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NCLEX-RN EXIT EXAM QUESTION WITH RATIONALES
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NCLEX-RN EXIT EXAM QUESTION WITH RATIONALES
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lOMoARcPSD|40206794
NCLEX-RN 2024-2025 EXIT EXAM QUESTION WITH
RATIONALES
A 21-year-old male with Hodgkin’s lymphoma is a senior at
v v v v v v v v v
the local
v v
university. He is engaged to be married and is to begin a new
v v v v v v v v v v v v
v job upon graduation. Which of the following diagnoses would be
v v v v v v v v v
v a priority for this client?
vv v v v
• A. Sexual dysfunction related to radiation therapy
v v v v v v
• B. Anticipatory grieving related to terminal illness
v v v v v v
• C. Tissue integrity related to prolonged bed rest
v v v v v v v
• D. Fatigue related to chemotherapy
v v v v
Correct Answer: A. Sexual dysfunction related to
v v v v v v
v radiation therapy v
Radiation therapy often causes sterility in male clients and
v v v v v v v v
v would v be v of v primary v importance v to v this v client. v The
v psychosocial needs of the client are important to address in
v v v v v v v v v
v light of the age and life choices. Hodgkin’s disease, however,
v v v v v v v v v
v has a good prognosis when diagnosed early. Know the
v v v v v v v v
v importance v of v sex v to v individual, v partner, v and v patient’s
v motivation for change. Because lymphomas often affect the
v v v v v v v
v relatively young who are in their productive years, these
v v v v v v v v
v people may be affected more by these problems and may
v v v v v v v v v
v be less knowledgeable about the possibilities of change.
v v v v v v v
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• Option B: Grieving may not be an appropriate
v v v v v v v
vdiagnosis since v
the client would be experiencing new milestones in his
v v v v v v v v
v life despite his condition. Let the patient describe the
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v problem in their own words. Provides a more accurate
v v v v v v v v
v picture of patient experience with which to develop a
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v plan of care. v v
• Option C: v v v Option B is not applicable since the client is
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v not on bed rest. Encourage the patient to share thoughts
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v and concerns with his partner and to clarify values and
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v impact of condition on relationship. Helps the couple begin
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v to deal with issues that can strengthen or weaken
v v v v v v v v v the
v relationship.
Option D: Fatigue may occur during chemotherapy, but
v v v v v v v
v it is not the priority diagnosis. Identify pre-existing and
v v v v v v v v
v current v stress v factors v that v may be
v affecting
v v the
v relationship. The patient may be concerned about other v v v v v v v
v issues, v such v as v job, v financial, v and v illness-related
v problems.
NCLEXRN-08-002
Question Tag: thrombocytopenic purpura
v v v
Question Category: Physiological Integrity
v v v
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A client
v v has v autoimmune v thrombocytopenic v purpura. v To
v determine the client’s response to treatment, the nurse
v v v v v v v
v would monitor:
v
• A. Platelet count
v v
• B. White blood cell count
v v v v
• C. Potassium levels
v v
• D. Partial prothrombin time (PTT)
v v v v
Correct Answer: A. Platelet count
v v v v
Clients with autoimmune thrombocytopenic purpura (ATP)
v v v v v
v have low platelet counts, making answer A the correct
v v v v v v v v
v answer. The laboratory tests will show low platelet count,
v v v v v v v v
v usually <40×10^9/L for over three months. Blood film
v v v v v v v
v shows large platelets and tiny platelet fragments. Bone
v v v v v v v
v marrow v examination v shows v an v increased v number v of
v megakaryocytes.
• Option B: Often associated with the CBC is a differential,
v v v v v v v v v
v which refers to the relative amounts of white blood cell
v v v v v v v v v
v types (i.e., neutrophil, lymphocyte, eosinophil, etc.) as a
v v v v v v v
v percentage of the total number of WBCs. Of note, if av v v v v v v v v v
v subtype of white blood cells seems to be elevated based
v v v v v v v v v v
v on the differential, the actual
v v v v v v value of v v the v type v of
v white blood cells should be calculated
v v v v v v by
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multiplying the percentage listed on the differential by the
v v v v v v v v
v total number of white blood cells.
v v v v v
• Option C: Potassium disorders are related to cardiac
v v v v v v v
v arrhythmias. v Hypokalemia v occurs when
v v serum
v potassium levels under v v v v 3.6 v v mmol/L—weakness, v v
v fatigue, v v and v v muscle v v twitching v present v in
v hypokalemia. v Hyperkalemia v occurs v when v the serum v
v potassium levels above 5.5 mmol/L, which can result in
v v v v v v v v
v arrhythmias. v Muscle v cramps, v muscle
v v v weakness,
v rhabdomyolysis, myoglobinuria are presenting signs and v v v v v
v symptoms in hyperkalemia. v v
Patients with a propensity for bleeding
v v v v v
v should undergo testing to determine the presence of a
v v v v v v v v
v clotting disorder. For patients with deficiencies or defects
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v of the intrinsic clotting cascade, the PTT will be elevated.
v v v v v v v v v
v Normal PTT values can vary between laboratories but 25
v v v v v v v v
v to 35 seconds is considered norm al.
v v v v v v
NCLEXRN-08-003
Question Tag: thrombocytopenic purpura
v v v
Question Category: Physiological Integrity
v v v
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