Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 111

1. A 15-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia. Which of the following would be included in educating the mother and child as part of discharge planning?

A) Give oral iron medication every day.
B) Have the child - s blood pressure monitored every week.
C) Know the signs and symptoms of iron overload.
D) Keep exercise at a minimum to reduce stress.

2. An 8-year-old boy has been diagnosed with hemophilia. Which of the following diagnostic blood studies is characteristically abnormal in this disorder?

A) Partial thromboplastin time
B) Platelet count
C) Complete blood count
D) Bleeding time

3. A murmur has been discovered during the routine physical examination of a 1-year-old child. The parent is extremely concerned about this diagnosis. Which of the following explanations by the nurse indicates understanding of this dysfunction?

A) The blood shifts from the right to the left atrium.
B) Surgical closure by suture or patch is recommended before school age.
C) Most atrial septal defects close spontaneously.
D) The child can be treated medically with antibiotics to prevent bacterial endocarditis.

4. An alcoholic client who is completing the inpatient segment of a substance abuse program was placed on disulfiram (Antabuse) drug therapy. What should the nurse include in the discharge instructions?

A) If disulfiram is taken and alcohol ingested, the client experiences nausea, vomiting and elevated blood pressure.
B) Disulfiram is most effective when prescribed as late as possible in a recovery program.
C) Disulfiram works on the desensitization principle.
D) The effects of disulfiram can be triggered by alcohol 5 days to 2 weeks after the drug is discontinued.

5. An 82-year-old former restaurant owner walks to the nursing station and states, 'I have to go. The restaurant opens at 11 am.' Which response by the nurse is the most appropriate?

A) 'Go back to your room. You do not own a restaurant.'
B) 'You are in the hospital now. Calm down.'
C) 'You once owned a restaurant. Tell me about it.'
D) 'It is snowing outside. The restaurant is closed.'

1. Right Answer: C
Explanation: (A) Oral iron supplements are contraindicated in thalassemia. (B) Although heart failure may be an end result of this disease, this action is unnecessary. (C) Iron overload is a potential complication of frequent blood transfusions of children with thalassemia. (D) Children should be encouraged to pursue activities related to their exercise tolerance.

2. Right Answer: A
Explanation: (A) Partial thromboplastic time measures activity of thromboplastin, which depends on the intrinsic clotting factors deficient in children who are hemophiliacs. (B)Platelet counts are normal in hemophilia. (C) Hemophilia does not affect the complete blood count. (D) Bleeding times are normal in hemophiliacs. They measure the time interval for the bleeding from small superficial wounds to cease.

3. Right Answer: B
Explanation: (A) Because the left atrial pressure is greater than right atrial pressure, oxygenated blood flows from the left to the right atria. (B) Because of the risk of pulmonary obstructive diseases and congestive heart failure later in life, surgery is usually performed between age 4 and 6 years, with essentially no operative mortality or postoperative complications. (C) Many ventricular septal defects close spontaneously (2060%) as a result of growth and proliferation of the muscular septum or formation of a membrane across the opening. (D) This management is usually recommended with children with mild pulmonary stenosis.

4. Right Answer: D
Explanation: (A) When alcohol is ingested with disulfiram therapy, the client experiences nausea, vomiting, and a potentially serious drop in blood pressure. (B) Disulfiram is most successful when used early in the recovery process while the individual makes major lifestyle changes necessary for long-term recovery. (C) Disulfiram works on the classical conditioning principle. (D) The effects of disulfiram can be felt when alcohol is ingested 12 weeks after disulfiram is discontinued.

5. Right Answer: C
Explanation: (A) This response cuts off communication with the client. It does not address her feelings. (B) Reality orientation frequently does not work alone. Feelings must be addressed. Telling a client to calm down is frequently ineffective. (C) Reminiscence is used here to reorient and recall past pleasant events. Talking about the restaurant will allay anxiety. (D) This response may confirm to the client that she indeed does still own a restaurant, buying into her confusion. Her feelings and anxiety require nursing intervention.

80% DISCOUNT: NCLEX-RN PRACTICE EXAMS