FINAL EXAMS FOR NCLEX PN
A 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. - CORRECT ANSWER-
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 wto wavoid whigh-potassium wfoods.
d. Call wthe wlab wand wrequest wa wredraw wof wthe wlab wto wverify wresults. w- wCORRECT
wANSWER-
a. Dysrhythmias wmay woccur wwith wan welevated wpotassium wlevel wand ware
wpotentially wlethal. wMonitor wthe wrhythm wwhile wcontacting wphysician wor wcalling
wthe wrapid wresponse wteam.
A wpatient wis wadmitted wto wthe whospital wwith wCKD. wYou wunderstand wthat wthis
wcondition wis wcharacterized wby
,A. Progressive wirreversible wdestruction wof wthe wkidneys
B. A wrapid wdecrease win wurinary woutput wwith wan welevated wBUN wlevel
C. Increasing wcreatinine wclearance wwith wa wdecrease win wurinary woutput
D. Prostration, wsomnolence, wand wconfusion wwith wcoma wand wimminent wdeath w-
wCORRECT wANSWER-A. wProgressive wirreversible wdestruction wof wthe wkidneys
CKD winvolves wprogressive, wirreversible wloss wof wkidney wfunction.
Measures windicated win wthe wconservative wtherapy wof wCKD winclude
A. decreased wfluid wintake, wcarbohydrate wintake, wand wprotein wintake.
B. increased wfluid wintake; wdecreased wcarbohydrate wintake wand wprotein wintake.
C. decreased wfluid wintake wand wprotein wintake; wincreased wcarbohydrate wintake.
D. decreased wfluid wintake wand wcarbohydrate wintake; wincreased wprotein
wintake. w- wCORRECT wANSWER-C. wdecreased wfluid wintake wand wprotein
wintake; wincreased wcarbohydrate wintake.
Water wand wany wother wfluids ware wnot wroutinely wrestricted win wthe wpre-end-stage
wrenal wdisease w(ESRD) wstages. wPatients won whemodialysis whave wa wmore
wrestricted wdiet wthan wpatients wreceiving wperitoneal wdialysis. wFor wthose wreceiving
whemodialysis, was wtheir wurinary woutput wdiminishes, wfluid wrestrictions ware
wenhanced. wIntake wdepends won wthe wdaily wurine woutput.
Generally, w600 wmL w(from winsensible wloss) wplus wan wamount wequal wto wthe
wprevious wday's wurine woutput wis wallowed wfor wa wpatient wreceiving whemodialysis.
wPatients ware wadvised wto wlimit wfluid wintake wso wthat wweight wgains ware wno wmore
wthan w1 wto w3 wkg wbetween wdialyses w(interdialytic wweight wgain). wFor wthe wpatient
wwho wis wundergoing wdialysis, wprotein wis wnot wroutinely wrestricted. wThe wbeneficial
wrole wof wprotein wrestriction win wCKD wstages w1 wthrough w4 was wa wmeans wto wreduce
wthe wdecline win wkidney wfunction wis wbeing wstudied. wHistorically, wdietary wcounseling
woften wencouraged wrestriction wof wprotein wfor wCKD wpatients. wAlthough wthere wis
wsome wevidence wthat wprotein wrestriction whas wbenefits, wmany wpatients wfind wthese
wdiets wdifficult wto wadhere wto. wFor wCKD wstages w1 wthrough w4, wmany wclinicians
wencourage wa wdiet wwith wnormal wprotein wintake. wHowever, wyou wshould wteach
wpatients wto wavoid whigh-protein wdiets wand wsupplements wbecause wthey wmay
woverstress wthe wdiseased wkidneys.
Nurses wneed wto weducate wpatients wat wrisk wfor wCKD. wWhich windividuals ware
wconsidered wto wbe wat wincreased wrisk w(select wall wthat wapply)?
