NCLEX-RN Daily Ten Question Practical Exercise 55

Welcome to our NCLEX-RN Daily Ten Practice! This practice is designed to help you solidify your knowledge, improve your skills, and prepare thoroughly for the NCLEX-RN exam. With ten questions to tackle each day, you’ll have the opportunity to review a broad range of subjects covered in the NCLEX-RN exam.

 

1. During a community health assessment at a local school’s parent-teacher conference, the nurse encounters several parents and caregivers. Based on their shared histories and lifestyles, the nurse determines the risk factors for hypertension among them. Which of the following individuals is at the HIGHEST risk for developing hypertension?

A. A 45-year-old African-American attorney with a family history of hypertension, who has a sedentary lifestyle, consumes a diet high in sodium, and recently had a significant weight gain.

B. A 60-year-old Asian-American shop owner with a BMI of 28, who has well-managed type 2 diabetes, takes medications for high cholesterol, and engages in regular physical activity.

C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is a non-smoker but reports high levels of work-related stress and consumes excessive amounts of caffeine.

D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy BMI, participates in a moderate-intensity exercise program, and recently started taking oral contraceptives.

Correct Answer: A

Answer Explanation:

African-American adults have a higher prevalence of hypertension compared to other racial and ethnic groups in the United States. This individual also has a family history of hypertension, a sedentary lifestyle, and a diet high in sodium, which are all risk factors for hypertension. Therefore, this individual is at the greatest risk for developing hypertension among the given choices.

Option B. 60-year-old Asian-American shop owner: Although age is a risk factor for hypertension, this individual has well-managed type 2 diabetes and engages in regular physical activity. Their BMI of 28 suggests being overweight, but the combination of other factors makes this individual’s risk lower than the African-American attorney.
Option C. 40-year-old Caucasian nurse: While this individual reports high levels of work-related stress, which can be a risk factor for hypertension, they have a healthy BMI, are a vegetarian, and a non-smoker. These factors help offset their risk, making them less likely to develop hypertension compared to the African-American attorney.
Option D. 55-year-old Hispanic teacher: Although this individual smokes occasionally, which is a risk factor for hypertension, they have a healthy BMI and participate in a moderate-intensity exercise program. These factors help reduce their risk, making them less likely to develop hypertension compared to the African-American attorney.

2. A 15-year-old female with a history of depression is brought to the emergency department.

Nurse’s Notes:
1115: A 15-year-old female with a history of depression and recent relationship troubles with her close friends is brought to the emergency department by her concerned parents after they found an empty bottle of maximum-strength acetaminophen in her room. Upon questioning, the patient tearfully admits to ingesting 15 tablets of the medication 45 minutes ago. She is visibly anxious and frequently looks at the marks on her wrists, which seem to be superficial scratches.

Vital signs as of 1115: 

  • Blood pressure: 120/70
  • Heart rate: 88 bpm
  • Respiratory rate: 18 bpm
  • Oxygen saturation: 98% on room air

As the nurse prepares to address the situation, several orders from the primary care provider come in. Which of the following orders should the nurse prioritize and carry out first?

Correct Answer: B

Answer Explanation:

Although gastric lavage can help remove any remaining acetaminophen from the stomach, it is not the priority intervention in this situation. Administering the antidote, acetylcysteine (Mucomyst), should be the primary focus to counteract the toxic effects of acetaminophen on the liver. Acetylcysteine is the antidote for acetaminophen toxicity and should be administered as soon as possible to maximize its effectiveness in preventing liver damage.

3. A 68-year-old male with a history of hypertension and diabetes has undergone a cardiac catheterization to evaluate potential coronary artery disease. He has a known allergy to iodine-based contrast agents, which required premedication with corticosteroids and antihistamines. The procedure was successful, but the patient experienced brief hypotension during the administration of the contrast material. The patient has been transferred to the cardiac step-down unit for observation, and the nurse is aware of the potential complications that can arise in the initial 24 hours post-procedure. Which complication should the nurse monitor closely during this period?

Correct Answer: B

Answer Explanation:

In the initial 24 hours after a cardiac catheterization, the nurse should closely monitor for thrombus formation. Thrombus formation at the catheterization site can lead to serious complications, such as decreased blood flow to the extremities or embolization to other parts of the body. While the other options (angina at rest, dizziness, and falling blood pressure) can be potential concerns, thrombus formation is the most critical complication to monitor for during the immediate post-procedure period.

4. A 43-year-old male with a history of recurrent renal calculi is admitted to the emergency department presenting with severe left flank pain radiating to the groin, nausea, and an episode of vomiting. He also reports burning and urgency during urination. His vital signs reveal a temperature of 100.8ºF (38.2ºC), blood pressure of 145/90 mmHg, pulse of 100 beats/min, and respiratory rate of 20 breaths/min. The client is visibly anxious and uncomfortable due to the severity of the pain. The nurse is assigned to care for the patient and must prioritize the nursing goals to ensure optimal care. Which nursing goal should be the top priority for this client?

Correct Answer: C

Answer Explanation:

Managing pain is always a priority because it ultimately improves the quality of life. The cornerstone of ureteral colic management is analgesia, which can be achieved most expediently with parenteral narcotics or nonsteroidal anti-inflammatory drugs (NSAIDs).

Option A: IV hydration in the setting of acute renal colic is controversial. Whereas some authorities believe that IV fluids hasten the passage of the stone through the urogenital system, others express concern that additional hydrostatic pressure exacerbates the pain of renal colic.
Option B: Because nausea and vomiting frequently accompany acute renal colic, antiemetics often play a role in renal colic therapy. Several antiemetics have a sedating effect that is often helpful.
Option D: Overuse of the more effective antibiotic agents leaves only highly resistant bacteria, but failure to adequately treat a UTI complicated by an obstructing calculus can result in potentially life-threatening urosepsis and pyonephrosis.

5. During a school screening program for children aged 6-12, a nurse is tasked with evaluating their growth parameters. She encounters a 9-year-old girl who is shorter than her peers and seems to have less muscle development. To align her observations with typical growth expectations for school-age children, what would the nurse expect to see?

Correct Answer: D

Answer Explanation:

School-age children gain about 5.5 pounds each year and increase about 2 inches in height. Between ages 2 to 10 years, a child will grow at a steady pace.

Option A: Decreasing amounts of body fat and muscle mass are common in toddlers.
Option B: A decrease in the change in body appearance occurs among young adults.
Option C: Growth spurts are common in school-age children, as are periods of slow growth.

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