NCLEX-PN clinical judgment practice questions, set 68
NCLEX-PN · clinical judgment
NCLEX-PN clinical judgment practice questionsset 68
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Five clinical judgment questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A central venous pressure reading of 11cm/H(2)O of an IV of normal saline is determined by the nurse caring for the patient. The patient has a diagnosis of pericarditis. Which of the following is the most applicable?
A. The patient has a condition of hypovolemia.
B. Not enough fluid has been given to the patient.
C. Pericarditis may cause pressures greater than 10cm/H(2)O with testing of CVP.
D. The patient may have a condition of arteriosclerosis.
Show answer and rationale
Correct answer: C — Pericarditis may cause pressures greater than 10cm/H(2)O with testing of CVP.
A central venous pressure reading above 10cm/H(2)O may indicate a condition of pericarditis, as the inflammation and fluid accumulation around the heart can lead to elevated pressures. Choices A, B, and D are incorrect. Hypovolemia would typically result in lower CVP readings, not higher. Not enough fluid given would also lead to lower CVP levels. Arteriosclerosis is not directly related to CVP readings in the context of pericarditis.
Question 2
A client asks a nurse working in a dental office what type of drug the dentist uses to provide anesthesia during the extraction of the client's wisdom teeth. The dentist uses an anesthetic gas, also known as laughing gas. This agent is:
A. nitrous oxide.
B. nitrogen.
C. nitric oxide.
D. nitrogen dioxide.
Show answer and rationale
Correct answer: A — nitrous oxide.
The correct answer is nitrous oxide. Nitrous oxide is commonly known as laughing gas and is used as an anesthetic gas for procedures like dental extractions. It produces analgesia and mild euphoria without loss of consciousness. Nitrogen is a nonmetallic element found in air, while nitric oxide is a vasodilator produced from L-arginine. Nitrogen dioxide is a poisonous gas found in smog and exhaust fumes and is not used for anesthesia.
Question 3
All of the following are common reasons that nurses are reluctant to delegate except:
A. lack of self-confidence.
B. desire to maintain authority.
C. confidence in subordinates.
D. getting trapped in the 'I can do it better myself' mindset.
Show answer and rationale
Correct answer: C — confidence in subordinates.
The correct answer is 'confidence in subordinates.' If a delegator has confidence in their subordinates' abilities, they are more likely to delegate tasks. Reasons why nurses are reluctant to delegate include their own lack of self-confidence, the desire to maintain authority, and getting trapped in the 'I can do it better myself' mindset. Therefore, having confidence in subordinates is not a common reason for reluctance to delegate.
Question 4
What vitamin is important in preventing peripheral neuritis in a client with alcohol abuse?
A. Vitamin D
B. Fat-soluble vitamins
C. B vitamins
D. Potassium
Show answer and rationale
Correct answer: B — Fat-soluble vitamins
The correct answer is 'Fat-soluble vitamins.' Vitamin B, not Vitamin D, is crucial in preventing peripheral neuritis in individuals with alcohol abuse. Vitamin B deficiency, particularly B1 (thiamine), is commonly associated with peripheral neuritis in alcoholics. Therefore, choices A, C, and D are incorrect. Vitamin D is not directly related to peripheral neuritis, and potassium deficiency typically presents with different symptoms.
Question 5
What skin color does a client with jaundice have?
A. pale
B. ruddy
C. yellow
D. pink
Show answer and rationale
Correct answer: C — yellow
The correct answer is C: yellow. Jaundice is a condition characterized by yellowing of the skin due to increased levels of bilirubin in the blood. This excess bilirubin causes the skin and whites of the eyes to appear yellow. Choice A, pale, is not typically associated with jaundice. Choice B, ruddy, describes a reddish skin color and is not indicative of jaundice. Choice D, pink, is a normal skin color and not a symptom of jaundice.
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Question 6
Distribution of a drug to various tissues depends on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?
A. skin
B. adipose tissue
C. skeletal muscle
D. myocardium
Correct answer:
The correct answer is 'myocardium.' Highly perfused tissues include vital organs like the brain, heart, kidneys, adrenal glands, and liver. The myocardium, being heart muscle, receives the highest amount of cardiac output and thus the highest amount of a drug. Choices A, B, and C are incorrect because the skin and adipose tissue are poorly perfused, while skeletal muscle is less perfused compared to vital organs like the myocardium.
The nurse is teaching a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?
