NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #11 : Respiratory Conditions

You are a pulmonology nurse taking care of a patient who complains of episodic wheezing. You perform a diagnostic test in which you perform pulmonary function tests on the patient before, and after administering albuterol, a beta-2 adrenergic agonist. You note that the patient's symptoms and FEV1 readings improve drastically with bronchodilator administration. Based upon these findings, the patient most likely has which of the following?

Possible Answers:

Lung Cancer

Throat Cancer

Asthma

Chronic Obstructive Pulmonary Disease

Sarcoidosis

Correct answer:

Asthma

Explanation:

The correct answer is "Asthma." This answer is correct because asthma is an inflammatory airway condition that is characteristically improved symptomatically and quantitatively (in terms of pulmonary function tests, including FEV1 readings) with bronchodilator administration (e.g. albuterol, the beta-2 adrenergic agonist administered in this patient). In this patient who presented for evaluation of wheezing, a characteristic symptom of asthma, his substantial response to bronchodilator administration makes the likelihood of an asthma diagnosis very high. 

Chronic Obstructive Pulmonary Disease (COPD) is an obstructive physiology of the airways often due to chronic tobacco smoking. While bronchodilators may be of some clinical value in these patients, their FEV1 readings characteristically do not correct after bronchodilator administration, as this is a major method in which COPD can be distinguished from asthma and other inflammatory airway conditions. 

Sarcoidosis, lung cancer, and throat cancer symptoms would not necessarily improve with bronchodilator administration, nor would pulmonary function test readings in patients with these conditions.

Example Question #12 : Respiratory Conditions

A 45-year old obese male with a history of obstructive sleep apnea, hypertension, diabetes, and coronary artery disease presents to your primary care clinic for help in managing his fatigue due to his sleep apnea. He is not a candidate for tonsillectomy and adenoidectomy. Which of the following interventions would be the best recommendation to treat his obstructive sleep apnea?

Possible Answers:

Metoprolol

Tamsulosin

Metformin

Insulin

Continuous positive airway pressure mask (CPAP)

Correct answer:

Continuous positive airway pressure mask (CPAP)

Explanation:

The correct answer is "continuous positive airway pressure mask (CPAP)." This is the correct answer as a CPAP mask helps to force airway into the lungs that is otherwise obstructed by the patient's oropharyngeal anatomy at standard breathing pressures due to obstructive sleep apnea. When wearing a CPAP mask (typically when sleeping), snoring is reduced, and oxygenation is improved, allowing patients to have a more restful sleep and feel less fatigued the following day. 

While medications like metoprolol, insulin, and metformin may be beneficial to the patient in treating his conditions co-morbid to obstructive sleep apnea, they do not have a direct effect on treating his sleep apnea or the resultant fatigue.

Tamsulosin is an alpha-adrenergic blocker and can be used to treat benign prostatic hyperplasia among other conditions, but not obstructive sleep apnea. 

Example Question #11 : Respiratory Conditions

Which of the following best describes a diagnosis of uncomplicated or simple silicosis?
Possible Answers:
Normal pulmonary function but shortness of breath
Massive pulmonary fibrosis visible on chest x-ray, but no extrapulmonary symptoms
Silica in the bloodstream but no clinical symptoms
Mild ventilation restriction and fibrosis on chest x-ray
Correct answer: Mild ventilation restriction and fibrosis on chest x-ray
Explanation: Simple silicosis results in mild ventilation restriction and fibrosis on chest x-ray. Simple silicosis often results from long-term exposure to relatively low concentrations of silica dust, where symptoms usually appear 10-30 years after exposure.

Example Question #21 : Respiratory Conditions

A 63 year old female client is newly admitted to the hospital for pneumococcal pneumonia. The nurse recognizes that this patient will most likely exhibit certain symptoms associated with this condition. 

Which clinical findings are most commonly consistent with pneumococcal pneumonia?

Possible Answers:

Sudden onset of fever, chills, with a productive cough with rust colored sputum.

Fever, chills, and a non-productive cough.

Headache, muscle aches, and a cough with frothy pink sputum. 

Slow onset of cough, nasal congestion, sore throat, and fever. 

Dry cough with fatigue, nausea and vomiting.

Correct answer:

Sudden onset of fever, chills, with a productive cough with rust colored sputum.

Explanation:

Pneumococcal (bacterial) pneumonia typically presents with an abrupt onset of fever, shaking chills, and a productive cough (usually rust in color). Usually viral pneumonias will present with a dry non productive cough and associated with other viral infections. 

Example Question #1 : Respiratory Condition Follow Up

What population is most at risk during pertussis infection?

