NCLEX : NCLEX

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #11 : Causes And Treatments Of Other Conditions

You are the nurse taking care of a 15-year old male wrestler at a primary care clinic who complains of a raised, red, ring-like rash with central clearing on his lower back that he states is very itchy. Which of the following is the most likely diagnosis?

Possible Answers:

Tinea pedis

Tinea cruris

Tinea corporis

Tinea capitis 

Tinea manuum

Correct answer:

Tinea corporis

Explanation:

The correct answer is "Tinea corporis," which is also known colloquially as "ringworm." 

The described case is a classic case for tinea corporis, in which the patient is a young athlete, often a wrestler (due to the frequent skin-to-skin or skin-to-mat contact in damp, sweaty environments), who presents with an itchy, red, ring-like rash that exhibits central clearing. The word "corporis" qualifies that the fungal dermatophyte infection ("tinea") is specifically located on the body/torso/back region.

The other choices are incorrect as tinea capitis is a fungal infection of the scalp, tinea pedis is a fungal infection of the feet, tinea cruris is a fungal infection of the groin ("jock itch"), and tinea manuum is a fungal infection of the hands.

Example Question #961 : Nclex

You are a nurse in an emergency department and a patient presents with a 5 cm by 6 cm abscess on the dorsal aspect of his left hand. The hand is very painful, but he has full range of motion, and no sensory deficits. He is afebrile and has no systemic or localized symptoms aside from the abscess. Which of the following is the most appropriate next step in management?

Possible Answers:

Incision and drainage of the abscess

Amputate the affected hand at the wrist

Apply topical antibiotic to the abscess

Prescribe oral antibiotics without draining the abscess

Inject steroid into the abscess

Correct answer:

Incision and drainage of the abscess

Explanation:

The correct answer is "incision and drainage of the abscess." This is the correct answer, because an abscess, by definition, is a walled off collection of pus and bacteria, that is typically impenetrable to topical or systemic antibiotics. The only way to truly resolve an abscess is to incise and drain it, such that the walled off material can be expelled, and the pressure and pain can be relieved. Further, the material should be sent for culture so that the patient can be placed on appropriate antibiotics if the physician deems it necessary for post-drainage care. 

The other choices are incorrect. Surgical amputation of the affected hand would be a drastic measure for a localized abscess that is not otherwise causing limb ischemia or necrosis. Incision and drainage is a much more reasonable first step. Injecting a steroid into the abscess would be a potentially dangerous intervention as steroids decrease the body's immune response to infection, and as such, could increase the bacterial load within the abscess, allowing it to expand and become more serious. As mentioned earlier, topical and oral antibiotics would likely be impenetrable to the abscess and would be inappropriate first steps when the option of incision and drainage exists.

Example Question #961 : Nclex

Which of the following causes microcytic hypochromic anemia? 

Possible Answers:

Thalassemia

Chronic lead exposure

All of these

Iron deficiency

Correct answer:

All of these

Explanation:

All of these result in microcytic hypochromic anemia, which is a type of anemia characterized by small red blood cells called microcytes that contain lower concentrations of hemoglobin than healthy red blood cells.

Example Question #31 : Other Conditions

What is the most significant risk of hyperkalemia (elevated serum potassium)?

Possible Answers:

Respiratory depression

Weakness, tremors, and cramps

Sudden cardiac death

Rhabdomyolysis

Correct answer:

Sudden cardiac death

Explanation:

Mild hyperkalemia may be asymptomatic, but a significant rise if potassium levels above normal can cause fatal heart arrhythmia, resulting in sudden cardiac death. 

Weakness, tremors, and cramps are common symptoms of mild hypokalemia (depressed potassium levels), while respiratory depression and rhabdomyolysis can occur with severe cases of hypokalemia.

Example Question #152 : Conditions And Treatments

Cranial nerves are important to assess to determine the neurological status of a patient in regards to possible deficits.

All the following cranial nerves should be assessed for proper eye movement and function, including vision except __________.

