NCLEX-RN PRACTICE QUESTION/WILMS TUMOR

NCLEX-RN EXAM PRACTICE QUESTION:
A child is admitted to the hospital with a diagnosis of Wilms tumor, stage II. Which of the following statements most accurately describes this stage?

A. The tumor is less than 3 cm. in size and requires no chemotherapy.
B. The tumor did not extend beyond the kidney and was completely resected.
C. The tumor extended beyond the kidney but was completely resected.
D. The tumor has spread into the abdominal cavity and cannot be resected.

HINT:
The staging of Wilms tumor is confirmed at surgery as follows: Stage I, the tumor is limited to the kidney and completely resected; stage II, the tumor extends beyond the kidney but is completely resected; stage III, residual non hematogenous tumor is confined to the abdomen; stage IV, hematogenous metastasis has occurred with spread beyond the abdomen; and stage V, bilateral renal involvement is present at diagnosis.

ANSWER: C--The tumor extended beyond the kidney but was completely resected.

NCLEX-RN PRACTICE QUESTION/CHILD ALLERGIC RESPONSE

NCLEX-RN Practice Exam Question

A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose?

A. It is the correct dose.
B. The dose is too low.
C. The dose is too high.
D. The dose should be increased or decreased, depending on the symptoms.

HINTS:
This child weighs 30 kg, and the pediatric dose of diphenhydramine is 5 mg/kg/day (5 X 30 = 150/day).

Therefore, the correct dose is 150 mg/day. Divided into 3 doses per day, the child should receive 50 mg 3 times a day rather than 25 mg 3 times a day.

Dosage should not be titrated based on symptoms without consulting a physician.

ANSWER: B. The dose is too low.

NCLEX-RN PRACTICE QUESTION/HYPERPARATHYROIDISM

NCLEX-RN PRACTICE QUESTION

A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient’s lab results would expect which of the following changes in laboratory findings?

A. Elevated serum calcium.
B. Low serum parathyroid hormone (PTH).
C. Elevated serum vitamin D.
D. Low urine calcium.

HINTS:
The parathyroid glands regulate the calcium level in the blood.

In hyperparathyroidism, the serum calcium level will be elevated.

Parathyroid hormone levels may be high or normal but not low.

The body will lower the level of vitamin D in an attempt to lower calcium.

Urine calcium may be elevated, with calcium spilling over from elevated serum levels. This may cause renal stones.

ANSWER-A

NCLEX-RN PRACTICE QUESTION/DILANTIN

NCLEX-RN PRACTICE QUESTION

A patient taking Dilantin (phenytoin) for a seizure disorder is experiencing breakthrough seizures. A blood sample is taken to determine the serum drug level. Which of the following would indicate a sub-therapeutic level?

A. 15 mcg/mL.
B. 4 mcg/mL.
C. 10 mcg/dL.
D. 5 mcg/dL.

RATIONALE
A level of 4 mcg/mL is subtherapeutic and may be caused by patient non-compliance or increased metabolism of the drug.

A level of 15 mcg/mL is therapeutic.

Choices C and D are expressed in mcg/dL, which is the incorrect unit of measurement.

The therapeutic serum level for Dilantin is 10 – 20 mcg/mL

ANSWER: B

NCLEX-RN PRACTICE QUESTION/PVD

NCLEX-RN PRACTICE QUESTION

Claudication is a well-known effect of PVD (peripheral vascular disease). Which of the following facts about claudication is correct? More than one answer may be correct.

A. It results when oxygen demand is greater than oxygen supply.
B. It is characterized by pain that often occurs during rest.
C. It is a result of tissue hypoxia.
D. It is characterized by cramping and weakness.

HINTS:
Claudication describes the pain experienced by a patient with PVD when oxygen demand in the leg muscles exceeds the oxygen supply.

This most often occurs during activity when demand increases in muscle tissue.

The tissue becomes hypoxic, causing cramping, weakness, and discomfort.

ANSWER: A, C, D

NCLEX-RN PRACTICE QUESTION/LABOR

NCLEX-RN PRACTICE QUESTION

During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is most likely in which position?

a. Right breech presentation
b. Right occipital anterior presentation
c. Left sacral anterior presentation
d. Left occipital transverse presentation

HINTS:
If the infant is positioned in the right occiput anterior presentation, the FHTs will be located in the right lower quadrant, so answer B is incorrect.

If the fetus is in the sacral position, the FHTs will be located in the center of the abdomen, so answer C is incorrect.

If the FHTs are heard in the left lower abdomen, the infant is most likely in the left occiput transverse position, making answer D incorrect.

If the fetal heart tones are heard in the right upper abdomen, the infant is in a breech presentation.

ANSWER--A

NCLEX-RN PRACTICE QUESTION/DC AFTER PACEMAKER

NCLEX-RN Practice Question:

A patient is being discharged after the insertion of a permanent pacemaker. Which statement made by the patient indicates an understanding regarding appropriate self-care?

1. “Every morning I will perform arm and shoulder stretches.”

2. “Each day I’ll take my pulse and record it in a log.”

3. “I’ll have to get rid of my microwave oven.”

4. “I won’t be able to use my electric blanket anymore.”

HINTS:
*Initially, patients should limit arm and shoulder activity on the operative side to prevent dislodgment of the pacing leads.

*Microwave ovens and electric blankets will not adversely affect the pacemaker.

*Tracking one’s pulse can help the patient know if the pacemaker is working properly.

ANSWER: #2