NCLEX-PN
NCLEX PN Exam Cram
1. An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
- A. It protects the bacteria from antibiotic and immunologic destruction.
- B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
- C. It competes with the antibiotic for binding sites on the microbe.
- D. Glycocalyx provides nutrients for microbial growth.
Correct answer: A
Rationale: Bacterial glycocalyx is a viscous polysaccharide or polypeptide slime that covers microbes. It plays a significant role in protecting bacteria by enhancing adherence to surfaces, resisting phagocytic engulfment by white blood cells, and preventing antibiotics from contacting the microbe. Choice A is correct because glycocalyx shields the bacteria from both antibiotics and the immune system, allowing the infection to persist. Choices B, C, and D are incorrect because glycocalyx does not neutralize antibiotics, compete for binding sites with antibiotics, or provide nutrients for microbial growth.
2. The nurse is caring for a preschool child who is being treated in the hospital for respiratory syncytial virus (RSV). In planning the client's care, the nurse should recognize that the child is likely to view this illness as?
- A. Punishment.
- B. Disturbance to body image.
- C. Rejection from parents.
- D. Change in routine with friends.
Correct answer: A
Rationale: The correct answer is A: Punishment. Preschool children often see illness as a form of punishment, especially when they are unable to understand the cause of their sickness. This perception is rooted in their limited cognitive abilities and understanding of health concepts. Choices B, C, and D are incorrect because preschool children are less likely to associate illness with disturbance to body image, rejection from parents, or changes in routine with friends. These options are not developmentally appropriate for how preschoolers typically interpret illness.
3. When discussing possible complications of pregnancy with a client, the nurse should explain that all of the following are symptoms of urinary tract infection (UTI). Which of the following is least indicative of UTI during pregnancy?
- A. low back pain
- B. urinary frequency
- C. GI distress
- D. malaise
Correct answer: B
Rationale: Urinary frequency is least indicative of UTI during pregnancy. It is a common minor discomfort of pregnancy caused by pressure of the growing uterus on the bladder. As the uterus rises in the second trimester, there are usually no problems. Frequency may return in the third trimester when the uterus drops into the pelvic cavity. UTI symptoms include low back pain, suprapubic discomfort, and malaise, and are confirmed by laboratory findings. Low back pain, GI distress, and malaise are more closely associated with UTI during pregnancy compared to urinary frequency.
4. Which of the following lab values would indicate symptomatic AIDS in the medical chart? (T4 cell count per deciliter)
- A. Greater than 1000 cells per deciliter
- B. Less than 500 cells per deciliter
- C. Greater than 2000 cells per deciliter
- D. Less than 200 cells per deciliter
Correct answer: D
Rationale: A T4 cell count of less than 200 cells per deciliter indicates symptomatic AIDS. This severe depletion of T4 cells signifies advanced HIV infection and a significantly compromised immune system. Choices A, B, and C are incorrect because T4 cell counts above 2000, above 1000, or below 500 cells per deciliter, respectively, are not indicative of symptomatic AIDS.
5. A 14-year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse's first response be?
- A. Create an atmosphere of seclusion for the boy according to procedures.
- B. Remove other patients from the area for added safety.
- C. Ask the patient, "What is making you mad?"?
- D. Ask the patient, "Why are you behaving this way? Have you thought about what may help you calm down?"?
Correct answer: A
Rationale: In a situation where a patient is agitated and yelling, the first response should be to create an atmosphere of seclusion for the safety of the patient and others. Seclusion is a standard procedure to help manage aggressive behaviors and prevent harm. Options B, C, and D are not appropriate in this scenario. Removing other patients may not address the immediate safety concern, asking the patient what is making them mad can escalate the situation, and questioning why the patient is behaving that way may not help in managing the current agitation. Therefore, seclusion is the recommended course of action in this scenario to ensure the safety and well-being of all involved.
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