NCLEX Daily Practical Exercise 18

6. Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?

Correct Answer: B

Answer Explanation:

Maintaining adequate fluid and replacing vasopressin are the main objectives in treating diabetes insipidus.

Option A: Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. Insulin produced by the pancreas lowers blood glucose.
Option C: Diabetic ketoacidosis is a result of severe insulin insufficiency.
Option D: An excess of antidiuretic hormone leads to SIADH, causing the patient to retain fluid.

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7. Patients with Type 1 diabetes mellitus may require which of the following changes to their daily routine during periods of infection?

Correct Answer: C

Answer Explanation:

During periods of infection or illness, patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels.

Option A: Changes should be applied to the patient’s daily routine to avoid complications from infection.
Option B: Less insulin could lead to hyperglycemia.
Option D: Oral diabetic agents may not be enough to decrease the blood glucose.

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8. On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has a decreased hematocrit level. Which of the following complications does this suggest?

Correct Answer: A

Answer Explanation:

A decreased hematocrit level is a sign of hematoma, a delayed complication of abdominal and vaginal hysterectomy.

Option B: Symptoms of hypovolemia include increased hematocrit and hemoglobin values.
Option C: Infection manifests with fever and high WBC count.
Option D: Symptoms of a PE include dyspnea, chest pain, cough, hemoptysis, restlessness, and signs of shock.

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9. A patient has partial-thickness burns to both legs and portions of his trunk. Which of the following I.V. fluids are given first?

Correct Answer: C

Answer Explanation:

Lactated Ringer’s solution replaces lost sodium and corrects metabolic acidosis, both of which commonly occur following a burn.

Option A: Albumin is used as an adjunct therapy, not a primary fluid replacement.
Option B: Dextrose isn’t given to burn patients during the first 24 hours because it can cause pseudodiabetes.
Option D: The patient is hyperkalemic from the potassium shift from the intracellular space to the plasma, so potassium would be detrimental.

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10. Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site?

Correct Answer: C

Answer Explanation:

Rolling a swab from the center outward is the right way to obtain a culture specimen from a wound.

Option A: Irrigating the wound washes away drainage, debris, and many of the colonizing or infecting microorganisms.
Option B: The outside of the wound and the dressing may be colonized with microorganisms that haven’t affected the wound, so specimens from these sites could give inaccurate results.
Option D: The dressing is considered contaminated and should not be used for collection of specimens.

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