Possible Answers:

Infants

Elderly

Adolescents

Pregnant women

Correct answer:

Infants

Explanation:

Due to their susceptibility to suffocation, infants are more at risk of mortality than older children, pregnant women, or the elderly during pertussis infection. Mortality in infants with this condition can be as high as 2%. There is also an increase in infant co-moridities such as pneumonia, encephalopathy, seizures, and failure to thrive.

Example Question #22 : Respiratory Conditions

You are the nurse taking care of a 78-year old man with a 60 pack-year smoking history who is hospitalized for shortness of breath. You review the x-ray and notice a 1-cm solitary pulmonary nodule within the middle lobe of the right lung. Which of the following is the most appropriate next step?

Possible Answers:

Attempt to obtain and review a prior x-ray

Administer radiotherapy to the pulmonary nodule

Administer chemotherapy

Arrange for biopsy of the nodule

Refer the patient for surgical excision of the nodule

Correct answer:

Attempt to obtain and review a prior x-ray

Explanation:

The correct answer is "Attempt to obtain and review a prior x-ray." This is the correct answer because while the patient appears to have a very concerning story for a primary lung neoplasm given his age and smoking history, or a metastasis from another neoplasm, if this nodule was noted on a prior x-ray, especially a much older x-ray, and is unchanged, then the degree of concern about the nodule is much lower, given its stability over time. On the contrary, if you can obtain a recent prior x-ray and the nodule is not present on that scan, or has grown since that scan, then the level of concern about the nodule should be greater, and should guide clinical decision-making as such.

Measures such as biopsy, surgery, chemotherapy, or radiotherapy administration are all possible future steps if indeed this pulmonary nodule turns out to be a malignant neoplasm. That being said, there is no definite evidence at this time that the patient's nodule is of malignant origin, and should this nodule be something that has been stable on prior x-rays for multiple years, then the level of concern should be far lower, and the need for more invasive measures would be obviated.

Example Question #1 : Identifying Pediatric Conditions

Which of the following terms describes the congenital abnormality of the forebrain in which an infant is born with a diminished brain size?

Possible Answers:

Agyri

Microcephaly

Anencephaly

Polymicrogyri

Correct answer:

Microcephaly

Explanation:

Microcephaly denotes a congenital abnormality of the forebrain in which an infant is born with a diminished brain size. Potential causes include fetal alcohol syndrome, congenital rubella, and trisomy 18. 

The other answers are all examples of congenital forebrain birth defects:

  • Anencephaly is the complete absence of major portions of the brain, skull, and scalp.
  • Agyri is the absence of gyri.
  • Polymicrogyri is a condition in which gyri are too many, too small, and very shallow.

Example Question #71 : Conditions And Treatments

Anencephaly and other neural tube defects have been linked to maternal deficiency of what nutrient?

Possible Answers:

Biotin

Beta carotene

Folate

Calcium

Correct answer:

Folate

Explanation:

Anencephaly and other neural tube defects have been linked to maternal deficiency of folate. This is most likely due to folate's role in methylation and nucleic acid synthesis. The other nutrients listed are all important to maternal health but have no known correlation with neural tube defects such as anencephaly.

Example Question #2 : Identifying Pediatric Conditions

Periventricular leukomalacia (PVL) is the most common finding on autopsy of newborns with what condition?

Possible Answers:

Hypoxia

Fetal alcohol syndrome

Anencephaly

Cerebral palsy

Correct answer:

Cerebral palsy

Explanation:

Periventricular leukomalacia is the most common finding on autopsy of newborns with cerebral palsy. PVL involves the softening of the brain tissue and subsequent death of the white matter. This is caused by lack of blood flow to the periventricular area of the brain, which results in necrosis and gliosis of brain tissue. Neonates born with PVL are likely to have mental impairment, motor disorders, and compromised vision and hearing. PVL is usually diagnosed with ultrasound of the head. None of the other conditions listed typically present with this finding.

Example Question #1 : Pediatric Conditions

A mother one hour post birth expresses concern because her baby's head looks slightly cone shaped. The nurse tells the mother that __________.

Possible Answers:

this is abnormal and she should consult a neurologist

this is normal but is not temporary

this is abnormal but does not require immediate medical intervention

this is abnormal and she should contact her pediatrician

this is normal and usually temporary

Correct answer:

this is normal and usually temporary

Explanation:

It is normal for a child's head to be slightly misshapen immediately following birth. The infant's skull is composed of bony plates connected by membranes (fontanelles), allowing for accommodation of the baby's growing brain. Caput succedaneum (swelling of the scalp) can also be found following a long delivery. A misshapen head usually resolves on its own and is normal but does not require any medical intervention.

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