NCLEX-RN
Results Analysis Questions
Extract:
Question 1 of 5
A client manages peptic ulcer disease (PUD) with excessive amounts of oral antacids. Signs/symptoms of which acid-base imbalance should the nurse assess for?
Correct Answer: B
Rationale: Oral antacids can be effective treatment for PUD when administered properly, but when they are taken in excess they can lead to metabolic alkalosis (a pH of more than 7.45 and a bicarbonate ion [HCO3] level of more than 27 mEq/L [27 mmol/L]). As effective therapy for PUD, antacids bind with the hydrochloric acid (HCl-) of gastric secretions and halt the corrosive action of the HCl-. However, antacids are alkaline substances, and excessive administration can exceed the kidney's ability to clear the excess HCO3, which leads to the accumulation of HCO3, an increased pH, and metabolic alkalosis. Metabolic acidosis occurs when the pH is low and the HCO3 is low; respiratory acidosis occurs when the pH is low and the partial pressure of carbon dioxide (PCO2) is high; and respiratory alkalosis occurs when the pH is high and the PCO2 is low.
Question 2 of 5
A pregnant client diagnosed with mitral valve prolapse is prescribed anticoagulant therapy during pregnancy. The nurse reviews the client's medical record, expecting to note that which medication therapy is prescribed daily?
Correct Answer: D
Rationale: Pregnant women with mitral valve prolapse are frequently given anticoagulant therapy during pregnancy because they are at greater risk for thromboembolic disease during the antenatal, intrapartal, and postpartum periods. Heparin, which does not pass the placental barrier, is a safe anticoagulant therapy during pregnancy, and it would be administered by the subcutaneous route. Warfarin is contraindicated during pregnancy because it passes the placental barrier and causes potential fetal malformations and hemorrhagic disorders. Terbutaline is a medication that is indicated for preterm labor management.
Question 3 of 5
A child is admitted to the hospital with a suspected diagnosis of bacterial endocarditis. The child has been experiencing fever, malaise, anorexia, and a headache. Which diagnostic study will confirm the diagnosis?
Correct Answer: A
Rationale: The diagnosis of bacterial endocarditis is primarily established on the basis of a positive blood culture of the organisms and the visualization of vegetation on echocardiographic studies. Other laboratory tests that may help confirm the diagnosis are an elevated sedimentation rate and the C-reactive protein level. An ECG is not usually helpful for the diagnosis of bacterial endocarditis.
Question 4 of 5
A child was diagnosed with acute poststreptococcal glomerulonephritis and renal insufficiency. Which laboratory result should the nurse expect to note in the child?
Correct Answer: D
Rationale: With poststreptococcal glomerulonephritis, a urinalysis will reveal hematuria with red cell casts. Proteinuria is also present. If renal insufficiency is severe, the BUN and creatinine levels will be elevated. The WBC is usually within normal limits, and mild anemia is common. Platelets would be lower, whereas glucose is not related.
Question 5 of 5
A 3-week-old infant is brought to the well-baby clinic for a phenylketonuria (PKU) screening test. The nurse reviews the results of the serum phenylalanine levels and notes that the level is 1.0 mg/dL (60 mmol/L). What is the nurse's priority action?
Correct Answer: A
Rationale: The normal PKU level is 0.8 to 1.8 mg/dL (48 to 109 mmol/L). With early postpartum discharge, screening is often performed when the infant is less than 2 days old because of the concern that the infant will be lost to follow-up. Infants should be rescreened by the time that they are 14 days old if the initial screening was done when the infant was 24 to 48 hours old.