NCLEX-RN
NCLEX RN Practice Questions Quizlet Questions
Extract:
Question 1 of 5
A mother has recently been informed that her child has Down syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down syndrome?
Correct Answer: C
Rationale: Individuals with Down syndrome commonly have certain physical characteristics, such as a simian crease (single transverse palmar crease), brachycephaly (shortened front-to-back skull dimension), and hypotonicity (low muscle tone). Oily skin is not a characteristic associated with Down syndrome; instead, individuals with Down syndrome often have dry skin.
Therefore, oily skin is the correct answer in this context.
Question 2 of 5
A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose?
Correct Answer: B
Rationale: The correct pediatric dose of diphenhydramine is 5 mg/kg/day. This child weighs 30 kg, so the calculated dose would be 5 mg/kg x 30 kg = 150 mg/day. Since the prescription is for 25 mg 3 times a day, the total daily dose is 25 mg x 3 = 75 mg/day, which is lower than the calculated dose of 150 mg/day.
Therefore, the prescribed dose of 25 mg 3 times a day is too low for this child. The dose should be adjusted to meet the correct dosage of 150 mg/day, which would be 50 mg 3 times a day. It is important not to titrate the dosage based on symptoms without consulting a physician, as this can lead to inappropriate medication administration.
Question 3 of 5
The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is:
Correct Answer: A
Rationale: The most crucial action for the nurse when preparing to administer enteral feeding via a nasogastric tube is to verify the correct placement of the tube. Proper placement of the tube is vital to prevent complications such as aspiration into the lungs. The definitive methods to confirm the position of the nasogastric tube include visualization through an x-ray or aspirating stomach contents and checking their pH (usually pH 1 to 5). Aspirated stomach content can also be tested for bilirubin to confirm placement in the stomach.
Choice B, checking that the feeding solution matches the dietary order, is important for ensuring the correct nutrition is provided but is not as critical as verifying tube placement to prevent potential harm.
Choice C, aspirating gastric contents to determine the amount of the last feeding remaining in the stomach, is a common nursing practice but is not the most crucial action when compared to ensuring correct tube placement.
Choice D, ensuring that the feeding solution is at room temperature, is relevant for patient comfort and preventing thermal injury but is not as essential as confirming correct tube placement to prevent serious complications.
Question 4 of 5
A 24-year-old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?
Correct Answer: B
Rationale: The correct answer is Hypercalcemia. In this case, the patient's history of myeloma, constipation, intense abdominal pain, and polyuria suggests hypercalcemia. Elevated calcium levels can lead to polyuria, severe abdominal pain, and confusion. Diverticulosis (
Choice
A), characterized by small pouches in the colon wall, typically does not present with confusion and polyuria. Hypocalcemia (
Choice
C) is unlikely given the symptoms described. Irritable bowel syndrome (
Choice
D) does not typically cause confusion and polyuria as seen in hypercalcemia.
Question 5 of 5
A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included in the nursing care plan?
Correct Answer: D
Rationale: A platelet count of 25,000/microliter indicates severe thrombocytopenia, which increases the risk of bleeding. It is crucial to initiate bleeding precautions, including regularly checking for signs of bleeding such as examining urine and stool for blood. Monitoring for fever every 4 hours (
Choice
A) should be included for neutropenic precautions, not specifically related to platelet count. Requiring visitors to wear respiratory masks and protective clothing (
Choice
B) is more relevant for patients with airborne precautions. Considering transfusion of packed red blood cells (
Choice
C) is not indicated for low platelet count but is more appropriate for managing anemia or low hemoglobin levels.