NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #951 : Nclex

The community health nurse educates a group of young boys who are learning about hiking safety. Which of the following statements made by the nurse is not effective for preventing Lyme disease?

Possible Answers:

“You should be aware of where ticks infected with Lyme disease are located, particularly in the upper Midwest, New England, and the mid-Atlantic region.”

“After you hike in a Lyme disease-endemic area, carefully examine your skin for ticks.”

“You should wear insect repellant on your skin and clothes if you are in an area endemic to Lyme disease.”

“You can take antibiotic medications before hiking to make sure you don’t get Lyme disease.”

“Try to cover as much of your skin as possible - long pants, long sleeves, long socks, and cover your neck and hands too.”

Correct answer:

“You can take antibiotic medications before hiking to make sure you don’t get Lyme disease.”

Explanation:

Prophylactic antibiotics are not indicated for the prevention of Lyme disease. Antibiotics will be used after a tick bite when symptoms develop and an infection is suspected. The community health nurse should teach rules of prevention, including 1) knowing where Lyme disease is prevalent (New England, upper Midwest, mid-Atlantic states), 2) wearing long sleeves and long pants, covering as much skin as possible with clothing, 3) using insect repellant such as sprays over the whole body, and 4) checking for tick bites especially after exposure is anticipated, so you may receive care as quickly as possible if needed.

Example Question #952 : Nclex

Which of the following should be restricted in a patient with end-stage renal failure?

Possible Answers:

Fluids

All of these are correct

Potassium

Protein

Correct answer:

All of these are correct

Explanation:

A patient with end-stage renal failure should be kept on a low-protein, low potassium diet. Fluid restriction is also an important part of management of patients with end-stage renal failure and patients on dialysis. 

Example Question #151 : Conditions And Treatments

A 75 year old female with end-stage renal failure asks her nurse for advice about her diet. Knowing that this patient must adhere to a low-potassium diet, the nurse cautions her against which of the following foods?

Possible Answers:

Orange juice

Cherries

Eggplant

Apples

Correct answer:

Orange juice

Explanation:

Orange juice is very high in potassium. One 12oz glass of orange juice contains 705mg of potassium. This could easily increase blood potassium to dangerous levels. The other fruits and vegetables listed are all low-potassium foods suitable for consumption by individuals needing to follow a low potassium diet.  

Example Question #955 : Nclex

A nurse is looking over a basic metabolic panel for a 69 year old male. She notices that his BUN is . This value is __________.

Possible Answers:

normal

elevated

borderline elevated

depressed 

Correct answer:

normal

Explanation:

BUN, or blood urea nitrogen, is a measurement of the kidney's ability to excrete urea, which is a byproduct of protein metabolism. This patient's BUN is within normal range: the reference range for BUN is .  

Example Question #951 : Nclex

You are the nurse taking care of an elderly patient with severe dementia and limited mobility who is at a high risk for developing a pressure ulcer. Which of the following options is the best first-line approach to preventing development of a pressure ulcer in this patient?

Possible Answers:

Turning the patient multiple times per day

Applying topical antibiotic ointment to cover the patient's entire body surface

Administering broad-spectrum intravenous antibiotics

Request a dermatology consult 

Administer a one time dose of broad spectrum intramuscular antibiotics

Correct answer:

Turning the patient multiple times per day

Explanation:

The correct answer is "Turning the patient multiple times per day." This is the correct answer because in the preventive stage for pressure ulcer management, there is no need to perform any invasive procedures, administer antibiotics in a patient who may be at high-risk for needing broad-spectrum antibiotics in the future (hence fostering antibiotic resistance), or consult subspecialty services (as there is no dermatological condition to be treated at the moment). The best option to prevent a pressure ulcer in a patient who is at high risk for developing a pressure ulcer is to turn the patient regularly while they are in bed, if they are bed-bound. By turning the patient, the high-pressure areas that would be at the highest risk for development of a pressure ulcer are able to have relief from pressure for a greater proportion of the day/night, and as such, can have blood flow restored while the patient is turned. By allowing for maximal blood flow to these regions, the risk of ischemia and subsequent infection and/or ulcer development is decreased. Without the actual development of an ulcer or infection, administering antibiotics, either topically, intramuscularly, or intravenously is inappropriate.

Example Question #31 : 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 corporis

Tinea manuum

Tinea cruris

Tinea pedis

Tinea capitis 

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:

Chronic lead exposure

Iron deficiency

All of these

Thalassemia

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 #962 : Nclex

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

Possible Answers:

Respiratory depression

Rhabdomyolysis

Weakness, tremors, and cramps

Sudden cardiac death

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 #32 : Other Conditions

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 III

cranial nerve VI

cranial nerve II

cranial nerve VIII

cranial nerve IV

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.

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