NCLEX-PN
Physiological Adaptation NCLEX Questions
Extract:
Question 1 of 5
What are the implications for a client with renal insufficiency who wants to start a low-carbohydrate (CHO) diet?
Correct Answer: B
Rationale: A client with renal insufficiency should not start a low CHO diet because it could result in an increased renal solute load. Clients who have renal disease (renal failure, endstage renal disease [ESRD], dialysis, and transplant) or liver disease (liver failure, hepatic encephalopathy, cirrhosis, transplant, and hepatitis) require some form of protein control in dietary patterns to prevent complications from an inability to handle protein solute load. Proteins used in the diet must be of high biologic value, and protein intake is usually weight based, starting at 0.8 g/kg of dry weight, depending on the client's underlying clinical condition. Protein levels may be increased as necessary to account for metabolic response to dialysis and regeneration of liver tissue (1.5-2.0 g/kg/day). A minimum level of CHOs are needed in the diet (50-100 g/day) to spare protein. Vitamin and mineral supplements might be indicated with clients who have liver failure. The dietician is instrumental in calculating specific nutrient requirements for these clients and reviewing fluid intake and output, medication profile, and daily weight to monitor client outcomes in conjunction with dialysis technicians and nurses.
Question 2 of 5
A client receives a cervical intracavity radium implant as part of her therapy. A common side effect of a cervical implant is:
Correct Answer: A
Rationale: Creamy, pink-tinged vaginal drainage persists for 1 to 2 months after removal of a cervical implant.
Question 3 of 5
A nurse is screening patients for immunizations. Which of following is not a contraindication for immunization?
Correct Answer: D
Rationale: Chronic conditions are not considered a contraindication for immunization.
Question 4 of 5
If a client is suffering from thyroid storm, the PN can expect to find on assessment:
Correct Answer: A
Rationale: In thyroid storm, excessive thyroxine causes increased metabolic rate, leading to tachycardia, hyperthermia, and other signs of hyperthyroidism such as atrial fibrillation.
Question 5 of 5
A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:
Correct Answer: A
Rationale: Drug tolerance is characterized by the ability to ingest a larger dose without adverse effect and decreased sensitivity to the substance. Substance dependence is a severe condition indicating physical problems and disruption of the person's social, family, and work life. The psychological behaviors related to substance use are termed addiction. Dual diagnosis is the coexistence of substance abuse and psychiatric disorders.