NCLEX Chronic Illness Practice Questions

NCLEX Chronic Illness Practice Questions Related

Review NCLEX Chronic Illness Practice Questions related questions and content

The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which of the following interventions will be most appropriate for this child?

  • A. Applying aloe vera lotion to irradiated areas of skin
  • B. Administering antiemetics as prescribed for nausea
  • C. Giving medications as ordered via least invasive route
  • D. Maintaining isolation as prescribed to avoid infection
Correct Answer: C

Rationale: Post-surgical care for a stage I neuroblastoma (localized, surgically resected) focuses on recovery with minimal invasiveness, making giving medications via the least invasive route preferably oral most appropriate for a 4-year-old. This reduces trauma, anticipates needs like pain relief, antiemetics, or steroids (e.g., dexamethasone for swelling), and suits a stable post-op child without chemotherapy or radiation yet, as stage I often requires surgery alone. Aloe vera implies radiation, not indicated here post-surgery. Antiemetics are useful but too narrow broader medication needs apply. Isolation isn't standard for stage I post-op unless immunosuppression emerges later. This intervention balances efficacy and comfort, aligning with pediatric nursing's goal to minimize distress while ensuring effective postoperative management.

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Which of the following clients would not be a candidate for thrombolytic therapy?

  • A. Client with a pulse of 102 beats/minute
  • B. Client with a blood pressure of 100/60 mm Hg
  • C. Client with a history of hemorrhagic stroke one month ago
  • D. Client age 65 years
Correct Answer: C

Rationale: Thrombolytics bust clots but bleed big hemorrhagic stroke history, even a month back, bans them, as re-bleed risk soars, a firm no-go. Tachycardia, low BP, or age 65 don't nix it BP's workable, age isn't a cutoff. Nurses screen this, dodging brain bleeds, a safety lock in this clot-dissolving call.

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.

The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:

  • A. Engage the patient in shared decision making
  • B. Threaten the patient into adherence with insulin therapy
  • C. Provide close supervision and follow-up when the patient is newly initiated on insulin therapy
  • D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLPIRA
Correct Answer: B

Rationale: Insulin's hurdles yield to shared decisions, close watch, weight tricks, and goal setting empowering, not bullying. Threats tank trust and adherence, backfiring in chronic care where buy-in's king. Support beats scare tactics, aligning with diabetes' need for partnership, a strategy flop amid solid aids.

The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer?

  • A. Teach the patient about the seven warning signs of cancer.
  • B. Plan to monitor the patient's carcinoembryonic antigen (CEA) level.
  • C. Teach the patient about annual chest x-rays for lung cancer screening.
  • D. Discuss risks associated with cigarette smoking during each patient encounter.
Correct Answer: D

Rationale: Smoking's the lung cancer kingpin two packs a day screams risk. Hitting the patient with smoking's dangers every visit pushes primary prevention, aiming to cut exposure to tar and carcinogens fueling 85% of cases. Warning signs (CAUTION) and chest x-rays are secondary catching cancer, not stopping it. CEA's a tumor marker for tracking, not prevention. Nurses in oncology know preaching cessation at every chance leverages behavior change, the gold standard to slash lung cancer odds, trumping screening or monitoring in a heavy smoker like this.

Toxic shock syndrome:

  • A. will often manifest without fever
  • B. is a misnomer because BP is often maintained
  • C. is caused by pseudomonas species
  • D. often produces elevated creatinine kinase
Correct Answer: D

Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.

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