NCLEX RN Predictor Exam
Question 1 of 5.
A 68-year-old man was recently diagnosed with endstage renal disease. He has not yet begun dialysis but is experiencing severe anemia with associated symptoms of dyspnea on exertion and chest pain. Which statement best describes the management of anemia in renal failure?
A. Hematocrit levels usually remain slightly below normal in clients with renal failure.
B. Transfusion is often begun as early as possible to prevent complications of anemia such as dyspnea and angina.
C. Anemia in renal failure is frequently caused by low serum iron and ferritin and corrected by oral iron and ferritin replacement therapy.
D. The renal secretion of erythropoiesis is decreased. The bone marrow requires erythropoietin to mature red blood cells.
Explanation: Clients in renal failure typically have very low hematocrits, often in the range of 16-22%. Transfusion is avoided unless the client exhibits acute symptoms such as dyspnea, chest pain, tachycardia, and extreme fatigue. When the client is given a transfusion, the bone marrow adjusts by producing less red blood cells. Anemia in renal failure is caused primarily by decreased erythropoietin. Low serum iron and ferritin may aggravate the anemia and require treatment. Decreased secretion of erythropoietin by the kidney is the primary cause of anemia. The bone marrow requires this hormone to mature red blood cells. Treatment is with replacement therapy.
Question 2 of 5.
A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?
A. Resting tremors
B. Double vision
C. Flaccid paralysis
D. Pill-rolling tremors
Explanation: Double vision (diplopia) is a common early symptom of multiple sclerosis due to demyelination affecting the optic nerves or brainstem.
Question 3 of 5.
A child with Down syndrome has a developmental age of four years. According to the Denver Developmental Assessment, the four-year-old should be able to:
A. Draw a man in six parts
B. Give his first and last name
C. Dress without supervision
D. Define a list of words
Explanation: Per the Denver Developmental Screening Test, a four-year-old should be able to state their first and last name, a milestone achievable despite Down syndrome delays.
Question 4 of 5.
Parents of a toddler are dismayed when they learn that their child has Duchenne's muscular dystrophy. Which statement describes the inheritance pattern of the disorder?
A. An affected gene is located on one of the 21 pairs of autosomes.
B. The disorder is caused by an over-replication of the X chromosome in males.
C. The affected gene is located on the Y chromosome of the father.
D. The affected gene is located on the X chromosome of the mother.
Explanation: Duchenne's muscular dystrophy is an X-linked recessive disorder, with the affected gene on the mother's X chromosome, primarily affecting males.
Question 5 of 5.
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
A. Increased pulse rate
B. Increased urinary output
C. Decreased diastolic blood pressure
D. Increased pupil size
Explanation: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid from the brain.
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