Pass the NCLEX Certification NCLEX-PN Questions and answers with ExamsMirror

Huntington’s chorea is characterized by writhing, twisting movements of the face and limbs. The remaining

options are neurological disorders that do not have such movements as part of their disease process.Reduction of

Risk Potential

The kidneys of a client in renal failure produce no erythropoietin, a hormone necessary for RBC production.

Erythropoietin can be given as replacement, but the client needs adequate iron, folate, and B12 to increase the

effectiveness of EPO. Choice 2 is not necessary for RBC production and can increase uremia. Choices 3 and 4

are not necessary for RBC production.Physiological Adaptation

There are many competencies that the nurse must have to care for families and clients at the end of life.

Demonstration of respect and compassion as well as using knowledge and skills in the care of the client and

family are major competencies.Basic Care and Comfort

If findings are ominous, the grieving process will not be completed before birth. If the couple elects to

terminate a pregnancy based on diagnostic tests, there will be grief and concerns for future pregnancies. Couples

might choose to access support services and prepare for the birth of an infant with special needs. Some fetal

conditions can be treated in utero.Health Promotion and Maintenance

The nurse needs to open the airway first when the oxygen saturation drops. The other actions might be

appropriate, but the airway must be patent.Reduction of Risk Potential

Promoting healthy nutritional practices is an appropriate nursing goal for a client at risk for nutritional

problems. Choice 1 is incorrect because it is a nursing intervention, not a goal statement. Choice 3 is incorrect

because it is a therapeutic treatment. Choice 4 is incorrect because weight gain is an appropriate goal only if the

client is underweight.Basic Care and Comfort

Of the nursing diagnoses listed, the client’s statement most represents Body Image Disturbance because it

directly refers to loss of the function of having a child. Nothing in the statement indicates that the client is at

risk for harming herself. Ineffective Role Performance could be correct but is not the best choice because the

statement does not reflect a disruption of the parent’s role. Powerlessness could be an appropriate nursing

diagnosis if the client described feeling powerless about the infertility.Health Promotion and Maintenance

Mammography is used to detect tumors or cysts in the breasts, not the other conditions.Reduction of Risk

Potential

Uric acid levels are indicated for clients with gout.Reduction of Risk Potential

Dental problems are prevalent because of the lack of preventive care and access to care. High infant mortality

is one of the most significant problems correlated with poverty. Pregnant women who do not have access to

care might come to the Emergency Department when in labor. Those in poverty are likely to use Emergency

Departments because they may not be turned away. Those in poverty might also turn to folk healers or other

persons in their community for care who might be easier to access and might not demand payment.Health

Promotion and Maintenance

Nutrition, elimination, comfort, and safety are the major areas of importance. The diet should be high in

protein with adequate fluids.Basic Care and Comfort

Altered Family Processes is a potential nursing diagnosis for the family and client with a new diagnosis of

Hemophilia. Infants are aware of how their caregivers respond to their needs. Stresses can have an immediate

impact on the infant’s development of trust and how others relate to them because of their diagnosis. The longterm

effects of hemophilia can include problems related to immobility. Altered growth and development could not

have developed in a newly diagnosed client. Hemarthrosis is acute bleeding into a joint space that is characteristic

of hemophilia. It does not have an immediate effect on the body image of a newly diagnosed hemophiliac.Health

Promotion and Maintenance

Glucose is monitored closely when a client is on total parenteral nutrition, due to high glucose concentration

in the solutions. The other values are not monitored as closely.Health Promotion and Maintenance

In general, children begin dentition around 6 months of age. During the first 2 years of life, a quick guide to

the number of teeth a child should have is as follows: Subtract the number 6 from the number of months in the

age of the child. In this example, the child is 18 months old, so the formula is 18 – 6 = 12. An 18-month-old child

should have approximately 12 teeth.Health Promotion and Maintenance

Meals that are high in carbohydrates promote rapid gastric emptying. The other options are associated with

decreased emptying time.Basic Care and Comfort