NCLEX Daily Ten Question Practical Exercise 11


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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. A 45-year-old male patient who recently underwent a kidney transplant is being monitored in the post-operative period. During a routine check-up, the patient reports feeling generally unwell and expresses discomfort in the area of the transplant. The nurse is vigilant for signs of organ rejection. Which of the following assessments would most strongly prompt the nurse to suspect organ rejection?

Correct Answer: C

Answer Explanation:

Hypertension, along with fever, and tenderness over the grafted kidney, reflects acute rejection.

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2. A 52-year-old male patient, who is overweight and has a history of mild hypertension, presents to the healthcare facility with symptoms of severe flank pain and hematuria. The patient has been diagnosed with ureteral colic. The nurse is focusing on the immediate management of the patient’s condition. What should be the immediate objective of nursing care for this patient?

Correct Answer: A

Answer Explanation:

Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by urethral distention and smooth muscle spasm; relief from pain is the priority.

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3. A 38-year-old female patient with a diagnosis of hyperthyroidism is scheduled to receive Lugol’s iodine solution as a preoperative preparation before undergoing a subtotal thyroidectomy. The patient experiences symptoms including rapid heart rate, weight loss, and anxiety. The nurse is preparing to administer the medication and educates the patient on its purpose. What is the primary reason for administering Lugol’s iodine solution to this patient?

Correct Answer: D

Answer Explanation:

Lugol’s solution provides iodine, which aids in decreasing the vascularity of the thyroid gland, which limits the risk of hemorrhage when surgery is performed.

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4. A 30-year-old male patient, recently diagnosed with type 1 diabetes, is being educated by the nurse on potential complications of diabetes, including acute hypoglycemia. The patient is keen to understand how different health conditions might interact with his diabetes. The nurse is discussing other conditions that might also predispose a patient to develop acute hypoglycemia. Which of the following conditions can also lead to acute hypoglycemia?

Correct Answer: A

Answer Explanation:

The client with liver disease has a decreased ability to metabolize carbohydrates because of a decreased ability to form glycogen (glycogenesis) and to form glucose from glycogen.

Option B: The hemodynamic changes associated with hypoglycemia include an increase in heart rate and peripheral systolic blood pressure, a fall in the central blood pressure, reduced peripheral arterial resistance, and increased myocardial contractility, stroke volume, and cardiac output.
Option C: Type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon-secreting alpha cell and the insulin-secreting beta-cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia.
Option D: Hyperthyroidism is usually associated with poor blood glucose control and a need for additional insulin. An increased metabolism “clears” insulin from the system at a faster rate, and increased production and absorption of glucose can raise blood sugars.

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5. A 55-year-old female patient is receiving combination chemotherapy for the treatment of metastatic carcinoma. The patient has been experiencing fatigue and nausea. The nurse is closely monitoring the patient for potential systemic side effects of the chemotherapy treatment. Which of the following systemic side effects should the nurse monitor for in this patient?

Correct Answer: C

Answer Explanation:

Leukopenia, a reduction in WBCs, is a systemic effect of chemotherapy as a result of myelosuppression.

Option A: Ascites is common in some cancers that have reached the advanced stages and spread in the abdominal area. Sometimes chemotherapy might help manage ascites; it is not a side effect of chemotherapy.
Option B: Platinum-based chemotherapy is an effective antineoplastic intervention that is used for a variety of human malignancies. There were reports of spontaneous nystagmus in 7 out of 10 patients (70%) and positional nystagmus (60%).
Option D: While polycythemia vera is not a side effect of chemotherapy, it can become drug-induced with the excess use of rHuEPO or anabolic steroids.

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