NCLEX Daily Practical Exercise 56

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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 29-year-old female client, who is a professional dancer, presents to the emergency department after a performance complaining of severe lower abdominal pain, fever, and an unusual vaginal discharge. She mentions that she had similar symptoms two months ago and was treated in an urgent care clinic. She also reports having multiple sexual partners in the past year and inconsistent condom use. Given the clinical presentation and her history, which of the following infections is most frequently associated with a recurrence of pelvic inflammatory disease (PID)?

A. Trichomoniasis

B. Chlamydia

C. Staphylococcus

D. Streptococcus

Correct Answer: B

Answer Explanation:

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It’s usually caused by a sexually transmitted infection. Chlamydia and gonorrhea are the most common causes of PID. Among these options, Chlamydia is the most frequently associated with PID. It’s essential to diagnose and treat Chlamydia promptly as it can lead to serious complications if left untreated, including infertility.

2. An experienced registered nurse, specialized in spinal rehabilitation, is floated to the busy emergency department for a shift. The emergency department is currently short-staffed, and there’s a power outage in the adjacent building, causing a surge of patients. Among the patients waiting, which client should the charge nurse most appropriately assign to this RN, keeping in mind her expertise and the current situation?

A. A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing out of my chest.”

B. A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking two (2) days ago for my family. Why are my arms and legs jerking?”

C. An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 11.

D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room.

Correct Answer: C

Answer Explanation:

Nurses who are floated to other units should be assigned to a client who has minimal anticipated immediate complications of their problem. This client exhibits opioid toxicity with the pinpoint pupils and has the least risk of complications to occur in the near future.

3. A 60-year-old male client is admitted to the cardiology ward following an angioplasty for coronary artery disease. Nutrition education is a part of his discharge planning. What dietary advice should the nurse prioritize?

A. Eating three (3) balanced meals a day

B. Adding complex carbohydrates

C. Avoiding very heavy meals

D. Limiting sodium to 7 gms per day

Correct Answer: C

Answer Explanation:

Eating large, heavy meals can pull blood away from the heart for digestion and is dangerous for the client with coronary artery disease. Too much plaque may accumulate in the arteries and block the delivery of blood and oxygen in major organs of the body.

Option A: Eating a balanced diet should be a part of the management of a client with coronary artery disease.
Option B: Complex carbohydrates decrease inflammation and help decrease the risk of plaque build-up in the arteries.
Option C: People with cardiovascular diseases should have a limit of less than 1.5 grams per day.

4. A 45-year-old patient in the intensive care unit, who was recently involved in a severe car accident, has multiple fractures and internal injuries. The patient has a history of chronic back pain and has been on long-term opioid therapy. The patient is currently on a pump set to deliver a basal rate of 10 ml per hour of morphine plus PRN doses for breakthrough pain. The nurse also notes that the patient has been frequently pressing the PRN button for additional relief. Given this scenario, which observation indicates that the pump may not be functioning correctly?

A. The client complains of discomfort at the IV insertion site and has slight redness around the area.

B. The client states “I just can’t get relief from my pain,” even after pressing the PRN button multiple times.

C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon, despite the patient’s frequent requests for PRN doses.

D. The level of the drug is 100 ml at 8 AM and is 50 ml at noon.

Correct Answer: C

Answer Explanation:

The pump is set to deliver a basal rate of 10 ml per hour. From 8 AM to noon, which is 4 hours, the pump should have delivered 40 ml (10 ml x 4 hours). If the level of the drug was 100 ml at 8 AM, it should be 60 ml at noon (100 ml – 40 ml). The fact that it’s 80 ml at noon indicates that only 20 ml has been delivered over 4 hours, suggesting the pump may not be functioning correctly, especially given the patient’s frequent requests for PRN doses.

5. During a community meeting on health promotion in a small town with a significant elderly population, the nurse is approached by a group of senior citizens. They express concerns about their chronic back pain and have heard about alternative treatments. One of them asks about the effectiveness of chiropractic treatments for their age group and associated ailments. Considering the demographic and the context, in responding, what should be the focus of the nurse’s answer?

A. Electrical energy fields and their role in pain management.

B. Spinal column manipulation and its potential benefits for chronic back pain.

C. Mind-body balance and its holistic approach to health.

D. Exercise of joints and its importance in maintaining mobility.

Correct Answer: B

Answer Explanation:

Chiropractic care primarily focuses on the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine. Spinal column manipulation is a central component of chiropractic treatments. Given the context of the question, where elderly individuals are specifically inquiring about chronic back pain, the nurse should focus on explaining the potential benefits and considerations of spinal column manipulation for their specific ailments.

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