A. "Do not sit on toilet seats without protection."?
B. "Oral sex can transmit the virus."?
C. "This infection can be transmitted via intercourse even when you do not feel ill."?
D. "Try to drink lots of fluids after sex to flush the reproductive tract."?
Correct answer:
Genital herpes can be transmitted through oral, genital, and anal sex. It's crucial to understand that the infection can be spread through intercourse even when symptoms are not present. Option A is incorrect because genital herpes is not transmitted through toilet seats. Option B is correct as oral sex can transmit the virus. Option D is incorrect as drinking fluids after sex does not prevent the transmission of genital herpes.
The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
A. That can be assessed
B. That is in situ
C. With increasing lymph node involvement
D. With distant metastasis
Correct answer:
The correct answer is B: 'That is in situ.' Cancer in situ means that the cancer is still localized to the primary site. Cancer is graded in terms of tumor, grade, node involvement, and metastasis. Answer A is incorrect because Tis indicates a tumor that is in situ and can be assessed. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrect because a tumor that is in situ is not metastasized.
A client is taking phenelzine (Nardil), and their spouse would like to bring lunch from home. Which of the following is most appropriate for the client to eat?
A. a banana
B. grapefruit
C. a salami sandwich
D. avocado slices
Correct answer:
The correct answer is grapefruit. Clients taking MAO Inhibitors like phenelzine (Nardil) should avoid foods rich in tyramine to prevent hypertensive crisis. Grapefruit is a suitable choice as it is not high in tyramine. Bananas, avocados, and salami are foods that should be avoided due to their tyramine content, which can interact adversely with MAO Inhibitors. Therefore, choosing grapefruit is the safest option for the client.
A female sex worker enters a clinic for treatment of a sexually transmitted disease. This disease is the most prevalent STD in the United States. The nurse can anticipate that the woman has which of the following?
A. herpes
B. chlamydia
C. gonorrhea
D. syphilis
Correct answer:
The question describes a female sex worker seeking treatment for the most prevalent sexually transmitted disease in the United States. Chlamydia is the correct answer as it is the most common STD in the country according to epidemiological studies. While herpes (choice A) is common, it is not the most prevalent. Gonorrhea (choice C) and syphilis (choice D) are less prevalent compared to chlamydia, making them incorrect choices.
A client with which of the following conditions is at risk for developing a high ammonia level?
A. renal failure
B. psoriasis
C. lupus
D. cirrhosis
Correct answer:
Cirrhosis is the correct answer. In cirrhosis, the liver is unable to detoxify ammonia to urea, leading to an accumulation of ammonia in the blood. This can result in hepatic encephalopathy, a condition characterized by high ammonia levels affecting brain function. Renal failure (Choice A), psoriasis (Choice B), and lupus (Choice C) are not directly associated with an increased risk of high ammonia levels as seen in cirrhosis.
What is a chemical reaction between drugs before their administration or absorption known as?
A. a drug incompatibility
B. a side effect
C. an adverse event
D. an allergic response
Correct answer:
A chemical reaction between drugs before their administration or absorption is termed a drug incompatibility. This phenomenon commonly happens when drug solutions are mixed before intravenous administration, but it can also occur with orally administered drugs. Choices B, C, and D are incorrect because side effects, adverse events, and allergic responses occur after the administration and absorption of drugs, not prior to it.
Lidocaine is a medication frequently ordered for the client experiencing
A. Atrial tachycardia
B. Ventricular tachycardia
C. Heart block
D. Ventricular bradycardia
Correct answer:
Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electrical stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because lidocaine does not slow the heart rate, so it is not used for heart block or bradycardia.
Which system is primarily affected by tuberculosis (Mycobacterium)?
A. stomach (GI)
B. heart (cardiac)
C. lungs (respiratory)
D. skin (integumentary)
Correct answer:
Tuberculosis, caused by Mycobacterium tuberculosis, primarily affects the respiratory system. This aerobic bacillus thrives in highly oxygenated body sites, such as the lungs, growing ends of bones, and the brain. The bacillus is airborne, making the lungs a common site for infection. Choices A, B, and D are incorrect as tuberculosis predominantly impacts the respiratory system and rarely involves the stomach, heart, or skin.
Upon first meeting, a new nurse manager makes eye contact, smiles, initiates conversation about the previous work experience of nurses, and encourages active participation by nurses in the dialogue. Her behavior is an example of:
A. Aggressiveness.
B. Passive aggressiveness.
C. Passiveness.
D. Assertiveness.
Correct answer:
The correct answer is 'Assertiveness.' This nurse manager is demonstrating assertive behavior by confidently engaging with the nurses, showing interest in their work experience, and encouraging active participation. Aggressive behavior is forceful and dominating, while passive behavior is submissive and timid. Passive-aggressive behavior involves indirect manipulation or control, which is not demonstrated in this scenario.
NCLEX-PN clinical judgment practice questions, set 68 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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