A. Older wAfrican wAmericans
B. Individuals wolder wthan w60 wyears
C. Those wwith wa whistory wof wpancreatitis
D. Those wwith wa whistory wof whypertension
E. Those wwith wa whistory wof wtype w2 wdiabetes w- wCORRECT wANSWER-A.
wOlder wAfrican wAmericans
B. wIndividuals wolder wthan w60 wyears
D. wThose wwith wa whistory wof whypertension
E. wThose wwith wa whistory wof wtype w2 wdiabetes
,Risk wfactors wfor wCKD winclude wdiabetes wmellitus, whypertension, wage wolder wthan
w60 wyears, wcardiovascular wdisease, wfamily whistory wof wCKD, wexposure wto
wnephrotoxic wdrugs, wand wethnic wminorities w(e.g., wAfrican wAmerican, wNative
wAmerican).
Which wstatement wregarding wcontinuous wambulatory wperitoneal wdialysis w(CAPD) wis
wof whighest wpriority wwhen wteaching wa wpatient wnew wto wthis wprocedure?
A. w"It wis wessential wthat wyou wmaintain waseptic wtechnique wto wprevent wperitonitis."
B. w"You wwill wbe wallowed wa wmore wliberal wprotein wdiet wafter wyou wcomplete wCAPD."
C. w"It wis wimportant wfor wyou wto wmaintain wa wdaily wwritten wrecord wof wblood
wpressure wand wweight."
D. w"You wmust wcontinue wregular wmedical wand wnursing wfollow-up wvisits wwhile
wperforming wCAPD." w- wCORRECT wANSWER-A. w"It wis wessential wthat wyou wmaintain
waseptic wtechnique wto wprevent wperitonitis."
Peritonitis wis wa wpotentially wfatal wcomplication wof wperitoneal wdialysis, wand wit wis
wimperative wto wteach wthe wpatient wmethods wto wprevent wit wfrom woccurring. wAlthough
wthe wother wteaching wstatements ware waccurate, wthey wdo wnot waddress wthe wpotential
wfor wmortality wby wperitonitis, wmaking wthat wnursing waction wthe whighest wpriority.
How wshould wyou wassess wthe wpatency wof wa wnewly wplaced warteriovenous wgraft wfor
wdialysis?
A. wIrrigate wthe wgraft wdaily wwith wlow-dose wheparin.
B. wMonitor wfor wany wincrease win wblood wpressure win wthe waffected warm.
C. wListen wwith wa wstethoscope wover wthe wgraft wfor wpresence wof wa wbruit.
D. wFrequently wmonitor wthe wpulses wand wneurovascular wstatus wdistal wto wthe wgraft.
w- wCORRECT wANSWER-C. wListen wwith wa wstethoscope wover wthe wgraft wfor
wpresence wof wa wbruit.
A wthrill wcan wbe wfelt wby wpalpating wthe warea wof wanastomosis wof wthe warteriovenous
wgraft, wand wa wbruit wcan wbe wheard wwith wa wstethoscope. wThe wbruit wand wthrill ware
wcreated wby warterial wblood wrushing winto wthe wvein.
What ware wthe wmain wadvantages wof wperitoneal wdialysis wcompared wto whemodialysis?
A. wNo wmedications ware wrequired wbecause wof wthe wenhanced wefficiency wof wthe
wperitoneal wmembrane win wremoving wtoxins.
B. wThe wdiet wis wless wrestricted wand wdialysis wcan wbe wperformed wat whome.
C. wThe wdialysate wis wbiocompatible wand wcauses wno wlong-term wconsequences.
, D. wHigh wglucose wconcentrations wof wthe wdialysate wcause wa wreduction win wappetite,
wpromoting wweight wloss. w- wCORRECT wANSWER-B. wThe wdiet wis wless wrestricted
wand wdialysis wcan wbe wperformed wat whome.
Advantages wof wperitoneal wdialysis winclude wfewer wdietary wrestrictions wand whome
wdialysis wis wpossible.
The wnurse wteaches wa wclient wwho wis wrecovering wfrom wacute wkidney wdisease wto
wavoid wwhich wtype wof wmedication?
