NCLEX Daily Practical Exercise 40

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. During a routine checkup, Nurse Marianne assesses a male client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?

Correct Answer: D

Answer Explanation:

Kaposi’s sarcoma is the most common cancer associated with AIDS.

Option A: It is suggested that the immune-suppression results in co-infection with the papilloma virus. The immunosuppression causes reduction in the effectiveness of the immune surveillance system resulting in growth of the tumor.
Option B: Multiple myeloma is a very uncommon neoplasm complicating HIV infection but when it occurs, it is associated with an aggressive course and a worse prognosis.
Option C: Untreated HIV infection causes AIDS and this major impairment in the immune system is associated with an increased risk of cancer, including a number of “solid tumor” cancers and non-Hodgkin lymphoma, but also Hodgkin lymphoma, myeloma, and leukemia.

ADVERTISEMENT

2. Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist’s instructions. Why does the client require special positioning for this type of anesthesia?

Correct Answer: C

Answer Explanation:

The client receiving a subarachnoid block requires special positioning to prevent CSF leakage and headache and to ensure proper anesthetic distribution.

Option A: Anesthetics are well known to cause confusion, but this typically decreases as the body processes the medications and removes them from circulation.
Option B: Generalized seizure as a complication following epidural anesthesia has been reported, but rarely following spinal anesthesia.
Option D: The incidence of arrhythmias, as well as hypotension during spinal anesthesia, is higher for Cesarean section mostly.

ADVERTISEMENT

3. A male client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:

Correct Answer: A

Answer Explanation:

If abdominal distention is accompanied by nausea, the nurse must first auscultate bowel sounds. If bowel sounds are absent, the nurse should suspect gastric or small intestine dilation and these findings must be reported to the physician.

Option B: Palpation is the examination of the abdomen for crepitus of the abdominal wall, for any abdominal tenderness, or for abdominal masses. It may be used to assess the client but this will not be the first choice following a nephrectomy.
Option C: Changing positions would not diminish the client’s nausea and abdominal pressure.
Option D: If peristalsis is absent, inserting a rectal tube won’t relieve the client’s discomfort.

ADVERTISEMENT

4. Wilfredo with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse Patricia position the client for this test initially?

Correct Answer: B

Answer Explanation:

For a colonoscopy, the nurse initially should position the client on the left side with knees bent.

Option A: Lying on the right side with legs straight is not an appropriate position for this procedure. It would not allow proper visualization.
Option C: This position may not allow proper visualization of the large intestine.
Option D: Bent over with hands touching the floor wouldn’t allow proper visualization of the large intestine.

ADVERTISEMENT

5. A male client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, Nurse Oliver notes that the client’s stoma appears dusky. How should the nurse interpret this finding?

Correct Answer: A

Answer Explanation:

An ileostomy stoma forms as the ileum is brought through the abdominal wall to the surface skin, creating an artificial opening for waste elimination. The stoma should appear cherry red, indicating adequate arterial perfusion. A dusky stoma suggests decreased perfusion, which may result from interruption of the stoma’s blood supply and may lead to tissue damage or necrosis.

Option B: Stoma necrosis or a dusky stoma usually occurs within the first 5 postoperative days. The stoma appears discolored rather than red, moist, and shiny. Discoloration may be cyanotic, black, dark red, dusky bluish-purple, or brown.
Option C: Adjusting the ostomy bag wouldn’t affect stoma color, which depends on blood supply to the area.
Option D: Symptoms of intestinal obstruction may include acute abdominal pain, absence of output or extremely watery output, nausea or vomiting, and a swollen, hard abdomen.

ADVERTISEMENT

Leave A Comment?