NCLEX-RN Practice Quiz Test Bank #8 (75 Questions)
NCLEXRN-08-001
Question Tag: Hodgkin’s lymphoma
Question Category: Physiological Integrity
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 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.
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
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 seems
to be elevated based on the differential, the actual value of the type of white blood cells
should be calculated by multiplying the percentage listed on the differential by the total
number of white blood cells.
Option C: Potassium disorders are related to cardiac arrhythmias. Hypokalemia occurs
when serum potassium levels under 3.6 mmol/L—weakness, fatigue, and muscle
twitching present in hypokalemia. Hyperkalemia occurs when the serum potassium levels
above 5.5 mmol/L, which can result in arrhythmias. Muscle cramps, muscle weakness,
rhabdomyolysis, myoglobinuria are presenting signs and symptoms in hyperkalemia.
Option D: Patients with a propensity for bleeding should undergo testing to determine
the presence of a clotting disorder. For patients with deficiencies or defects of the
intrinsic clotting cascade, the PTT will be elevated. Normal PTT values can vary between
laboratories but 25 to 35 seconds is considered normal.
NCLEXRN-08-003
Question Tag: thrombocytopenic purpura
Question Category: Physiological Integrity
The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP).
The client’s platelet count currently is 80, it will be most important to teach the client and family
about:
A. Bleeding precautions
B. Prevention of falls
, C. Oxygen therapy
D. Conservation of energy
Correct Answer: A. Bleeding precautions
The normal platelet count is 120,000–400, Bleeding occurs in clients with low platelets. The
priority is to prevent and minimize bleeding. Review laboratory results for coagulation status as
appropriate: platelet count, prothrombin time/international normalized ratio (PT/INR), activated
partial thromboplastin time (aPTT), fibrinogen, bleeding time, fibrin degradation products,
vitamin K, activated coagulation time (ACT); and educate the at-risk patient and caregivers
about precautionary measures to prevent tissue trauma or disruption of the normal clotting
mechanisms.
Option B: Thoroughly conform patient to surroundings; put call light within reach and
teach how to call for assistance; respond to call light immediately; avoid use of restraints;
obtain a physician’s order if restraints are needed; and eliminate or drop all possible
hazards in the room such as razors, medications, and matches.
Option C: Option C is important, but platelets do not carry oxygen. Wash hands and
teach patient and SO to wash hands before contact with patients and between procedures
with the patient; encourage fluid intake of 2,000 to 3,000 mL of water per day, unless
contraindicated.
Option D: Option D is of lesser priority and is incorrect in this instance. Recommend the
use of soft-bristled toothbrushes and stool softeners to protect mucous membranes; and if
infection occurs, teach the patient to take antibiotics as prescribed; instruct the patient to
take the full course of antibiotics even if symptoms improve or disappear.
NCLEXRN-08-004
NCLEXRN-08-001
Question Tag: Hodgkin’s lymphoma
Question Category: Physiological Integrity
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 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.
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
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 seems
to be elevated based on the differential, the actual value of the type of white blood cells
should be calculated by multiplying the percentage listed on the differential by the total
number of white blood cells.
Option C: Potassium disorders are related to cardiac arrhythmias. Hypokalemia occurs
when serum potassium levels under 3.6 mmol/L—weakness, fatigue, and muscle
twitching present in hypokalemia. Hyperkalemia occurs when the serum potassium levels
above 5.5 mmol/L, which can result in arrhythmias. Muscle cramps, muscle weakness,
rhabdomyolysis, myoglobinuria are presenting signs and symptoms in hyperkalemia.
Option D: Patients with a propensity for bleeding should undergo testing to determine
the presence of a clotting disorder. For patients with deficiencies or defects of the
intrinsic clotting cascade, the PTT will be elevated. Normal PTT values can vary between
laboratories but 25 to 35 seconds is considered normal.
NCLEXRN-08-003
Question Tag: thrombocytopenic purpura
Question Category: Physiological Integrity
The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP).
The client’s platelet count currently is 80, it will be most important to teach the client and family
about:
A. Bleeding precautions
B. Prevention of falls
, C. Oxygen therapy
D. Conservation of energy
Correct Answer: A. Bleeding precautions
The normal platelet count is 120,000–400, Bleeding occurs in clients with low platelets. The
priority is to prevent and minimize bleeding. Review laboratory results for coagulation status as
appropriate: platelet count, prothrombin time/international normalized ratio (PT/INR), activated
partial thromboplastin time (aPTT), fibrinogen, bleeding time, fibrin degradation products,
vitamin K, activated coagulation time (ACT); and educate the at-risk patient and caregivers
about precautionary measures to prevent tissue trauma or disruption of the normal clotting
mechanisms.
Option B: Thoroughly conform patient to surroundings; put call light within reach and
teach how to call for assistance; respond to call light immediately; avoid use of restraints;
obtain a physician’s order if restraints are needed; and eliminate or drop all possible
hazards in the room such as razors, medications, and matches.
Option C: Option C is important, but platelets do not carry oxygen. Wash hands and
teach patient and SO to wash hands before contact with patients and between procedures
with the patient; encourage fluid intake of 2,000 to 3,000 mL of water per day, unless
contraindicated.
Option D: Option D is of lesser priority and is incorrect in this instance. Recommend the
use of soft-bristled toothbrushes and stool softeners to protect mucous membranes; and if
infection occurs, teach the patient to take antibiotics as prescribed; instruct the patient to
take the full course of antibiotics even if symptoms improve or disappear.
NCLEXRN-08-004
