NCLEX Daily Practical Exercise 51


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

 

1. A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?

Correct Answer: D

Answer Explanation:

It is important to assess the extremities for blood vessel occlusion in the client with sickle cell anemia because a change in capillary refill would indicate a change in circulation.

Options A, B, and C: Body temperature, motion, and sensation would not give information regarding peripheral circulation.

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2. A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

Correct Answer: D

Answer Explanation:

Placing the client in a semi-Fowler’s position provides the best oxygenation for this client.

Options A, B, and C: Flexion of the hips and knees, which includes the knee-chest position, impedes circulation and is not correct positioning for this client.

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3. A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of the highest priority for this client?

Correct Answer: B

Answer Explanation:

It is important to keep the client in sickle cell crisis hydrated to prevent further sickling of the blood.

Option A: Taking hourly blood pressures with mechanical cuff is incorrect because a mechanical cuff places too much pressure on the arm.
Option C: Position in high Fowler’s with knee gatch raised is inappropriate because it impedes circulation.
Option D: Administering Tylenol is too mild an analgesic for the client in crisis.

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4. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?

Correct Answer: C

Answer Explanation:

Hydration is important in the client with sickle cell disease to prevent thrombus formation. Popsicles, gelatin, juice, and pudding have high fluid content.

Options A, B, D: These food items do not aid in hydration and are, therefore, incorrect.

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5. A newly admitted client has a sickle cell crisis. The nurse is planning care based on the assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.

Correct Answer: C

Answer Explanation:

The most prominent clinical manifestation of sickle cell crisis is pain. However, the pulse oximetry indicates that oxygen levels are low; thus, oxygenation takes precedence over pain relief.

Option A: Warm environment reduces pain and minimizes sickling, it would not be a priority.
Option B: Although hydration is important, it would not require a bolus.
Option D: Demerol is acidifying to the blood and increases sickling.

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