Published - Thu, 23 Feb 2023

NCLEX-PN Exam Questions - Part 27

1. A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?

A) turning out the room light and closing the door
B) tiring the child during the evening with play exercises
C) identifying the child - s home bedtime rituals and following them
D) encouraging visitation by friends during the evening

2. The 24-hour day-night cycle is known as:

A) circadian rhythm.
B) infradium rhythm.
C) ultradian rhythm.
D) non-REM rhythm.

3. Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?

A) 0.9% sodium chloride
B) 5% dextrose in water solution
C) sterile water
D) Heparin sodium

4. Central venous access devices (CVADs) are frequently utilized to administer chemotherapy. What is an advantage of using CVADs for chemotherapeutic agent administration?

A) CVADs are less expensive than a peripheral IV.
B) Weekly administration is possible.
C) Chemotherapeutic agents can be caustic to smaller veins.
D) The client or family can administer the drug at home.

5. The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they:

A) cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA.
B) have few, if any, side effects.
C) are used to treat multiple types of cancer.
D) are cell-cycle-specific agents.

1. Right Answer: C
Explanation: Preschool-age children require bedtime rituals that should be followed in the hospital if possible. Choice 1 increases a childs fear. Choices 2 and 4 do not promote sleep. Basic Care and Comfort

2. Right Answer: A
Explanation: Circadian rhythm is rhythmic repetition of patterns each 24 hours. The other options are incorrect.Basic Care and Comfort

3. Right Answer: A
Explanation: Normal saline is 0.9% sodium chloride. This solution has the same osmolarity as blood. Its use does not cause lysis of cells. Choices 2 and 3 are hypotonic solutions that can cause cell lysis. Choice 4 is an anticoagulant.Pharmacological Therapies

4. Right Answer: C
Explanation: Many chemotherapeutic drugs are vesicants (highly active corrosive materials that can produce tissue damage even in low concentrations). Administration into a large vein is optimal. Choice 1 is incorrect because CVADs are more expensive than a peripheral IV. Choice 2 is incorrect because dosing depends on the drug.Choice 4 is incorrect because IV chemotherapeutic agents are not routinely administered at home; they are usually given in a hospital or in an outpatient or clinic setting. Pharmacological Therapies

5. Right Answer: A
Explanation: Alkylating agents are highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning, replication, and transcription. Choice 2 is incorrect because alkylating agents have numerous side effects including alopecia, nausea, vomiting, and myelosuppression. Choice 3 is incorrect because nitrogen mustards have a broad spectrum of activity against chronic lymphocytic leukemia, non-Hodgkins lymphoma, and breast and ovarian cancer, but they are effective chemotherapeutic agents because of DNA crosslinkage. Choice 4 is incorrect because alkylating agents are non-cell-cycle-specific agents. Pharmacological Therapies

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