NCLEX-RN 2026-2027 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
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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