NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #101 : Conditions And Treatments

While doing a standard ophthalmoscopic exam on a seven year old female, the examiner notices that while the light reflex of the left eye is red, the light reflex of the right eye appears bright yellow. The right pupil is also less reactive to light, and the right eye appears to be slightly bulging. The examiner should be suspicious of which of the following conditions?

Possible Answers:

Pinguecula

Retinoblastoma

Cataract

Hordeolum

Correct answer:

Retinoblastoma

Explanation:

Retinoblastoma is the most common form of ocular cancer in children. It is derived from developing retinal cells. The most common symptoms are a white or yellow light reflex (also known as leukocoria), diminished pupillary reflex, crossing of the eyes, impaired vision, and bulging of the affected eye. A cataract may also cause the pupil to appear white or to produce a white or yellow light reflex, but it will not cause bulging of the eye.

A pinguecula is a fatty deposit on the sclera which will not alter the red-light reflex, and a hordeolum is outside the eye itself: it is an infection of a hair follicle of the eyelid, also known as a stye. 

Example Question #102 : Conditions And Treatments

A labor and delivery nurse is speaking to a new mother about her premature infant, and is explaining why the infant will have difficulty with heat regulation.

Which of the following statements made by the nurse best explains why a perterm infant cannot conserve heat properly?

Possible Answers:

"The preterm infant lacks white fat, which provides the infant with a heat source due to underdeveloped musculature and the inability to utilize the process of shivering to produce heat."

"The preterm infant has a lack of subcutaneous fat, and a large surface area to body weight ratio, as well as a lack of brown fat that provides heat to infants due to its unique thermogenic properties."

"The preterm infant cannot generate heat effectively because of a lack of surfactant in the skin and therefore cannot generate or preserve a proper body temperature."

"The preterm infant has an immature hypothalamus, which cannot set the infant's internal temperature properly leading to large amounts of heat being lost via convection."

"The preterm infant has too little protein reserves around the kidneys, the neck, between the scapulae, and behind the sternum, and therefore cannot generate heat and can lead to hypothermia."

Correct answer:

"The preterm infant has a lack of subcutaneous fat, and a large surface area to body weight ratio, as well as a lack of brown fat that provides heat to infants due to its unique thermogenic properties."

Explanation:

A preterm infant cannot conserve heat due to several reasons. The infant has a lack of subcutaneous fat, has a large surface area relative to their body weight, a lack of glucose reserves, and a lack of brown fat - which is a unique type of fat that is capable of generating a greater amount of heat than just ordinary fat. 

Example Question #25 : Pediatric Conditions

What specific enzyme deficiency accounts for 95% of all cases of congenital adrenal hyperplasia?

Possible Answers:

7-alpha-hydroxylase deficiency

Beta-glucuronidase deficiency

Estrogen synthetase deficiency

21-hydroxylase deficiency

Correct answer:

21-hydroxylase deficiency

Explanation:

In 21-hydroxylase deficiency, cortisol production is reduced, which in turn causes adrenocorticotropic hormone (ACTH) to increase. The precursors for the cortisol are then shunted into androgen production since these are steroids, and are thus derived from cholesterol.

Example Question #102 : Conditions And Treatments

The community health nurse knows that teaching has been effective when the father of a newborn states __________.

Possible Answers:

"I will place bumper pads in the crib to prevent injury."

"I will place my child on his/her back and in a crib with stuffed animals to create familiarity."

"My child will sleep in the bed with me until the first month of life."

"I will place my child on his/her back to sleep."

"I will place my child on his/her side to sleep, supported by pillows."

Correct answer:

"I will place my child on his/her back to sleep."

Explanation:

Newborns should be placed on their back, in their crib, with nothing else when put to sleep. The crib may contain a fitted sheet or a light blanket. Crib pads, pillows, and stuffed animals are not advised because they may interfere with the child's ability to breathe.

Example Question #103 : Conditions And Treatments

The postpartum nurse is caring for a family and their new baby, a two day old infant. The baby is "spitting up" following every formula feeding. The nurse may suggest __________.

