NCLEX-RN
NCLEX RN Predictor Exam Questions
Extract:
Question 1 of 5
A 68-year-old man was recently diagnosed with endstage renal disease. He has not yet begun dialysis but is experiencing severe anemia with associated symptoms of dyspnea on exertion and chest pain. Which statement best describes the management of anemia in renal failure?
Correct Answer: D
Rationale: Clients in renal failure typically have very low hematocrits, often in the range of 16-22%. Transfusion is avoided unless the client exhibits acute symptoms such as dyspnea, chest pain, tachycardia, and extreme fatigue. When the client is given a transfusion, the bone marrow adjusts by producing less red blood cells. Anemia in renal failure is caused primarily by decreased erythropoietin. Low serum iron and ferritin may aggravate the anemia and require treatment. Decreased secretion of erythropoietin by the kidney is the primary cause of anemia. The bone marrow requires this hormone to mature red blood cells. Treatment is with replacement therapy.
Question 2 of 5
The physician prescribes a medical regimen of isoniazid, rifampin, and vitamin B6 for a tuberculosis client. The nurse instructs the client that B6 is given because it:
Correct Answer: D
Rationale: Isoniazid leads to Vitamin B6 deficiency, which is manifested as peripheral neuropathy.
Question 3 of 5
The nurse is teaching a client with a history of hypertension about dietary modifications. The nurse should tell the client to avoid:
Correct Answer: C
Rationale: Processed foods are high in sodium, which can exacerbate hypertension by increasing blood volume, so they should be avoided.
Question 4 of 5
A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?
Correct Answer: A
Rationale: Footling breech presentation carries a high risk of cord prolapse and is typically delivered by Caesarean section to ensure fetal safety. Internal monitoring or genupectoral positioning are not appropriate and ultrasound is unnecessary if the presentation is confirmed.
Question 5 of 5
The client is admitted with a diagnosis of HELLP syndrome. Which laboratory finding is consistent with this diagnosis?
Correct Answer: C
Rationale: HELLP syndrome (Hemolysis Elevated Liver enzymes Low Platelets) is characterized by elevated liver enzymes and decreased platelet count reflecting liver damage and thrombocytopenia. Both findings are consistent with the diagnosis.