A wNonsteroidal wanti-inflammatory wdrugs w(NSAIDs)
B wAngiotensin-converting wenzyme w(ACE) winhibitors
C wOpiates
D wCalcium wchannel wblockers wfiltration wrate wand wblood wflow wwithin wthe wkidney. w-
wCORRECT wANSWER-A wNonsteroidal wanti-inflammatory wdrugs w(NSAIDs)
NSAIDs wmay wbe wnephrotoxic wto wa wclient wwith wacute wkidney wdisease, wand
wshould wbe wavoided. wACE winhibitors ware wused wfor wtreatment wof whypertension
wand wto wprotect wthe wkidneys, wespecially win wthe wdiabetic wclient, wfrom wprogression
wof wkidney wdisease. wOpiates wmay wbe wused wby wclients wwith wkidney wdisease wif
wsevere wpain wis wpresent; whowever, wexcretion wmay wbe wdelayed. wCalcium wchannel
wblockers wcan wimprove wthe wglomerular
A wclient wwith wend-stage wkidney wdisease whas wbeen wput won wfluid wrestrictions. wWhich
wassessment wfinding windicates wthat wthe wclient whas wnot wadhered wto wthis wrestriction?
A wBlood wpressure wof w118/78 wmm wHg
B wWeight wloss wof w3 wpounds wduring whospitalization
C wDyspnea wand wanxiety wat wrest
D wCentral wvenous wpressure w(CVP) wof w6 wmm wHg w- wCORRECT wANSWER-C
wDyspnea wand wanxiety wat wrest
Dyspnea wis wa wsign wof wfluid woverload wand wpossible wpulmonary wedema; wthe
wnurse wshould wassist wthe wclient win wcorrelating wsymptoms wof wfluid woverload wwith
wnonadherence wto wfluid wrestriction. wNonadherence wto wfluid wrestriction wresults win
wfluid wvolume wexcess wand whigher wblood wpressures; w118/78 wmm wHg wis wa wnormal
wblood wpressure. wExcess wfluid wintake wand wfluid wretention ware wmanifested wby wan
welevated wCVP w(>8 wmm wHg) wand wweight wgain, wnot wweight wloss.
Which wassessment wfinding wrepresents wa wpositive wresponse wto werythropoietin
w(Epogen, wProcrit) wtherapy?
A wHematocrit wof w26.7%
B wPotassium wwithin wnormal wrange
C wAbsence wof wspontaneous wfractures
D wLess wfatigue w- wCORRECT wANSWER-D wLess wfatigue
A 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. - CORRECT ANSWER-
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 wto wavoid whigh-potassium wfoods.
d. Call wthe wlab wand wrequest wa wredraw wof wthe wlab wto wverify wresults. w- wCORRECT
wANSWER-
a. Dysrhythmias wmay woccur wwith wan welevated wpotassium wlevel wand ware
wpotentially wlethal. wMonitor wthe wrhythm wwhile wcontacting wphysician wor wcalling
wthe wrapid wresponse wteam.
A wpatient wis wadmitted wto wthe whospital wwith wCKD. wYou wunderstand wthat wthis
wcondition wis wcharacterized wby
,A. Progressive wirreversible wdestruction wof wthe wkidneys
B. A wrapid wdecrease win wurinary woutput wwith wan welevated wBUN wlevel
C. Increasing wcreatinine wclearance wwith wa wdecrease win wurinary woutput
D. Prostration, wsomnolence, wand wconfusion wwith wcoma wand wimminent wdeath w-
wCORRECT wANSWER-A. wProgressive wirreversible wdestruction wof wthe wkidneys
CKD winvolves wprogressive, wirreversible wloss wof wkidney wfunction.
Measures windicated win wthe wconservative wtherapy wof wCKD winclude
A. decreased wfluid wintake, wcarbohydrate wintake, wand wprotein wintake.
B. increased wfluid wintake; wdecreased wcarbohydrate wintake wand wprotein wintake.
C. decreased wfluid wintake wand wprotein wintake; wincreased wcarbohydrate wintake.
D. decreased wfluid wintake wand wcarbohydrate wintake; wincreased wprotein
wintake. w- wCORRECT wANSWER-C. wdecreased wfluid wintake wand wprotein
wintake; wincreased wcarbohydrate wintake.
Water wand wany wother wfluids ware wnot wroutinely wrestricted win wthe wpre-end-stage
wrenal wdisease w(ESRD) wstages. wPatients won whemodialysis whave wa wmore
wrestricted wdiet wthan wpatients wreceiving wperitoneal wdialysis. wFor wthose wreceiving
whemodialysis, was wtheir wurinary woutput wdiminishes, wfluid wrestrictions ware
wenhanced. wIntake wdepends won wthe wdaily wurine woutput.
