiological instability first.

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The blood glucose level rises after meals. This glucose is stored in various organs under the influence of insulin. Question: During the postprandial period, most glucose is stored in which tissue?

  • A. Intestinal tissue
  • B. Liver tissue
  • C. Muscle tissue
  • D. Fat tissue
Correct Answer: C

Rationale: Post-meal glucose floods muscle insulin shoves it there, 60% of the haul, a chronic storehouse. Liver grabs next, fat lags, intestines pass nurses track this, a bulk uptake king.

A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

  • A. Administer an antiemetic
  • B. Administer an antimetabolite
  • C. Administer a tumor antibiotic
  • D. Administer an anticoagulant
Correct Answer: A

Rationale: Chemo's nastiest duo nausea and vomiting strike most patients, triggered by gut and brain reactions to drugs like cyclophosphamide. Antiemetics (e.g., ondansetron) preempt this, keeping patients eating and hydrated, a frontline move in oncology. Antimetabolites (like methotrexate) and tumor antibiotics (like doxorubicin) are chemo agents, not side-effect fixes. Anticoagulants dodge clots, not nausea. Nurses prioritize this relief, knowing it's the biggest hurdle to treatment tolerance.

A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?

  • A. A fluid bolus as ordered
  • B. Fluid restrictions as ordered
  • C. Urinalysis as ordered
  • D. Sodium-restricted diet as ordered
Correct Answer: B

Rationale: SIADH, common in lung cancer, overproduces ADH, retaining water and diluting sodium hyponatremia causes weight gain, weakness, nausea. Fluid restriction, the initial fix, curbs water intake, raising sodium levels naturally, tackling the root imbalance. A fluid bolus worsens dilution, risking seizures. Urinalysis checks concentration, not a treatment. Sodium restriction deepens hyponatremia, counterproductive. Anticipating fluid limits aligns with SIADH's pathophysiology nurses expect this order to stabilize the patient, monitoring for symptom relief or escalation, a frontline step in managing this paraneoplastic crisis.

A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose?

  • A. 0.25
  • B. 0.5
  • C. 1
  • D. 1.5
Correct Answer: B

Rationale: Digoxin math: 125 mcg ordered, 0.25 mg (250 mcg) per tablet 125 ÷ 250 = 0.5 tablets, a precise dose nurses calc to boost heart failure's pump, avoiding toxicity's narrow edge. Wrong cuts (0.25, 1, 1.5) miss the mark. Accuracy here rules, a daily win in this med game.

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, 'I am so tired I can hardly get out of bed in the morning.' Which intervention should the nurse add to the plan of care?

  • A. Minimize activity until the treatment is completed.
  • B. Establish time to take a short walk almost every day.
  • C. Consult with a psychiatrist for treatment of depression.
  • D. Arrange for delivery of a hospital bed to the patient's home.
Correct Answer: B

Rationale: Radiation fatigue's brutal Hodgkin's therapy saps energy, but short walks fight deconditioning without overtaxing. Resting fully risks weakness; depression isn't assumed fatigue's treatment-driven. A bed doesn't fix it. Nurses in oncology balance this activity preserves function, key for lymphoma patients slogging through radiation's grind.

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