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