Generally, w600 wmL w(from winsensible wloss) wplus wan wamount wequal wto wthe
wprevious wday's wurine woutput wis wallowed wfor wa wpatient wreceiving whemodialysis.
wPatients ware wadvised wto wlimit wfluid wintake wso wthat wweight wgains ware wno wmore
wthan w1 wto w3 wkg wbetween wdialyses w(interdialytic wweight wgain). wFor wthe wpatient
wwho wis wundergoing wdialysis, wprotein wis wnot wroutinely wrestricted. wThe wbeneficial
wrole wof wprotein wrestriction win wCKD wstages w1 wthrough w4 was wa wmeans wto wreduce
wthe wdecline win wkidney wfunction wis wbeing wstudied. wHistorically, wdietary wcounseling
woften wencouraged wrestriction wof wprotein wfor wCKD wpatients. wAlthough wthere wis
wsome wevidence wthat wprotein wrestriction whas wbenefits, wmany wpatients wfind wthese
wdiets wdifficult wto wadhere wto. wFor wCKD wstages w1 wthrough w4, wmany wclinicians
wencourage wa wdiet wwith wnormal wprotein wintake. wHowever, wyou wshould wteach
wpatients wto wavoid whigh-protein wdiets wand wsupplements wbecause wthey wmay
woverstress wthe wdiseased wkidneys.
Nurses wneed wto weducate wpatients wat wrisk wfor wCKD. wWhich windividuals ware
wconsidered wto wbe wat wincreased wrisk w(select wall wthat wapply)?
A. Older wAfrican wAmericans
B. Individuals wolder wthan w60 wyears
C. Those wwith wa whistory wof wpancreatitis
D. Those wwith wa whistory wof whypertension
E. Those wwith wa whistory wof wtype w2 wdiabetes w- wCORRECT wANSWER-A.
wOlder wAfrican wAmericans
B. wIndividuals wolder wthan w60 wyears
D. wThose wwith wa whistory wof whypertension
E. wThose wwith wa whistory wof wtype w2 wdiabetes
,Risk wfactors wfor wCKD winclude wdiabetes wmellitus, whypertension, wage wolder wthan
w60 wyears, wcardiovascular wdisease, wfamily whistory wof wCKD, wexposure wto
wnephrotoxic wdrugs, wand wethnic wminorities w(e.g., wAfrican wAmerican, wNative
wAmerican).
Which wstatement wregarding wcontinuous wambulatory wperitoneal wdialysis w(CAPD) wis
wof whighest wpriority wwhen wteaching wa wpatient wnew wto wthis wprocedure?
A. w"It wis wessential wthat wyou wmaintain waseptic wtechnique wto wprevent wperitonitis."
B. w"You wwill wbe wallowed wa wmore wliberal wprotein wdiet wafter wyou wcomplete wCAPD."
C. w"It wis wimportant wfor wyou wto wmaintain wa wdaily wwritten wrecord wof wblood
wpressure wand wweight."
D. w"You wmust wcontinue wregular wmedical wand wnursing wfollow-up wvisits wwhile
wperforming wCAPD." w- wCORRECT wANSWER-A. w"It wis wessential wthat wyou wmaintain
waseptic wtechnique wto wprevent wperitonitis."
Peritonitis wis wa wpotentially wfatal wcomplication wof wperitoneal wdialysis, wand wit wis
wimperative wto wteach wthe wpatient wmethods wto wprevent wit wfrom woccurring. wAlthough
wthe wother wteaching wstatements ware waccurate, wthey wdo wnot waddress wthe wpotential
wfor wmortality wby wperitonitis, wmaking wthat wnursing waction wthe whighest wpriority.
How wshould wyou wassess wthe wpatency wof wa wnewly wplaced warteriovenous wgraft wfor
wdialysis?
