NCLEX Daily Practical Exercise 44

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. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

A. “I will drink 500mL of fluid or less each day.”

B. “I will wear support hose when I am up.”

C. “I will use an electric razor for shaving.”

D. “I will eat foods low in iron.”

Correct Answer: A

Answer Explanation:

The client with polycythemia vera is at risk for thrombus formation. Hydrating the client with at least 3L of fluid per day is important in preventing clot formation, so the statement to drink less than 500mL is incorrect.

Option B: Wearing a support hose promotes venous return.
Option C: The electric razor prevents bleeding due to injury.
Option D: A diet low in iron is essential to preventing further red cell formation.

2. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?

A. The client collects stamps as a hobby.

B. The client recently lost his job as a postal worker.

C. The client had radiation for treatment of Hodgkin’s disease as a teenager.

D. The client’s brother had leukemia as a child.

Correct Answer: C

Answer Explanation:

Radiation treatment for other types of cancer can result in leukemia. Some hobbies and occupations involving chemicals are linked to leukemia.

Option A: Collecting stamps does not predispose the client to acute leukemia.
Option B: Losing a job does not contribute to acute leukemia.
Option D: The incidence of leukemia is higher in twins than in siblings.

3. An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?

A. The abdomen

B. The thorax

C. The earlobes

D. The soles of the feet

Correct Answer: D

Answer Explanation:

Petechiae are not usually visualized on dark skin. The soles of the feet and palms of the hand provide a lighter surface for assessing the client for petechiae.

Options A, B, and C: The skin in the abdomen, thorax, and earlobes might be too dark to make an assessment.

4. A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?

A. “Have you noticed a change in sleeping habits recently?”

B. “Have you had a respiratory infection in the last 6 months?”

C. “Have you lost weight recently?”

D. “Have you noticed changes in your alertness?”

Correct Answer: B

Answer Explanation:

The client with leukemia is at risk for infection and has often had recurrent respiratory infections during the previous 6 months.

Options A, C, and D: Insomnolence, weight loss, and a decrease in alertness also occur in leukemia, but bleeding tendencies and infections are the primary clinical manifestations.

5. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?

A. Oral mucous membrane, altered related to chemotherapy

B. Risk for injury related to thrombocytopenia

C. Fatigue related to the disease process

D. Interrupted family processes related to life-threatening illness of a family member

Correct Answer: B

Answer Explanation:

The client with acute leukemia has bleeding tendencies due to decreased platelet counts, and any injury would exacerbate the problem.

Option A: Alterations in the oral mucous membrane may occur with chemotherapy but it is not a priority.
Option C: Fatigue is common among patients receiving chemotherapy but not a priority.
Option D: Interrupted family processes can also be a diagnosis but not a priority.

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