Possible Answers:

using a "soft" instead of a "standard" bottle nipple

giving only 15-30 milliliters per feeding

laying the baby on it's back after feedings

increasing the frequency of feedings

switching brands of formula

Correct answer:

giving only 15-30 milliliters per feeding

Explanation:

Typically, the digestive system of a 2-day-old infant can only accommodate 15-30 milliliters of formula comfortably. The infant's stomach will grow considerably over the coming weeks. Frequent spitting up could be due to overfeeding. Before switching formula brands, try decreasing the amount fed at each feeding. Increasing the frequency of feedings may add to this problem. Another possibility, that the infant is feeding too fast, may be corrected by using a "slow-flow" instead of a "soft" or "standard" nipple. "Soft" nipples may be helpful in infants with poor suck or latch. While feeding and directly afterwards, it is advised to keep the infant in a semi-upright position.

Example Question #104 : Conditions And Treatments

Hippotherapy has the ability to positively impact children who are cognitively, socially, emotionally, or physically challenged. Which of the following therapies is most closely related to hippotherapy? 

Possible Answers:

Art therapy

Music therapy

Massage therapy

Herbal therapy

Pet therapy

Correct answer:

Pet therapy

Explanation:

Hippotherapy is therapeutic horseback riding for the handicapped. The motion of the horse can help the child develop flexibility and balance. Working with others and animals can help the child cross social and emotional boundaries. A therapy involving animals (pet therapy) is most similar to hippotherapy.

Example Question #31 : Pediatric Conditions

Jennifer is a 14-year-old patient who has been diagnosed with diphtheria and subsequently, myocarditis. The nurse implements all of the following except __________.

Possible Answers:

practicing airborne precautions

enforcing bed rest

administering antibiotics

practicing standard precautions

administering antitoxin

Correct answer:

practicing airborne precautions

Explanation:

Diphtheria is an illness caused by bacteria (Corynebacterium diphtheriae). It is spread through droplets, requiring droplet precautions. Standard precautions should also be used, as with any patient. Delivery of antitoxin and antibiotics are important to a patient's recovery. Enforcing bedrest is important after a patient has developed myocarditis (inflammation of the heart).

Example Question #32 : Pediatric Conditions

A community health nurse is giving a presentation on pertussis (whooping cough). He tells his audience that which population is most at risk? 

Possible Answers:

Children under 4 years of age

Children from 4-12

Older adults above 85

Older adults from 65-75

Older adults from 75-85

Correct answer:

Children under 4 years of age

Explanation:

Children under 4 years of age hold the greatest risk of contracting Pertussis and developing serious complications, including death. Pertussis vaccines are recommended for all age groups. Children can start a vaccination series as early as 2 months of age. New parents are encouraged to become vaccinated before their baby arrives to prevent transmission before the infant is eligible for immunization.

Example Question #105 : Conditions And Treatments

A room designed to accommodate a child with the measles should include which of the following? 

Possible Answers:

Low microscopy pressure device

Positive air pressure

High microscopy pressure device

No air pressure device is necessary

Negative air pressure

Correct answer:

Negative air pressure

Explanation:

Measles is an airborne illness. For that reason, air pressure devices are necessary to prevent the spread of infection. Negative air pressure devices will adequately contain the measles virus because air will flow in to the room as opposed to out. Conversely, positive air pressure devices may be used to create an air flow out of a room in severely immunocompromised patients. 

Example Question #106 : Conditions And Treatments

The school nurse is approached by a 9-year-old boy who is complaining of severe scalp pruritus. Upon closer examination, the nurse concludes that he has a case of head lice (Pediculosis capitis). She knows all of the following to be true except __________.

Possible Answers:

his personal grooming items should be soaked in hot water or shampoo

sealing his backpack in a plastic bag for 10 days should kill the lice

treating the clothing of the child may be necessary

head lice may be a sign of poor hygiene

his 5-year-old sister should be examined

Correct answer:

head lice may be a sign of poor hygiene

Explanation:

Children and adults with exceptional personal hygiene are equally affected by head lice. The same applies to people of all socioeconomic groups, genders, and nationalities. All of the other options are true nursing interventions for head lice.

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