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NCLEX PN 140 FINAL EXAM PRACTICE
QUESTIONS WITH VERIFIED SOLUTIONS
WITH RATIONALE NEW MODIFIED
A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to
cry and tells the nurse that she is afraid that her skin will be disfigured with lesions. Which
intervention does the nurse plan to teach this client to minimize skin infections associated
with SLE?
Select all that apply.
A) Use sunscreen with an SPF of 15 or greater.
B) Remain indoors on sunny days.
C) Avoid swimming in a pool or the ocean.
D) Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
E) Decrease sun exposure between 3:00 p.m. and 5:00 p.m. -- ANSWER--Answer: A, D
The nurse teaches the client to live a normal life with a few extra precautions. There is a
relationship between sun exposure and infection, so the client is taught to use sunscreen with
an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may
swim but should reapply sunscreen after swimming. The client does not need to stay indoors
on sunny days or to decrease sun exposure between 3:00 p.m. and 5:00 p.m.
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action
that the nurse should take?
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a. Place the patient on a cardiac monitor.
b. Check the patient's BP.
c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results. -- ANSWER--a. Dysrhythmias
may occur with an elevated potassium level and are potentially lethal. Monitor the rhythm
while contacting physician or calling the rapid response team.
A patient is admitted to the hospital with CKD. You understand that this condition is
characterized by
A. Progressive irreversible destruction of the kidneys
B. A rapid decrease in urinary output with an elevated BUN level
C. Increasing creatinine clearance with a decrease in urinary output
D. Prostration, somnolence, and confusion with coma and imminent death -- ANSWER--A.
Progressive irreversible destruction of the kidneys
CKD involves progressive, irreversible loss of kidney function.
Measures indicated in the conservative therapy of CKD include
A. decreased fluid intake, carbohydrate intake, and protein intake.
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B. increased fluid intake; decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake; increased protein intake. -- ANSWER--C.
decreased fluid intake and protein intake; increased carbohydrate intake.
Water and any other fluids are not routinely restricted in the pre-end-stage renal disease
(ESRD) stages. Patients on hemodialysis have a more restricted diet than patients receiving
peritoneal dialysis. For those receiving hemodialysis, as their urinary output diminishes, fluid
restrictions are enhanced. Intake depends on the daily urine output. Generally, 600 mL (from
insensible loss) plus an amount equal to the previous day's urine output is allowed for a
patient receiving hemodialysis. Patients are advised to limit fluid intake so that weight gains
are no more than 1 to 3 kg between dialyses (interdialytic weight gain). For the patient who is
undergoing dialysis, protein is not routinely restricted. The beneficial role of protein
restriction in CKD stages 1 through 4 as a means to reduce the decline in kidney function is
being studied. Historically, dietary counseling often encouraged restriction of protein for
CKD patients. Although there is some evidence that protein restriction has benefits, many
patients find these diets difficult to adhere to. For CKD stages 1 through 4, many clinicians
encourage a diet with normal protein intake. However, you should teach patients to avoid
high-protein diets and supplements because they may overstress the diseased kidneys.
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at
increased risk (select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
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D. Those with a history of hypertension
E. Those with a history of type 2 diabetes -- ANSWER--A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years,
cardiovascular disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic
minorities (e.g., African American, Native American).
When caring for a client who receives peritoneal dialysis (PD), which finding does the nurse
report to the provider immediately?
A Pulse oximetry reading of 95%
B Sinus bradycardia, rate of 58 beats/min
C Blood pressure of 148/90 mm Hg
D Temperature of 101.2° F (38.4° C) -- ANSWER--D Temperature of 101.2° F (38.4° C)
Peritonitis is the major complication of PD, caused by intra-abdominal catheter site
contamination; meticulous aseptic technique must be used when caring for PD equipment. A
pulse oximetry reading of 95% is a normal saturation. Although a heart rate of 58 beats/min is
slightly bradycardic, the provider can be informed upon visiting the client. Clients with
NCLEX PN 140 FINAL EXAM PRACTICE
QUESTIONS WITH VERIFIED SOLUTIONS
WITH RATIONALE NEW MODIFIED
A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to
cry and tells the nurse that she is afraid that her skin will be disfigured with lesions. Which
intervention does the nurse plan to teach this client to minimize skin infections associated
with SLE?
