NCSBN TEST BANK - for the NCLEX-RN & NCLEX-PN, Updated 2025 with Case Studies and Next Generation NCLEX, Complete Questions & Answers with rationale ©NURSING

, NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING




Question 1


The nurse is caring for a 4 year-old who will have surgery
for Tetralogy of Fallot tomorrow. Which laboratory report
must receive PRIORITY attention by the nurse?


A) Erythrocyte sedimentation rate


B) White blood cell count


C) Hemoglobin and hematocrit


D) Arterial blood gases




Review Information: The correct answer is:


C) Hemoglobin and hematocrit.


Tetralogy of Fallot is a cyanotic heart defect, which can
manifest in polycythemia due to release of erythropoietin.

NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING

, NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING
Hemoglobin valuesof up to 20 and hematocrit''s of 60 or
higher may be seen. These must be noted and reported to
the physician.




Question 2


The nurse is assessing a client with portal hypertension.
Which of the following findings would the nurse expect?


A) Expiratory wheezes


B) Blurred vision


C) Acites


D) Dilated pupils


Review Information: The correct answer is:


C) Acites.


Portal hypertension can occur in a client with right-sided
heart failure or cirrhosis of the liver. Portal hypertension
NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING

, NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING
can lead to acites due to the increased protal pressure as
well as a lowered osmotic pressure.




Question 3


A 67 year-old client with non-insulin dependent diabetes
should be instructed to contact the out-patient clinic
IMMEDIATELY if the following symptoms are present


A) Temperature of 37.5 degrees C with painful urination


B) An open wound on their heel


C) Insomnia and daytime fatigue


D) Nausea with two episodes of vomiting




NCSBN TEST BANK - for the NCLEX-RN &
NCLEX-PN, Updated 2021, CompleteQuestions &
Answers with rationale ©NURSING