NCLEX Daily Practical Exercise 20

Welcome to our NCLEX Daily Ten Practice! This practice is designed to help you solidify your knowledge, improve your skills, and prepare thoroughly for the NCLEX exam. With ten questions to tackle each day, you’ll have the opportunity to review a broad range of subjects covered in the NCLEX exam.

 

1. A patient who has received chemotherapy for cancer treatment is given an injection of Epoetin. Which of the following should reflect the findings in a complete blood count (CBC) drawn several days later?

Correct Answer: B

Answer Explanation:

Epoetin is a form of erythropoietin, which stimulates the production of red blood cells, causing an increase in hematocrit. Epoetin is given to patients who are anemic, often as a result of chemotherapy treatment.

Option A: GCSFs, such as Neupogen (filgrastim, Amgen), Granix (tbo-filgrastim, Cephalon, Inc.), and Zarxio (filgrastim-sndz, Sandoz), stimulate and promote the maturation and activation of neutrophils.
Option C: Medications such as romiplostim (Nplate) and eltrombopag (Promacta) help the bone marrow produce more platelets.
Option D: Epoetin has no effect on neutrophils, platelets, or serum iron.

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2. A patient is admitted to the hospital with suspected polycythemia vera. Which of the following symptoms is consistent with the diagnosis? Select all that apply.

Correct Answer: B C D

Answer Explanation:

Polycythemia vera is a condition in which the bone marrow produces too many red blood cells. This causes an increase in hematocrit and viscosity of the blood. Patients can experience headaches, dizziness, and visual disturbances. Cardiovascular effects include increased blood pressure and delayed clotting time.

Option A: Weight loss is not a manifestation of polycythemia vera.
Option E: Polyphagia or excessive hunger is a symptom of diabetes mellitus.

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3. A nurse is caring for a patient with a platelet count of 20,000/microliter. Which of the following is an important intervention?

Correct Answer: A

Answer Explanation:

Platelet counts under 30,000/microliter may cause spontaneous petechiae and bruising, particularly in the extremities. When the count falls below 15,000, spontaneous bleeding into the brain and internal organs may occur. Headaches may be a sign and should be watched for.

Options B and D: Thrombocytopenia does not compromise immunity, and there is no reason to limit visitors as long as any physical trauma is prevented.
Option C: Aspirin disables platelets and should never be used in the presence of thrombocytopenia.

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4. A nurse in the emergency department assesses a patient who has been taking long-term corticosteroids to treat renal disease. Which of the following is a typical side effect of corticosteroid treatment? Select all that apply.

Correct Answer: A, B, D, and E.

Answer Explanation:

Side effects of corticosteroids include weight gain, fluid retention with hypertension, Cushingoid features, low serum albumin, suppressed inflammatory response, and mood swings. Patients are encouraged to eat a diet high in protein, vitamins, and minerals and low in sodium.

Option C: Corticosteroids cause hypernatremia and not hyponatremia.

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5. A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for a neutropenic patient?

Correct Answer: B

Answer Explanation:

The neutropenic patient is at risk of infection. Changing gloves immediately after use protects patients from contamination with organisms picked up on hospital surfaces. This contamination can have serious consequences for an immunocompromised patient.

Option A: Changing the respiratory mask is desirable, but not nearly as urgent as changing gloves.
Options C and D: Minimizing contact and conversation are not necessary and may cause nursing staff to miss changes in the patient’s symptoms or condition.

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