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NCLEX-PN FINAL EXAM 2024/2025
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NCLEX-PN FINAL EXAM 2024/2025 NCLEX-PN FINAL EXAM 2024/2025 NCLEX-PN FINAL EXAM 2024/2025
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NCLEX-PN FINAL EXAM 2024/2025A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to cry and tells
the nurse that she is afraid that her skin will be disfigured with lesions. Which intervention does the
nurse plan to teach this client to minimize skin infections associated with SLE?
Select all that apply.
A) Use sunscreen with an SPF of 15 or greater.
B) Remain indoors on sunny days.
C) Avoid swimming in a pool or the ocean.
D) Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
E) Decrease sun exposure between 3:00 p.m. and 5:00 p.m. - ANS Answer: A, D
The nurse teaches the client to live a normal life with a few extra precautions. There is a relationship
between sun exposure and infection, so the client is taught to use sunscreen with an SPF of at least 15
and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply
sunscreen after swimming. The client does not need to stay indoors on sunny days or to decrease sun
exposure between 3:00 p.m. and 5:00 p.m.
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action that the nurse
should take?
a. Place the patient on a cardiac monitor.
b. Check the patient's BP.
c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results. - ANS a. Dysrhythmias may occur with an
elevated potassium level and are potentially lethal. Monitor the rhythm while contacting physician or
calling the rapid response team.
,A patient is admitted to the hospital with CKD. You understand that this condition is characterized by
A. Progressive irreversible destruction of the kidneys
B. A rapid decrease in urinary output with an elevated BUN level
C. Increasing creatinine clearance with a decrease in urinary output
D. Prostration, somnolence, and confusion with coma and imminent death - ANS A. Progressive
irreversible destruction of the kidneys
CKD involves progressive, irreversible loss of kidney function.
Measures indicated in the conservative therapy of CKD include
A. decreased fluid intake, carbohydrate intake, and protein intake.
B. increased fluid intake; decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake; increased protein intake. - ANS C. decreased fluid
intake and protein intake; increased carbohydrate intake.
Water and any other fluids are not routinely restricted in the pre-end-stage renal disease (ESRD) stages.
Patients on hemodialysis have a more restricted diet than patients receiving peritoneal dialysis. For
those receiving hemodialysis, as their urinary output diminishes, fluid restrictions are enhanced. Intake
depends on the daily urine output. Generally, 600 mL (from insensible loss) plus an amount equal to the
previous day's urine output is allowed for a patient receiving hemodialysis. Patients are advised to limit
fluid intake so that weight gains are no more than 1 to 3 kg between dialyses (interdialytic weight gain).
For the patient who is undergoing dialysis, protein is not routinely restricted. The beneficial role of
protein restriction in CKD stages 1 through 4 as a means to reduce the decline in kidney function is being
studied. Historically, dietary counseling often encouraged restriction of protein for CKD patients.
Although there is some evidence that protein restriction has benefits, many patients find these diets
difficult to adhere to. For CKD stages 1 through 4, many clinicians encourage a diet with normal protein
intake. However, you should teach patients to avoid high-protein diets and supplements because they
may overstress the diseased kidneys.
,Nurses need to educate patients at risk for CKD. Which individuals are considered to be at increased risk
(select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes - ANS A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years, cardiovascular
disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic minorities (e.g., African
American, Native American).
Which statement regarding continuous ambulatory peritoneal dialysis (CAPD) is of highest priority when
teaching a patient new to this procedure?
A. "It is essential that you maintain aseptic technique to prevent peritonitis."
B. "You will be allowed a more liberal protein diet after you complete CAPD."
C. "It is important for you to maintain a daily written record of blood pressure and weight."
, D. "You must continue regular medical and nursing follow-up visits while performing CAPD." - ANS A. "It
is essential that you maintain aseptic technique to prevent peritonitis."
Peritonitis is a potentially fatal complication of peritoneal dialysis, and it is imperative to teach the
patient methods to prevent it from occurring. Although the other teaching statements are accurate,
they do not address the potential for mortality by peritonitis, making that nursing action the highest
priority.
How should you assess the patency of a newly placed arteriovenous graft for dialysis?
A. Irrigate the graft daily with low-dose heparin.
B. Monitor for any increase in blood pressure in the affected arm.
C. Listen with a stethoscope over the graft for presence of a bruit.
D. Frequently monitor the pulses and neurovascular status distal to the graft. - ANS C. Listen with a
stethoscope over the graft for presence of a bruit.
A thrill can be felt by palpating the area of anastomosis of the arteriovenous graft, and a bruit can be
heard with a stethoscope. The bruit and thrill are created by arterial blood rushing into the vein.
What are the main advantages of peritoneal dialysis compared to hemodialysis?
A. No medications are required because of the enhanced efficiency of the peritoneal membrane in
removing toxins.
B. The diet is less restricted and dialysis can be performed at home.
C. The dialysate is biocompatible and causes no long-term consequences.
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