A. wIrrigate wthe wgraft wdaily wwith wlow-dose wheparin.
B. wMonitor wfor wany wincrease win wblood wpressure win wthe waffected warm.
C. wListen wwith wa wstethoscope wover wthe wgraft wfor wpresence wof wa wbruit.
D. wFrequently wmonitor wthe wpulses wand wneurovascular wstatus wdistal wto wthe wgraft.
w- wCORRECT wANSWER-C. wListen wwith wa wstethoscope wover wthe wgraft wfor
wpresence wof wa wbruit.
A wthrill wcan wbe wfelt wby wpalpating wthe warea wof wanastomosis wof wthe warteriovenous
wgraft, wand wa wbruit wcan wbe wheard wwith wa wstethoscope. wThe wbruit wand wthrill ware
wcreated wby warterial wblood wrushing winto wthe wvein.
What ware wthe wmain wadvantages wof wperitoneal wdialysis wcompared wto whemodialysis?
A. wNo wmedications ware wrequired wbecause wof wthe wenhanced wefficiency wof wthe
wperitoneal wmembrane win wremoving wtoxins.
B. wThe wdiet wis wless wrestricted wand wdialysis wcan wbe wperformed wat whome.
C. wThe wdialysate wis wbiocompatible wand wcauses wno wlong-term wconsequences.
, D. wHigh wglucose wconcentrations wof wthe wdialysate wcause wa wreduction win wappetite,
wpromoting wweight wloss. w- wCORRECT wANSWER-B. wThe wdiet wis wless wrestricted
wand wdialysis wcan wbe wperformed wat whome.
Advantages wof wperitoneal wdialysis winclude wfewer wdietary wrestrictions wand whome
wdialysis wis wpossible.
The wnurse wteaches wa wclient wwho wis wrecovering wfrom wacute wkidney wdisease wto
wavoid wwhich wtype wof wmedication?
A wNonsteroidal wanti-inflammatory wdrugs w(NSAIDs)
B wAngiotensin-converting wenzyme w(ACE) winhibitors
C wOpiates
D wCalcium wchannel wblockers wfiltration wrate wand wblood wflow wwithin wthe wkidney. w-
wCORRECT wANSWER-A wNonsteroidal wanti-inflammatory wdrugs w(NSAIDs)
NSAIDs wmay wbe wnephrotoxic wto wa wclient wwith wacute wkidney wdisease, wand
wshould wbe wavoided. wACE winhibitors ware wused wfor wtreatment wof whypertension
wand wto wprotect wthe wkidneys, wespecially win wthe wdiabetic wclient, wfrom wprogression
wof wkidney wdisease. wOpiates wmay wbe wused wby wclients wwith wkidney wdisease wif
wsevere wpain wis wpresent; whowever, wexcretion wmay wbe wdelayed. wCalcium wchannel
wblockers wcan wimprove wthe wglomerular
A wclient wwith wend-stage wkidney wdisease whas wbeen wput won wfluid wrestrictions. wWhich
wassessment wfinding windicates wthat wthe wclient whas wnot wadhered wto wthis wrestriction?
A wBlood wpressure wof w118/78 wmm wHg
B wWeight wloss wof w3 wpounds wduring whospitalization
C wDyspnea wand wanxiety wat wrest
D wCentral wvenous wpressure w(CVP) wof w6 wmm wHg w- wCORRECT wANSWER-C
wDyspnea wand wanxiety wat wrest
Dyspnea wis wa wsign wof wfluid woverload wand wpossible wpulmonary wedema; wthe
wnurse wshould wassist wthe wclient win wcorrelating wsymptoms wof wfluid woverload wwith
wnonadherence wto wfluid wrestriction. wNonadherence wto wfluid wrestriction wresults win
wfluid wvolume wexcess wand whigher wblood wpressures; w118/78 wmm wHg wis wa wnormal
wblood wpressure. wExcess wfluid wintake wand wfluid wretention ware wmanifested wby wan
welevated wCVP w(>8 wmm wHg) wand wweight wgain, wnot wweight wloss.
Which wassessment wfinding wrepresents wa wpositive wresponse wto werythropoietin
w(Epogen, wProcrit) wtherapy?
A wHematocrit wof w26.7%
B wPotassium wwithin wnormal wrange
C wAbsence wof wspontaneous wfractures
D wLess wfatigue w- wCORRECT wANSWER-D wLess wfatigue
