NCLEX Chronic Illness Practice Questions

NCLEX Chronic Illness Practice Questions Related

Review NCLEX Chronic Illness Practice Questions related questions and content

The nurse is preparing an adolescent diagnosed with leukemia for a lumbar puncture. The nurse determines that the child understands the reason for the procedure when the child states that the procedure is done to:

  • A. Make sure I don't have meningitis along with my cancer.
  • B. Relieve some of the pressure on my brain.
  • C. Remove the blood cancer cells so I don't have to have surgery.
  • D. Check to see if the cancer has spread through my spinal cord and brain.
Correct Answer: D

Rationale: A lumbar puncture (LP) in leukemia is performed to collect cerebrospinal fluid (CSF) to check for central nervous system (CNS) involvement cancer cells spreading to the spinal cord and brain a critical staging step that influences treatment, like intrathecal chemotherapy. The adolescent's statement about checking for spread reflects accurate understanding, essential for informed consent and reducing anxiety through clarity. Ruling out meningitis is a possible LP use, but in leukemia, CNS metastasis is the primary concern unless symptoms suggest infection. Relieving brain pressure applies to conditions like hydrocephalus, not leukemia's typical presentation. Removing cancer cells via LP isn't a treatment; it's diagnostic. The nurse's confirmation of this understanding ensures the child is prepared, aligning with pediatric oncology's emphasis on patient education and procedural readiness.

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A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this patient most likely undergo?

  • A. Lymphadenectomy
  • B. Needle biopsy
  • C. Open biopsy
  • D. Sentinel node biopsy
Correct Answer: D

Rationale: Sentinel node biopsy (SLNB) is the modern go-to less invasive than old-school dissection (lymphadenectomy), it maps the first lymph node cancer hits, sparing arm swelling (lymphedema) if clean. Needle or open biopsies are less targeted, more for diagnosis than staging here. SLNB's standard for breast cancer now, checking spread without ripping out nodes like her mom's era. Nurses in oncology highlight this shift less trauma, same intel easing her fears with precision care.

Oxygen radicals play a role in the development of which of the following options?

  • A. Diabetic dyslipidaemia
  • B. Insulin resistance
  • C. Mitochondrial dysfunction
  • D. B+C
Correct Answer: D

Rationale: Oxygen radicals torch cells insulin resistance via inflammation, mitochondrial dysfunction via damage. Dyslipidaemia rides along, not direct nurses see this duo, a chronic stress pair.

After a road traffic accident at 50 miles per hour, a healthy 30-year-old patient is admitted to a major trauma centre with a closed femoral shaft fracture and pulmonary contusion. Routine management in the intensive care unit is likely to include:

  • A. A tertiary survey.
  • B. A course of broad-spectrum antibiotics.
  • C. Non-specific medical treatment of a rising creatinine kinase concentration (CK).
  • D. Delay in physiotherapy to minimize bleeding.
Correct Answer: A

Rationale: ICU care post-trauma ensures comprehensive management. A tertiary survey (head-to-toe reassessment) identifies missed injuries (e.g., fractures), routine within 24-48 hours per trauma protocols, critical with polytrauma risks like this case. Antibiotics aren't routine without infection (e.g., open fracture); pulmonary contusion alone doesn't justify them. Rising CK from muscle damage (femoral fracture) may need monitoring (rhabdomyolysis risk), but treatment (e.g., fluids) is specific, not non-specific. Early physiotherapy aids recovery, not delayed bleeding risk is minimal with closed fractures post-stabilization. Surviving Sepsis guidelines apply only with sepsis. The tertiary survey's systematic approach prevents oversight, ensuring holistic care in a high-energy trauma patient.

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.

The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:

  • A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
  • B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
  • C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
  • D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D

Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.

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