NCLEX-PN
NCLEX PN Test Questions
Extract:
Question 1 of 5
A client with chronic kidney disease has an arteriovenous fistula placed in the left wrist for hemodialysis. Which of the following statements indicate that the client understands how to care for the fistula properly? Select all that apply.
Correct Answer: B,D,E
Rationale: Avoiding sleeping on the arm prevents pressure on the fistula, squeezing a sponge promotes circulation, and feeling for a thrill ensures patency. Numbness/tingling requires evaluation, and blood pressure should be taken on the opposite arm to avoid fistula damage.
Question 2 of 5
An elderly client with a history of stable chronic obstructive pulmonary disease, alcohol abuse, and cirrhosis has a serum theophylline level of 25.8 mcg/mL (143 umol/L). Which clinical manifestation associated with theophylline toxicity should worry the nurse most?
Correct Answer: D
Rationale: Theophylline has narrow therapeutic index and plasma concentrations >20 mcg/mL (111 umol/L) are associated with theophylline drug toxicity.
Toxicity can be acute or chronic. Conditions associated with chronic toxicity include advanced age (>60), drug interactions (eg, alcohol, macrolide and quinolone antibiotics), and liver disease. Acute toxicity is associated with intentional or accidental overdose. Symptoms of toxicity usually manifest as central nervous system stimulation (eg, headache, insomnia, seizures), gastrointestinal disturbances (eg, nausea, vomiting), and cardiac toxicity (eg, arrhythmia).
Question 3 of 5
A hospitalized client has just been informed that he has terminal cancer. He says to the nurse, 'There must be some mistake in the diagnosis.' The nurse determines that the client is demonstrating which of the following?
Correct Answer: A
Rationale: Denial, per Kübler-Ross's
Question 4 of 5
The practical nurse is caring for a client with newly diagnosed infective endocarditis. Which assessment finding by the nurse is the most concerning?
Correct Answer: A
Rationale: Pain and pallor in one foot suggest an embolic event, a serious complication of infective endocarditis that could lead to tissue ischemia or infarction, requiring urgent intervention. Knee pain, splinter hemorrhages, and mild fever are less immediately threatening.
Question 5 of 5
Quality is defined as a combination of all of the following except:
Correct Answer: B
Rationale: Quality care involves meeting or exceeding standards and expectations, not merely performing at a minimal level, which is insufficient for quality. Coordinated Care