genotyping of hcv has an important role in managing treatment and is done before drug therapy is initiated because most patients with acute hcv infec

NCLEX-RN

NCLEX RN Exam Questions

1. Why is it important to genotype HCV before initiating drug therapy?

A. Side effects of nucleotide analogs
B. Measures for improving the appetite
C. Ways to increase activity and exercise
D. Administering alpha-interferon (Intron A)

Correct answer: B

Rationale: Genotyping of HCV plays a crucial role in managing treatment as it helps determine the most effective therapy for the specific viral strain. It allows healthcare providers to personalize treatment regimens and predict response rates. The statement about acute HCV infection converting to chronic state is accurate, highlighting the need for appropriate management. Immune globulin and vaccines are not available for HCV, and Ribavirin is commonly used for chronic HCV infection. Improving appetite is essential in liver health as adequate nutritional intake supports hepatocyte regeneration. Choices A, C, and D are incorrect as they do not address the specific importance of genotyping in HCV treatment or the significance of appetite improvement in liver function.

2. Which client is at highest risk for developing a pressure ulcer?

A. 23 year-old in traction for fractured femur
B. 72 year-old with peripheral vascular disease, who is unable to walk without assistance
C. 75 year-old with left sided paresthesia and is incontinent of urine and stool
D. 30 year-old who is comatose following a ruptured aneurysm

Correct answer: C

Rationale: Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.

3. A patient with Glaucoma is verbalizing his daily medication routine to the nurse. He states he has two different eye drop medications, both every twelve hours. He washes his hands, instills the drops, closes his eyes gently, and presses his finger to the corner of his eye nearest his nose. After waiting 1 minute with his eyes closed, he instills the other medication in the same way. What is the nurse's best response?

A. ''You should wait more than 1 minute between different medications.''
B. ''Your routine is very good! Can you demonstrate it for me?''
C. ''It is actually not the best practice to close your eyes after instilling eye drops.''
D. ''You should actually be pressing your finger in the other corner of the eye.''

Correct answer: A

Rationale: It is recommended to wait 10-15 minutes between different eye drop medications to give them time to absorb and avoid one medication washing another one out. Choice A is the correct response as the patient should wait more than 1 minute between administering different eye drop medications. Choice B is incorrect as the routine described by the patient needs improvement. Choice C is inaccurate as closing the eyes after instilling eye drops is a best practice to ensure proper absorption. Choice D is incorrect as pressing the finger to the corner of the eye nearest the nose is the correct technique.

4. After a bronchoscopy, what is the most appropriate intervention for a patient with a chronic cough?

A. Elevate the head of the bed to 80 to 90 degrees.
B. Keep the patient NPO until the gag reflex returns.
C. Place the patient on bed rest for at least 4 hours after bronchoscopy.
D. Notify the health care provider about blood-tinged mucus.

Correct answer: B

Rationale: The correct intervention is to keep the patient NPO until the gag reflex returns after a bronchoscopy. This is important because a local anesthetic is used during the procedure to suppress the gag and cough reflexes. Monitoring the return of these reflexes helps prevent the risk of aspiration and ensures the patient can safely resume oral intake. While blood-tinged mucus can occur after bronchoscopy, it is a common occurrence and not a cause for immediate concern. Placing the patient on bed rest for an extended period is unnecessary, and elevating the head of the bed to a high-Fowler's position is not specifically required post-bronchoscopy.

5. The client is being prepared for insertion of a pulmonary artery catheter (Swan-Ganz catheter). What information does the client need to know about the purpose of this catheter insertion?

A. Stroke volume
B. Cardiac output
C. Venous pressure
D. Left ventricular functioning

Correct answer: D

Rationale: The correct answer is D: Left ventricular functioning. The purpose of inserting a pulmonary artery catheter is to obtain information about left ventricular functioning when the catheter balloon is inflated. Choices A, B, and C are incorrect because while a pulmonary artery catheter can provide information on stroke volume, cardiac output, and venous pressure, its primary purpose is to assess left ventricular function.