Select all that apply.
A) Use sunscreen with an SPF of 15 or greater.
B) Remain indoors on sunny days.
C) Avoid swimming in a pool or the ocean.
D) Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
E) Decrease sun exposure between 3:00 p.m. and 5:00 p.m. -- ANSWER--Answer: A, D
The nurse teaches the client to live a normal life with a few extra precautions. There is a
relationship between sun exposure and infection, so the client is taught to use sunscreen with
an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may
swim but should reapply sunscreen after swimming. The client does not need to stay indoors
on sunny days or to decrease sun exposure between 3:00 p.m. and 5:00 p.m.
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action
that the nurse should take?
, Page|2
a. Place the patient on a cardiac monitor.
b. Check the patient's BP.
c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results. -- ANSWER--a. Dysrhythmias
may occur with an elevated potassium level and are potentially lethal. Monitor the rhythm
while contacting physician or calling the rapid response team.
A patient is admitted to the hospital with CKD. You understand that this condition is
characterized by
A. Progressive irreversible destruction of the kidneys
B. A rapid decrease in urinary output with an elevated BUN level
C. Increasing creatinine clearance with a decrease in urinary output
D. Prostration, somnolence, and confusion with coma and imminent death -- ANSWER--A.
Progressive irreversible destruction of the kidneys
CKD involves progressive, irreversible loss of kidney function.
Measures indicated in the conservative therapy of CKD include
A. decreased fluid intake, carbohydrate intake, and protein intake.
, Page|3
B. increased fluid intake; decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake; increased protein intake. -- ANSWER--C.
decreased fluid intake and protein intake; increased carbohydrate intake.
Water and any other fluids are not routinely restricted in the pre-end-stage renal disease
(ESRD) stages. Patients on hemodialysis have a more restricted diet than patients receiving
peritoneal dialysis. For those receiving hemodialysis, as their urinary output diminishes, fluid
restrictions are enhanced. Intake depends on the daily urine output. Generally, 600 mL (from
insensible loss) plus an amount equal to the previous day's urine output is allowed for a
patient receiving hemodialysis. Patients are advised to limit fluid intake so that weight gains
are no more than 1 to 3 kg between dialyses (interdialytic weight gain). For the patient who is
undergoing dialysis, protein is not routinely restricted. The beneficial role of protein
restriction in CKD stages 1 through 4 as a means to reduce the decline in kidney function is
being studied. Historically, dietary counseling often encouraged restriction of protein for
CKD patients. Although there is some evidence that protein restriction has benefits, many
patients find these diets difficult to adhere to. For CKD stages 1 through 4, many clinicians
encourage a diet with normal protein intake. However, you should teach patients to avoid
high-protein diets and supplements because they may overstress the diseased kidneys.
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at
increased risk (select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
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D. Those with a history of hypertension
E. Those with a history of type 2 diabetes -- ANSWER--A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years,
cardiovascular disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic
minorities (e.g., African American, Native American).
When caring for a client who receives peritoneal dialysis (PD), which finding does the nurse
report to the provider immediately?
A Pulse oximetry reading of 95%
B Sinus bradycardia, rate of 58 beats/min
C Blood pressure of 148/90 mm Hg
D Temperature of 101.2° F (38.4° C) -- ANSWER--D Temperature of 101.2° F (38.4° C)
Peritonitis is the major complication of PD, caused by intra-abdominal catheter site
contamination; meticulous aseptic technique must be used when caring for PD equipment. A
pulse oximetry reading of 95% is a normal saturation. Although a heart rate of 58 beats/min is
slightly bradycardic, the provider can be informed upon visiting the client. Clients with
