1. The client is admitted to the hospital in chronic renal failure. A diet low in protein is ordered. The rationale for alow-protein diet is:
A. Protein breaks down into blood urea nitrogen and metabolic waste.
B. High protein increases the sodium and potassium levels.
C. A high-protein diet decreases albumin production.
D. A high-protein diet depletes calcium and phosphorous.
Answer A is correct. A low-protein diet is required because protein breaks down into nitrogenous waste and causes an increased workload on the kidneys. Answers B, C, and D are incorrect.
2. The nurse is assisting in the care of a patient who is 2 days postoperative from a hemorroidectomy. The nurse would be correct in instructing the patient to:
A. Avoid a high-fiber diet because this can hasten the healing time
B. Continue to use ice packs until discharge and then when at home
C. Take 200mg of Colace bid to prevent constipation
D. Use a sitz bath after each bowel movement to promote cleanliness and comfort
Answer D is correct. The use of a sitz bath will help with the pain and swelling associated with a hemorroidectomy. The client should eat foods high in fiber, so answer A is incorrect. Ice packs, as stated in answer B, are ordered immediately after surgery only. Answer C, a stool softener, can be ordered, but only by the doctor.
3. The client is admitted to the emergency room with shortness of breath, anxiety, and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine, the nurse should monitor his ECG for:
A. Peaked P wave
B. Elevated ST segment
C. Inverted T wave
D. Prolonged QT interval
Answer D is correct. Quinidine can cause widened Q-T intervals and heart block. Other signs of myocardial toxicity are notched P waves and widened QRS complexes. The most common side effects are diarrhea, nausea, and vomiting. The client might experience tinnitus, vertigo, headache, visual disturbances, and confusion. Answers A, B, and C are not related to the use of quinidine
4. A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate’s action can result inwhat type of charge:
A. Fraud
B. Tort
C. Malpractice
D. Negligence
Answer A is correct. Identifying oneself as a nurse without a license defrauds the public and can be prosecuted. A tort is a wrongful act; malpractice is failing to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care. Therefore, answers B, C, and D are incorrect.
5. A client with cancer develops xerostomia. The nurse can help alleviate the discomfort associated with xerostomia by:
A. Offering hard candy
B. Administering analgesic medications
C. Splinting swollen joints
D. Providing saliva substitute
Answer D is correct. Xerostomia is dry mouth, and offering the client a saliva substitute will help the most. Eating hard candy in answer A can further irritate the mucosa and cut the tongue and lips. Administering an analgesic might not be necessary;
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A. Protein breaks down into blood urea nitrogen and metabolic waste.
B. High protein increases the sodium and potassium levels.
C. A high-protein diet decreases albumin production.
D. A high-protein diet depletes calcium and phosphorous.
Answer A is correct. A low-protein diet is required because protein breaks down into nitrogenous waste and causes an increased workload on the kidneys. Answers B, C, and D are incorrect.
2. The nurse is assisting in the care of a patient who is 2 days postoperative from a hemorroidectomy. The nurse would be correct in instructing the patient to:
A. Avoid a high-fiber diet because this can hasten the healing time
B. Continue to use ice packs until discharge and then when at home
C. Take 200mg of Colace bid to prevent constipation
D. Use a sitz bath after each bowel movement to promote cleanliness and comfort
Answer D is correct. The use of a sitz bath will help with the pain and swelling associated with a hemorroidectomy. The client should eat foods high in fiber, so answer A is incorrect. Ice packs, as stated in answer B, are ordered immediately after surgery only. Answer C, a stool softener, can be ordered, but only by the doctor.
3. The client is admitted to the emergency room with shortness of breath, anxiety, and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine, the nurse should monitor his ECG for:
A. Peaked P wave
B. Elevated ST segment
C. Inverted T wave
D. Prolonged QT interval
Answer D is correct. Quinidine can cause widened Q-T intervals and heart block. Other signs of myocardial toxicity are notched P waves and widened QRS complexes. The most common side effects are diarrhea, nausea, and vomiting. The client might experience tinnitus, vertigo, headache, visual disturbances, and confusion. Answers A, B, and C are not related to the use of quinidine
4. A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate’s action can result inwhat type of charge:
A. Fraud
B. Tort
C. Malpractice
D. Negligence
Answer A is correct. Identifying oneself as a nurse without a license defrauds the public and can be prosecuted. A tort is a wrongful act; malpractice is failing to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care. Therefore, answers B, C, and D are incorrect.
5. A client with cancer develops xerostomia. The nurse can help alleviate the discomfort associated with xerostomia by:
A. Offering hard candy
B. Administering analgesic medications
C. Splinting swollen joints
D. Providing saliva substitute
Answer D is correct. Xerostomia is dry mouth, and offering the client a saliva substitute will help the most. Eating hard candy in answer A can further irritate the mucosa and cut the tongue and lips. Administering an analgesic might not be necessary;
NCLEX Question Answers with Rationale.pdf
CLICK HERE FOR MORE NCLEX RN QUESTION ANSWERS
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