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NCLEX-PN Exam Questions - Part 55
1. A hospital discharge planning nurse is making arrangements for a client who has an epidural catheter for continuous infusion of opioids to be placed in a long-term care facility. The family prefers a facility in its neighborhood to facilitate visiting. The neighborhood facility has never cared for a client with this type of need. What is the most appropriate action by the discharge planning nurse?
A) Ask the physician for an extension of hospitalization until the epidural catheter is discontinued to allow for placement at the neighborhood facility.
B) Arrange for immediate in-services for the long-term care facility staff on pain management using epidural catheters.
C) Explain the situation to the client and family and seek another long-term care facility for discharge from the hospital.
D) Encourage the family to hire private duty nurses skilled in epidural catheter pain management to allow the client to be transferred to the neighborhood facility.
2. In managing nausea related to Morphine epidural analgesia, the nurse should administer:
A) Indocin
B) Codeine
C) Motrin
D) Compazine
3. A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?
A) 'You should discuss this with your physician.'
B) 'Sickle cell disease is genetically based and might be passed on to children.'
C) 'Sickle cell disease is genetically based and is not passed on to children.'
D) 'Sickle cell disease is caused by an infection and cannot be passed on to children.'
4. When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize:
A) when started, therapy must not be interrupted to prevent viral resistance.
B) when started, therapy must not be interrupted to prevent opportunistic infection.
C) therapy should be interrupted for one day each month to prevent toxicity.
D) therapy should be interrupted for one week every three months to prevent toxicity.
5. The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
A) platelet count.
B) protime (PT).
C) partial thromboplastin time (PTT).
D) D-dimer.
A) Ask the physician for an extension of hospitalization until the epidural catheter is discontinued to allow for placement at the neighborhood facility.
B) Arrange for immediate in-services for the long-term care facility staff on pain management using epidural catheters.
C) Explain the situation to the client and family and seek another long-term care facility for discharge from the hospital.
D) Encourage the family to hire private duty nurses skilled in epidural catheter pain management to allow the client to be transferred to the neighborhood facility.
2. In managing nausea related to Morphine epidural analgesia, the nurse should administer:
A) Indocin
B) Codeine
C) Motrin
D) Compazine
3. A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?
A) 'You should discuss this with your physician.'
B) 'Sickle cell disease is genetically based and might be passed on to children.'
C) 'Sickle cell disease is genetically based and is not passed on to children.'
D) 'Sickle cell disease is caused by an infection and cannot be passed on to children.'
4. When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize:
A) when started, therapy must not be interrupted to prevent viral resistance.
B) when started, therapy must not be interrupted to prevent opportunistic infection.
C) therapy should be interrupted for one day each month to prevent toxicity.
D) therapy should be interrupted for one week every three months to prevent toxicity.
5. The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
A) platelet count.
B) protime (PT).
C) partial thromboplastin time (PTT).
D) D-dimer.
1. Right Answer: C
Explanation: Safety demands that a client be transferred to a facility that can deliver care equal to the hospital. Basic Care and Comfort
2. Right Answer: D
Explanation: Compazine is the drug that should be administered. Basic Care and Comfort
3. Right Answer: B
Explanation: A client with sickle cell disease passes on the least sickle cell trait and possibly sickle cell disease, depending on the sickle status of the other parent. Choice 1 is not helpful to the client. Choices 3 and 4 are not true. Physiological Adaptation
4. Right Answer: A
Explanation: HIV mutates very rapidly, and any interruption of therapy can allow viral resistance to emerge even taking a dose late. Choice 2 is incorrect because, when the virus is kept in check with anti-retrovirals, the clients own immune system is able to keep opportunistic infections at bay. Choices 3 and 4 are incorrect because therapy should not be interrupted for any reason. If the client develops toxicity, another anti-retroviral drug might be prescribed. Physiological Adaptation
5. Right Answer: D
Explanation: In DIC, many small clots form throughout the body and are immediately broken down. D-dimer measures a specific fibrin split (or degradation) product and is the most specific test for DIC. Choice 1 is incorrect because platelets are consumed in DIC, but this is not specific. Choices 3 and 4 are both elevated (because clotting factors have been used up) but, again, are not specific. Physiological Adaptation
Explanation: Safety demands that a client be transferred to a facility that can deliver care equal to the hospital. Basic Care and Comfort
2. Right Answer: D
Explanation: Compazine is the drug that should be administered. Basic Care and Comfort
3. Right Answer: B
Explanation: A client with sickle cell disease passes on the least sickle cell trait and possibly sickle cell disease, depending on the sickle status of the other parent. Choice 1 is not helpful to the client. Choices 3 and 4 are not true. Physiological Adaptation
4. Right Answer: A
Explanation: HIV mutates very rapidly, and any interruption of therapy can allow viral resistance to emerge even taking a dose late. Choice 2 is incorrect because, when the virus is kept in check with anti-retrovirals, the clients own immune system is able to keep opportunistic infections at bay. Choices 3 and 4 are incorrect because therapy should not be interrupted for any reason. If the client develops toxicity, another anti-retroviral drug might be prescribed. Physiological Adaptation
5. Right Answer: D
Explanation: In DIC, many small clots form throughout the body and are immediately broken down. D-dimer measures a specific fibrin split (or degradation) product and is the most specific test for DIC. Choice 1 is incorrect because platelets are consumed in DIC, but this is not specific. Choices 3 and 4 are both elevated (because clotting factors have been used up) but, again, are not specific. Physiological Adaptation
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