Possible Answers:

cranial nerve IV

cranial nerve III

cranial nerve II

cranial nerve VI

cranial nerve VIII

Correct answer:

cranial nerve VIII

Explanation:

Cranial nerve VIII is the vestibulocochlear nerve responsible for hearing and balance. It does not control the eye. 

Cranial nerve II is the optic nerve: control vision and acuity; cranial nerve III is the oculomotor nerve, which controls eye movement, pupil reflex, eyelid, and proprioception. Cranial nerve IV is the trochlear nerve, which controls extraocular eye movement as does cranial nerve VI, the abducens.

Example Question #961 : Nclex

A 25-year-old male client presents to the emergency department complaining of severe headache, nausea, vomiting and nuchal rigidity. Nurse recognizes this patient may be experiencing some form of meningitis.

Which test is the most appropriate to determine if this patient is experiencing the bacterial form of meningitis?

Possible Answers:

X-ray of the spine

Cerebral spinal fluid analysis showing elevated protein levels

Blood culture positive for Streptococcus pneumoniae

Computerized tomography scan of the head to assess for increased intracranial pressure

Cerebral spinal fluid analysis to confirm elevated glucose levels

Correct answer:

Cerebral spinal fluid analysis showing elevated protein levels

Explanation:

Cerebral spinal fluid analysis is the best test - elevated protein, decreased glucose levels, with high levels of PMN's (polymorphonuclear cells) are indicative of bacterial meningitis, which is a medical emergency. Blood culture is appropriate but will not yield quick results, computer tomography (CT) scan is also helpful but not priority.

Example Question #961 : Nclex

A patient is severely dehydrated and is being given IV normal saline at a rate of 160 cc per hour. Which of the following laboratory values would you expect to be abnormally elevated in this patient?

Possible Answers:

Creatinine

Glucose

White blood count

Mast cell count

Hemoglobin

Correct answer:

Creatinine

Explanation:

In a dehydrated patient, the BUN and creatinine is often elevated. Creatinine is a marker of kidney function. Elevations in creatinine from baseline are considered kidney injury. Dehydration is decreased circulatory volume to the kidneys. This will result in an elevation of creatinine (and BUN) on laboratory testing. Rehydration therapy with IV fluids will often correct this abnormality.

Example Question #962 : Nclex

What is the medical term for the artificial mechanism by which fluid and toxic solutes are removed from circulation when the kidneys are unable to function?

Possible Answers:

Dialysis

Bronchoscopy

BiPAP

CPAP

Correct answer:

Dialysis

Explanation:

Dialysis is an artificial mechanism used to filter the blood when the kidneys are unable to do so. The two major types are hemodialysis and peritoneal dialysis. Dialysis is usually considered in the treatment of chronic kidney disease and toxic overdoses. BiPAP and CPAP are used to help with respirations. Bronchoscopy is used to explore the lung space. 

Example Question #1 : Other Condition Follow Up

The nurse is providing a teaching session to a client who has elevated uric acid levels. What type of diet will the nurse be teaching about?
Possible Answers:
High-calorie, high-protein diet
High-fiber diet
Low-purine diet
High-potassium diet
Correct answer: Low-purine diet
Explanation: Elevated uric acid levels is an indicator for a low-purine diet. Other indicators include gout and kidney stones. The patient should restrict the diet to foods that are low in purine.

Example Question #41 : Other Conditions

A nurse wishes to reduce the symptoms of a client with systemic lupus erythematosus. The nurse should do all of the following except:
Possible Answers:
Administer a high-iron diet and vitamin supplements
Instruct the client to avoid harsh sunlight and ultraviolet exposure
Instruct the client to use strong soaps to cleanse skin rashes
Administer topical corticosteroids as prescribed
Correct answer: Administer a high-iron diet and vitamin supplements
Explanation: Certain diets can exacerbate systemic lupus erythematosus symptoms, including diets high in iron. Diet should not be high in calories, zinc, or fats. Compounds that may provide benefits include vitamin E, vitamin A, fish oils, selenium, and flaxseed.
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