NCLEX Daily Ten Question Practical Exercise 10

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 managing care for several clients in the outpatient clinic. Among the following clients who called, which one should the nurse prioritize in responding to first?

Correct Answer: E

Answer Explanation:

It may indicate neurovascular compromise, requiring immediate assessment.

Option A: Bilirubin levels in hepatitis A may increase, and itching is a common symptom.
Option C: A client feeling nauseous may require consultation but is not a priority.
Option D: Clients with rheumatoid arthritis may feel pain in the affected areas at night. They may need a prescription for painkillers but it is not urgent.

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2. A nurse on the surgical floor is prioritizing care for clients after receiving the report from the previous shift. Which of the following patients should the nurse assess first?

Correct Answer: F

Answer Explanation:

The client is at risk for peritonitis; should be assessed for further symptoms and infection.

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3. A nurse in a post-surgical unit is monitoring a 46-year-old patient who underwent a thyroidectomy 12 hours ago for the treatment of Grave’s disease. Which of the following observations should most concern the nurse?

Correct Answer: E

Answer Explanation:

Carpal spasms (Trousseau’s sign) indicate hypocalcemia which can occur after thyroidectomy due to accidental removal or damage to the parathyroid glands. Hypocalcemia is a serious complication and requires immediate attention. The other options, while they might warrant monitoring, are not as immediately concerning as a potential sign of hypocalcemia.

Option A: The vital signs are all within the normal range.
Option B: Supporting the head and neck while turning protects the surgical site from dehiscence.
Option C: Common side effect of neck surgery.
Option D: Drowsiness may be a side effect of the anesthesia used during surgery and will fade away eventually; a sore throat is a normal finding after thyroid surgery.
Option F: Hoarseness of voice is a common side effect of post-op thyroidectomy due to one or more of the nerves irritated during the procedure of due to inflammation that occurs after surgery.

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4. A 38-year-old patient is admitted to the emergency department with severe pain in the lower right quadrant of the abdomen, nausea, and a low-grade fever, raising concerns about possible appendicitis. The nurse is considering pain relief strategies. Which of the following actions should the nurse prioritize?

Correct Answer: D

Answer Explanation:

Using comfort measures and pillows to position the client is a non-pharmacological method of pain relief.

Option A: Gentle position changes can help alleviate pain, but changing positions often might aggravate the pain felt by the client.
Option B: Demerol may be given if prescribed by the physician.
Option C: The client may be experiencing acute appendicitis; warm compresses may cause rupture of the inflamed appendix.
Option E: Addressing associated symptoms like nausea can improve overall comfort but is not the priority as of the moment.

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5. A 56-year-old patient, recently diagnosed with end-stage renal disease, is preparing for their first peritoneal dialysis session in a clinic. The patient has a history of diabetes and hypertension, and has been experiencing increasing fatigue and fluid retention. Upon arrival, the nurse notes that the patient appears anxious about the procedure. The patient’s vital signs are stable, with a blood pressure of 150/90 mmHg, pulse 78 bpm, and respiratory rate 16 breaths per minute. The nurse reviews the physician’s orders, which indicate the type and volume of dialysate to be used. The peritoneal dialysis catheter had been placed a week earlier, and there’s no sign of infection at the site. The patient is settled in a comfortable position in the dialysis room, which is equipped with all necessary emergency equipment. Considering this scenario, which of the following actions should the nurse prioritize?

Correct Answer: B

Answer Explanation:

Cold dialysate increases discomfort. The solution should be warmed to body temperature in a warmer or heating pad; don’t use a microwave oven.

Option A: Assessing for bruit and thrill can be done to check for the patency of the fistula.
Option C: The client may resume a position that will be comfortable for him.
Option D: A Foley catheter is unnecessary during peritoneal dialysis.

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