NCLEX-PN
Kaplan NCLEX Question of The Day
1. The client is being discharged after a concussion. Which of the following symptoms should be reported?
- A. Difficulty waking up
- B. Headache (3/10 on the pain scale)
- C. Bruising on knees and elbows
- D. Achy feeling all over
Correct answer: A
Rationale: The correct answer is 'Difficulty waking up' because it indicates a change in consciousness, which is a concerning symptom following a concussion. Reporting this symptom is crucial as it may signify a more severe head injury. 'Headache (3/10 on the pain scale)' may be common after a concussion but is not as urgent as a change in consciousness. 'Bruising on knees and elbows' is likely unrelated to the concussion and not a priority for reporting. 'Achy feeling all over' is a vague symptom and not specific to a concerning change in the client's condition post-concussion.
2. What advice should be given to a client with stress incontinence?
- A. to consider trying Kegel exercises
- B. to undergo surgery immediately
- C. to avoid all forms of treatment
- D. to ignore the issue as it is not serious
Correct answer: A
Rationale: For stress incontinence, advising the client to consider trying Kegel exercises is appropriate. Kegel exercises involve tightening and releasing the pelvic floor muscles, which can improve stress incontinence by strengthening the muscles that control urination. Choice B suggesting immediate surgery is incorrect as surgery is usually considered after conservative treatments like Kegel exercises have been tried. Choice C advising to avoid all forms of treatment is dangerous and neglectful. Choice D recommending to ignore the issue is inappropriate as it can impact the client's quality of life and may worsen over time without intervention.
3. Which of the following procedures describes an opening between the colon and abdominal wall?
- A. ileostomy
- B. jejunostomy
- C. colostomy
- D. cecostomy
Correct answer: C
Rationale: A colostomy is an opening between the colon and abdominal wall. An ileostomy is an opening between the ileum and abdominal wall, not the colon. Jejunostomy is an opening between the jejunum and abdominal wall, and cecostomy is an opening into the cecum. The term 'colostomy' specifically refers to the surgical procedure where a part of the colon is brought through the abdominal wall to create a stoma, allowing feces to leave the body. Therefore, the correct answer is colostomy as it accurately describes the opening between the colon and the abdominal wall, distinct from the other options.
4. For which adverse effect of the block does the postpartum nurse monitor the woman after receiving a subarachnoid (spinal) block for a cesarean delivery?
- A. Headache
- B. Pruritus
- C. Vomiting
- D. Hypertension
Correct answer: A
Rationale: The correct answer is 'Headache.' Postdural headache is a common adverse effect associated with a subarachnoid block due to cerebrospinal fluid leakage at the site of dural puncture. This headache worsens when the woman is upright and may improve when she lies flat. To manage this headache, bed rest and adequate hydration are recommended. Pruritus, vomiting, and hypertension are not typically associated with subarachnoid blocks. Pruritus, nausea, and vomiting are more commonly linked to the use of intrathecal opioids.
5. Which of the following is the drug of choice to decrease uric acid levels?
- A. prednisone (Colisone)
- B. allopurinol (Zyloprim)
- C. indomethacin (Indocin)
- D. hydrochlorothiazide (HydroDiuril)
Correct answer: B
Rationale: Allopurinol is the correct drug to decrease uric acid levels as it is used to treat gout by reducing uric acid formation. Prednisone is a corticosteroid that decreases inflammation, not uric acid levels. Indomethacin is an analgesic, anti-inflammatory, and antipyretic agent, not specifically used to reduce uric acid levels. Hydrochlorothiazide is a thiazide diuretic primarily used for treating hypertension and edema, not for reducing uric acid levels.
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