NCLEX-PN
NCLEX Question of The Day
1. A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with an overdose?
- A. Memory loss and lack of appetite
- B. Confusion and fatigue
- C. Heightened reflexes
- D. Tinnitus and spasticity
Correct answer: B
Rationale: The correct answer is 'Confusion and fatigue.' Lidocaine Hydrochloride, when taken in excess, can lead to symptoms such as confusion and fatigue. It affects the central nervous system, leading to these cognitive and physical impairments. Choice A ('Memory loss and lack of appetite') is incorrect because memory loss is not a common symptom of Lidocaine Hydrochloride overdose, and lack of appetite is not a typical effect. Choice C ('Heightened reflexes') is incorrect as Lidocaine Hydrochloride overdose usually depresses reflexes rather than heightening them. Choice D ('Tinnitus and spasticity') is incorrect as tinnitus and spasticity are not commonly associated with Lidocaine Hydrochloride overdose.
2. Which statement best describes electrolytes in intracellular and extracellular fluid?
- A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
- B. There is an equal concentration of sodium and potassium in extracellular fluid
- C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
- D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid
Correct answer: A
Rationale: Electrolytes are distributed unequally between intracellular and extracellular fluids. Sodium concentration is higher in extracellular fluid, while potassium concentration is higher in intracellular fluid. Therefore, the correct answer is 'There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.' Choices B, C, and D are incorrect because they do not accurately describe the typical distribution of sodium and potassium between intracellular and extracellular fluid.
3. A patient has just been prescribed Minipress to control hypertension. The nurse should instruct the patient to be observant of the following:
- A. Dizziness and light-headed sensations
- B. Weight gain
- C. Sensory changes in the lower extremities
- D. Fatigue
Correct answer: A
Rationale: The correct answer is 'Dizziness and light-headed sensations.' Minipress, a medication used to control hypertension, can cause hypotension as a side effect. Dizziness and light-headed sensations are common symptoms of hypotension. Weight gain, sensory changes in the lower extremities, and fatigue are not typically associated with Minipress or hypertension management. Therefore, they are incorrect choices.
4. Which reported symptom would indicate a client with Addison's disease has received too much fludrocortisone (Florinef) replacement?
- A. Oily skin and hair
- B. Weight gain of 6 pounds in one week
- C. Loss of muscle mass in arms and legs
- D. Increased blood glucose level
Correct answer: B
Rationale: Fludrocortisone (Florinef) replacement in Addison's disease involves mimicking aldosterone to retain sodium and water. This retention can lead to weight gain due to increased fluid retention. Rapid weight gain, such as 6 pounds in one week, is a concerning sign of excessive fluid retention, indicating a potential overdose of fludrocortisone. Choices A, C, and D are incorrect because oily skin and hair, loss of muscle mass, and increased blood glucose levels are not specific symptoms of excessive fludrocortisone replacement in Addison's disease.
5. What do the following ABG values indicate: pH 7.38, PO2 78 mmHg, PCO2 36mmHg, and HCO3 24 mEq/L?
- A. metabolic alkalosis
- B. homeostasis
- C. respiratory acidosis
- D. respiratory alkalosis
Correct answer: B
Rationale: The correct answer is 'homeostasis.' These ABG values fall within normal ranges, indicating a state of balance in the body's acid-base levels. Choices A, C, and D are incorrect as the ABG values provided do not point towards metabolic alkalosis, respiratory acidosis, or respiratory alkalosis. Instead, the values reflect a state of equilibrium where pH, PO2, PCO2, and HCO3 levels are within the normal range.
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