NCLEX with Greg
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Prepare for the exam with the BEST! Gregory is a licensed instructor and a Registered Nurse at Montefiore Medical Center.
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پستهای کانال
Correct answers - 2 and 4. Explanation
Clostridioides difficile is a gram-positive, anaerobic bacterium that causes widespread inflammation of the colon with profuse, watery diarrhea; abdominal pain; fever; and nausea. Antibiotic use can disrupt intestinal flora and increase the risk for C difficile infection. The bacterium is transmitted to susceptible individuals primarily via the fecal oral route and requires contact precautions to prevent transmission.
The nurse caring for the client with C difficile should wear a single-use, protective gown, use dedicated client care equipment (e.g., stethoscope, blood pressure cuff), and request that the client be placed in a private room (Options 2 and 4).
(Option 1) Sterile gloves are not necessary when caring for a client with C difficile. Instead, clean gloves should be used to reduce the transmission of infection to other individuals.
(Option 3) Soap and water should be used to cleanse the hands because C difficile spores have shown resistance to alcohol-based sanitizers.
(Option 5) Surgical masks (ie, face masks) must be worn as personal protective equipment if an organism is spread via droplets. However, masks are not required for preventing the spread of a contact-transmissible infection such as C difficile.
Educational objective:
Clostridioides difficile is transmitted via the fecal-oral route and requires contact precautions to prevent transmission. The nurse should wear a single-use, protective gown, use dedicated client care equipment, and place the client in a private room.
| 2 | بدون متن... | 179 |
| 3 | Appendicitis (i.e., inflammation of the appendix) often results from obstruction by fecal matter. The obstruction traps fluid and mucus typically secreted into the colon, causing increased intraluminal pressure and inflammation. This impairs blood circulation to the appendix, resulting in swelling and ischemia. These factors increase the risk for perforation, a medical emergency that can lead to peritonitis and sepsis.
When prioritizing care of the client with appendicitis, the nurse should utilize the ABCs (i.e., Airway, Breathing, Circulation). Fluid resuscitation with IV crystalloids (e.g., 0.9% sodium chloride, lactated Ringer solution) is an important intervention aimed at preventing circulatory collapse resulting from fluid losses (e.g., vomiting, diarrhea) and NPO status (Option 3).
(Option 1) Pain medications may be administered to promote comfort but should be administered via IV route to maintain NPO status in case of emergency surgery. In addition, circulation takes priority over pain medication. | 181 |
| 4 | The nurse is caring for a client with suspected appendicitis who has vomiting and right lower quadrant pain. It would be a priority for the nurse to | 165 |
| 5 |  بدون متن... | 177 |
| 6 | How many mL should the nurse administer to the client with
each dose? (Record your answer using 1 decimal place) | 176 |
| 7 | The nurse is caring for a client who has a prescription for cefuroxime 30 mg/kg/day
PO in 2 divided doses. The client weighs 35 lb. (15.9 kg). | 1 |
| 8 | (Option 4) Performing admission or initial assessments is outside the scope of the LPN and UAP. The RN must perform initial assessments to analyze the findings and formulate the client's plan of care before delegating tasks.
(Option 5) The LPN is capable of performing routine care (e.g., calculating daily intake and output, toileting). However, the UAP may also perform these tasks, which frees the LPN to perform more complex duties. Therefore, the most appropriate staff member to assign the task of calculating intake and output is the UAP.
Educational objective:
Nurses preparing to delegate client care should consider the 5 rights of delegation. Appropriate tasks to delegate to a licensed practical nurse include the administration of oral and parenteral medications (excluding those via the IV route) and reinforcement of teaching previously provided by the registered nurse. | 158 |
| 9 |  Nurses preparing to delegate client care to a licensed practical nurse (LPN) and/or unlicensed assistive personnel (UAP) should consider the 5 rights of delegation. The LPN can monitor and care for stable clients who have been initially evaluated by a registered nurse (RN). Interventions that LPNs may perform include:
Administering most medications (e.g., subcutaneous insulin, oral analgesics) (Options 1 and 2)
Reinforcing teaching and skills that have been initially taught by the RN (Option 3)
Performing focused assessments (e.g., bowel sounds) after the RN's initial assessment. | 148 |
| 10 | بدون متن... | 168 |
| 11 | The nurse is assigning client care activities to a licensed practical nurse (LPN) and
unlicensed assistive personnel (UAP). Which of the following activities would be
appropriate to assign to the LPN?
1) Administer the daily dose of subcutaneous insulin glargine to a client.
2) Administer a scheduled oral analgesic to a client who had surgery 2 days ago.
3) Reinforce teaching about self-administration of insulin for a client with diabetes
mellitus.
4) Complete an admission assessment for a client admitted for an elective
hysterectomy.
5) Record client intake and output totals during the shift for all clients on the unit. | 177 |
| 12 | Facial nerve irritability occurs with hypocalcemia. Parathyroid glands if not harvested for
relocation, are often removed during total thyroidectomy. 1. Nuchal rigidity develops
related to meningeal irritation. 2. Difficulty breathing may occur after thyroid surgery due to
hemorrhage or laryngeal edema. 4. Premature ventricular contractions are often related to
hypokalemia. Think of the signs and symptoms of hypocalcemia. | 390 |
| 13 | The nurse is caring for a client returning to the medical surgical unit after a total
thyroidectomy. Which assessment finding indicates a related electrolyte
deficiency? | 373 |
| 14 | Rationale
50/100 x 5ml = 0.5 x 5 -= 2.5 ml. | 424 |
| 15 | For the question above, please select the correct answer | 422 |
| 16 | The nurse has just received a new patient from the ED, admitted with chronic
alcohol abuse. The orders read 50 mg of Thiamine in 1 liter of Dextrose 5% 1/3
Normal Saline. The label on the Thiamine vial reads 100 mg/5 mL. How many
milliliters of Thiamine would you withdraw from the vial as an additive to the above
IV?
1) 2.5 ml
2) 1.75 ml
3) 2.75 ml
4) 2.0 ml | 389 |
| 17 | A client with crackles in the lungs is exhibiting signs of pulmonary fluid. Redness at the
insertion site indicates infection, which can lead to peritonitis if untreated. The sign listed
here, which is indicative of peritonitis, is cloudy dialysate drainage. When the dialysate is
drained from the peritoneal cavity, it should not be cloudy. A significant peritoneal cavity
infection may lead to scar tissue formation, eliminating the client’s ability to continue
peritoneal dialysis. Prevention of infection is the highest priority when caring for this client. | 379 |
| 18 | A nurse is assessing a client who has been performing continuous ambulatory
peritoneal dialysis for the last several weeks at home. Which of the signs and
symptoms are indicative of the potential complication of peritonitis? | 334 |
| 19 | }}Starting a question with “why” can give the impression of an accusation. B and C give false
reassurance. Instead, therapeutic communication techniques require the nurse to seek
out information about the client’s feelings. Answer A is the most therapeutic, and it is an
open-ended statement that encourages the client to elaborate.|| | 437 |
| 20 | A 42-year-old client tells you that he is sure that he will die during his surgery
tomorrow because his dad died at the age of 39. What would be an appropriate
response by the nurse? | 430 |
