NCLEX : Identifying Other Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : Other Conditions

What is the most common cause of renal failure in the United States?

Possible Answers:

Renal cell carcinoma

Drug overdose

Polycystic kidney disease

Diabetes mellitus

Correct answer:

Diabetes mellitus

Explanation:

The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.

Example Question #2 : Other Conditions

A nurse is caring for a client experiencing the oliguric phase of acute kidney failure. The nurse is aware that this condition is highly associated with electrolyte imbalances, in addition to the kidney's inability to produce sufficient amounts of urine. 

Which of the following electrolyte imbalances should the nurse monitor for?

Possible Answers:

Hyperalumbinemia, hypercalcemia, and hypoglycemia

Hypokalemia, hyponatremia, and decreased creatinine levels

Hypernatremia and hypokalemia only

Hypercalcemia, hypophosphatemia, and decreased nitrogen wastes

Hyperkalemia, hypocalcemia, and low bicarbonate levels

Correct answer:

Hyperkalemia, hypocalcemia, and low bicarbonate levels

Explanation:

During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF. 

Example Question #1 : Identifying Other Conditions

An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario. 

The nurse examining the client should be aware that __________.

Possible Answers:

after an electrical burn occurs, the damage to the underlying tissues can continue for up to 72 hours

electrical burns are different from other burns in that the damage that occurs is readily visible

the patient is at increased risk for metabolic alkalosis and should be receiving fluids continuously with the addition of sodium bicarbonate

massive losses of myoglobin from muscle damage can lead to liver dysfunction thereby leading to liver failure

all patients with electrical burns are at risk for cervical spine injuries and immobilization of the the cervical spine should be a priority

Correct answer:

all patients with electrical burns are at risk for cervical spine injuries and immobilization of the the cervical spine should be a priority

Explanation:

The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis. 

Example Question #4 : Other Conditions

Which of the following is an insect vector-borne illness? 

Possible Answers:

Rocky mountain spotted fever

Rabies

Roundworm

Cat scratch fever

Scabies

Correct answer:

Rocky mountain spotted fever

Explanation:

Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect. 

Example Question #5 : Other Conditions

Ed is an 85-year-old male who lives at a long-term care facility. He has recently begun having difficulty brushing his teeth, an activity he would previously complete on his own. He has also appeared to be more confused while engaging in basic conversation with the nursing staff. The nurse should first evaluate Ed for which of the following?

Possible Answers:

Depression

Bipolar disorder

Infection

Alzheimer's disease

Creutzfeldt-Jakob disease

Correct answer:

Infection

Explanation:

Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.

Example Question #2 : Other Conditions

A 3-year-old child is admitted to the pediatric medical unit from the emergency department with suspected rheumatic fever. Which of the following is not indicative of rheumatic fever?

Possible Answers:

A history of sore throat 3 weeks ago.

A red rash over his chest and back.

A negative titer for antistreptolysin O.

A red rash over his arms and legs.

A temperature of .

Correct answer:

A negative titer for antistreptolysin O.

Explanation:

Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.

Example Question #2 : Identifying Other Conditions

A nurse is teaching a 20-year-old male client newly diagnosed with herpes simplex virus (HSV) type 2. 

All of the following teaching points in regards to this condition should be included except which of these?

Possible Answers:

Transmission of the virus is possible by respiratory droplets.

HSV is a lifelong infection, with recurrent infections possible to the skin and mucous membranes.

Nystatin, is a common drug used to treat flare ups of skin lesions associated with HSV.

Recurrent episodes of HSV may exhibit grouped vesicles on an erythematous base. 

Certain factors may exacerbate the condition such as sunlight exposure, trauma, stress, or systemic infections. 

Correct answer:

Nystatin, is a common drug used to treat flare ups of skin lesions associated with HSV.

Explanation:

Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative. 

Example Question #7 : Other Conditions

A 35-year-old male has just been admitted to the emergency department in a sickle cell crisis. The nurse caring for this client is aware of the signs and symptoms associated with this condition. 

The proper nursing management for this patient should include which of these?

Possible Answers:

Large doses of continuous analgesics for pain and oxygen to control sickling of the red blood cells.

Blood transfusions and antibiotic prophylaxis.

Strict bed rest and hyperbaric oxygen therapy for 2 hours.

Give platelets and monitor hemoglobin and hematocrit levels hourly.

 Heparin administration and iron replacement.

Correct answer:

Large doses of continuous analgesics for pain and oxygen to control sickling of the red blood cells.

Explanation:

A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis. 

Example Question #4 : Other Conditions

The SIRS (Systemic Inflammatory Response Syndrome) criteria includes which of the following?

Possible Answers:

Temperature greater than  or less than 

None of these

Respiratory rate greater than 

Heart rate less than 

Correct answer:

Temperature greater than  or less than 

Explanation:

The SIRS criteria includes 4 factors. 1.) temperature greater than  or less than  2.) A respiratory rate > 20, or  < , 3.) Heart rate greater than , and 4.) , , or immature neutrophils greater than 10% bands. To meet the SIRS definition must have 2 or more of these findings. 

Example Question #3 : Identifying Other Conditions

The fact that an elementary school is shut down due to a measles outbreak is an example of a(n) __________.

Possible Answers:

endemic disease

sporadic disease

pandemic

epidemic

Correct answer:

epidemic

Explanation:

The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.

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