NCLEX-RN Daily Ten Question Practical Exercise 60

6. During chemotherapy for lymphocytic leukemia, Mathew develops abdominal pain, fever, and “horse barn” smelling diarrhea. It would be most important for the nurse to advise the physician to order:

Correct Answer: C

Answer Explanation:

Immunosuppressed clients — for example, clients receiving chemotherapy, — are at risk for infection with C. difficile, which causes “horse barn” smelling diarrhea. Successful treatment begins with an accurate diagnosis, which includes a stool test.

Option A: The ELISA test is diagnostic for human immunodeficiency virus (HIV) and isn’t indicated in this case.
Option B: An electrolyte panel and hemogram may be useful in the overall evaluation of a client but aren’t diagnostic for specific causes of diarrhea.
Option D: A flat plate of the abdomen may provide useful information about bowel function but isn’t indicated in the case of “horse barn” smelling diarrhea.

7. A male client seeks medical evaluation for fatigue, night sweats, and a 20-lb weight loss in 6 weeks. To confirm that the client has been infected with the human immunodeficiency virus (HIV), the nurse expects the physician to order:

Correct Answer: D

Answer Explanation:

HIV infection is detected by analyzing blood for antibodies to HIV, which form approximately 2 to 12 weeks after exposure to HIV and denote infection. The Western blot test — electrophoresis of antibody proteins — is more than 98% accurate in detecting HIV antibodies when used in conjunction with the ELISA. It isn’t specific when used alone.

Option A: E-rosette immunofluorescence is used to detect viruses in general; it doesn’t confirm HIV infection.
Option B: Quantification of T-lymphocytes is a useful monitoring test but isn’t diagnostic for HIV.
Option C: The ELISA test detects HIV antibody particles but may yield inaccurate results; a positive ELISA result must be confirmed by the Western blot test.

8. A complete blood count is commonly performed before Joe goes into surgery. What does this test seek to identify?

Correct Answer: C

Answer Explanation:

Low preoperative HCT and Hb levels indicate the client may require a blood transfusion before surgery. If the HCT and Hb levels decrease during surgery because of blood loss, the potential need for a transfusion increases.

Option A: Possible renal failure is indicated by elevated BUN or creatinine levels.
Option B: Urine constituents aren’t found in the blood. They are found in urine specimens.
Option D: Coagulation is determined by the presence of appropriate clotting factors, not electrolytes.

9. While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of what assessment parameters?

Correct Answer: A

Answer Explanation:

The diagnosis of DIC is based on the results of laboratory studies of prothrombin time, platelet count, thrombin time, partial thromboplastin time, and fibrinogen level as well as client history and other assessment factors.

Option B: Blood glucose levels are not used to diagnose DIC. Fasting plasma glucose tests or the A1C test help diagnose diabetes.
Option C: Calcium and potassium levels are not a part of assessment for DIC. A calcium blood test measures the amount of calcium in the blood. Potassium blood test is used to diagnose conditions including kidney disease, high blood pressure, and heart disease.
Option D: WBC count isn’t used to confirm a diagnosis of DIC. WBC count is used to diagnose autoimmune and inflammatory diseases.

10. When taking a dietary history from a newly admitted female client, Nurse Len should remember which of the following foods is a common allergen?

Correct Answer: D

Answer Explanation:

Common food allergens include berries, peanuts, Brazil nuts, cashews, shellfish, and eggs.

Option A: Bread is not a common allergen. Wheat, a common ingredient in some breads, may cause wheat allergy in some people.
Option B: Carrots rarely cause allergies. An allergic reaction to carrots can be one element of oral allergy syndrome, which is also known as pollen-food allergy syndrome.
Option C: Oranges rarely cause allergic reactions. If they do, the reaction is mild.


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