NCLEX-PN
NCLEX-PN Quizlet 2023
1. Chemotherapeutic agents often produce a degree of myelosuppression including leukopenia. Leukopenia does not present immediately but is delayed several days or weeks because:
- A. the client's hemoglobin and hematocrit are normal.
- B. red blood cells are affected first.
- C. folic acid levels are normal.
- D. the current white cell count is not affected by chemotherapy.
Correct answer: D
Rationale: Leukopenia does not present immediately after chemotherapy because time is required to clear circulating cells before the effect on precursor cell maturation in the bone marrow becomes evident. Leukopenia is characterized by an abnormally low white blood cell count. The correct answer is D because the white cell count is not immediately affected by chemotherapy. Choices A, B, and C are incorrect as they pertain to red blood cells (hemoglobin and hematocrit), which are not directly related to the delayed onset of leukopenia.
2. A female sex worker enters a clinic for treatment of a sexually transmitted disease. This disease is the most prevalent STD in the United States. The nurse can anticipate that the woman has which of the following?
- A. herpes
- B. chlamydia
- C. gonorrhea
- D. syphilis
Correct answer: B
Rationale: The question describes a female sex worker seeking treatment for the most prevalent sexually transmitted disease in the United States. Chlamydia is the correct answer as it is the most common STD in the country according to epidemiological studies. While herpes (choice A) is common, it is not the most prevalent. Gonorrhea (choice C) and syphilis (choice D) are less prevalent compared to chlamydia, making them incorrect choices.
3. The drug of choice to decrease uric acid levels is:
- A. prednisone (Colisone)
- B. allopurinol (Zyloprim)
- C. indomethacin (Indocin)
- D. hydrochlorothiazide (HydroDiuril)
Correct answer: B
Rationale: The correct answer is allopurinol (Zyloprim) as it is a xanthine oxidase inhibitor that decreases uric acid formation. Allopurinol is commonly used to manage gout by lowering uric acid levels. Prednisone is a corticosteroid used to decrease inflammation, not to lower uric acid levels. Indomethacin is an analgesic, anti-inflammatory, and antipyretic agent, but it is not the drug of choice for lowering uric acid levels. Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema, not to decrease uric acid levels.
4. High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by:
- A. the inability of the kidneys to excrete the drug metabolites.
- B. rapid cell catabolism.
- C. toxic effects of the prophylactic antibiotics that are given concurrently.
- D. the altered blood pH from the acidic nature of the drugs.
Correct answer: B
Rationale: The correct answer is 'rapid cell catabolism.' During chemotherapy, rapid cell destruction occurs, leading to an increase in uric acid levels as a byproduct of cell breakdown. High uric acid levels are primarily a result of the rapid breakdown of cells during chemotherapy, not due to the kidneys' inability to excrete drug metabolites (Choice A). The prophylactic antibiotics given concurrently do not directly cause high uric acid levels (Choice C). The altered blood pH from the acidic nature of the drugs (Choice D) is not a direct cause of elevated uric acid levels; the main mechanism is the rapid cell catabolism that occurs during chemotherapy.
5. Which of the following blood pressure parameters indicates PIH? Elevation over a baseline of:
- A. 30 mmHg systolic and/or 15 mmHg diastolic.
- B. 40 mmHg systolic and/or 20 mmHg diastolic.
- C. 10 mmHg systolic and/or 5 mmHg diastolic.
- D. 20 mmHg systolic and/or 20 mmHg diastolic.
Correct answer: A
Rationale: The correct answer is A: 30 mmHg systolic and/or 15 mmHg diastolic. These parameters indicate mild PIH (pregnancy-induced hypertension). Mild preeclampsia is characterized by an increase in systolic blood pressure greater than 30 mmHg or an increase in diastolic blood pressure greater than 15 mmHg, observed on two readings taken 6 hours apart (or reaching 140/90). Choice B (40 mmHg systolic and/or 20 mmHg diastolic) represents a more significant elevation and would indicate a more severe condition than mild PIH. Choices C (10 mmHg systolic and/or 5 mmHg diastolic) and D (20 mmHg systolic and/or 20 mmHg diastolic) do not meet the criteria for indicating PIH as they are below the accepted parameters for mild PIH.
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