NCLEX Questions, NCLEX-RN Exam Practice Questions, NCLEX-RN Questions, Nurselytic

Questions 157

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Question 1 of 5

A 3-year-old female client is brought into the pediatric clinic because she limps. She has not been to the clinic since she was 9 months old. The nurse practitioner describes the limp as a 'Trendelenburg gait.' This gait is characteristic of:

Correct Answer: B

Rationale: (A, C,
D) A Trendelenburg gait is not characteristic of any of these disorders. The downward slant of one hip is a positive sign of dislocation in the weight-bearing hip. If one hip is dislocated, the child walks with a characteristic limp known as the Trendelenburg gait.

Question 2 of 5

The nurse reviewing the lab results of a client receiving Cytoxan (cyclophosphamide) for Hodgkin's lymphoma finds the following: WBC 4,200, RBC 3,800,000, platelets 25,000, and serum creatinine 1.0 mg. The nurse recognizes that the greatest risk for the client at this time is:

Correct Answer: B

Rationale: A platelet count of 25,000 indicates severe thrombocytopenia, posing a significant risk of bleeding, which is the greatest immediate concern compared to infection, anemia, or renal failure.

Question 3 of 5

The physician has ordered a low-purine diet for a client with gout. Which protein source is high in purine?

Correct Answer: A

Rationale: Dried beans are high in purines, which can exacerbate gout by increasing uric acid levels, so they should be avoided on a low-purine diet.

Question 4 of 5

A nurse is caring for a client with a myocardial infarction. The nurse recognizes that the most common complication in the client following a myocardial infarction is:

Correct Answer: B

Rationale: Cardiac dysrhythmias are the most common complication post-MI due to ischemic damage to the conduction system. Hypertrophy develops later, and hyperkalemia is less common.

Question 5 of 5

A client with a history of a burn injury is receiving Silvadene (silver sulfadiazine). The nurse should monitor the client for:

Correct Answer: A

Rationale: Silver sulfadiazine can cause neutropenia, requiring monitoring of white blood cell counts. Hyperkalemia, hypoglycemia, and hypertension are not typical side effects.

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