NCLEX Questions, NCLEX RN Nursing Exam Questions, NCLEX-RN Questions, Nurselytic

Questions 158

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NCLEX-RN Test Bank

NCLEX RN Nursing Exam Questions

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Question 1 of 5

The parents of a 9-year-old child with acute lymphocytic leukemia expressed concern about his alopecia from cranial irradiation. The nurse explains that:

Correct Answer: D

Rationale: Alopecia has occurred, and knowing it is a side effect does not address their concern. Although true, it does not give them hope for the future. Although true, it does not provide them with information of the temporary nature of the situation. Knowing the hair will grow back provides comfort that the alopecia is temporary.

Question 2 of 5

A 55-year-old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:

Correct Answer: C

Rationale: Straining urine provides for assessment of calculi and evaluation of calculi descent through ureters and urethra.

Question 3 of 5

The nurse is caring for a client with a history of Raynaud’s disease. The nurse should expect the client to have:

Correct Answer: A

Rationale: Raynaud’s disease causes vasospasms, leading to color changes (white, blue, red) in the fingers triggered by cold or stress.

Question 4 of 5

The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primigravida as she completes the early phase of labor?

Correct Answer: D

Rationale: In early labor primigravidas may have reduced fluid intake due to nausea or restrictions increasing the risk of fluid volume deficit. This is more common than impaired gas exchange placental perfusion issues or mobility limitations at this stage.

Question 5 of 5

The client with a history of heart failure is prescribed spironolactone (Aldactone). The nurse should monitor for which potential side effect?

Correct Answer: B

Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia by reducing potassium excretion. Hypokalemia is caused by other diuretics, hypoglycemia is unrelated, and spironolactone lowers blood pressure.

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