NCLEX-RN 2024-2025 EXIT EXAM QUESTION WITH

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NCLEX-RN 2024-2025 EXIT EXAM QUESTION WITH

RATIONALES

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 ma y be less knowledgeable about the possibilities of change. 1 / 4

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• 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 2 / 4

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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 3 / 4

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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, wh ich can result in arrhythmias. Muscle cramps, muscle weakness, rhabdomyolysis, myoglobinuria are presenting signs and symptoms in hyperkalemia.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

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