NCLEX-PN
Nclex 2024 Questions
1. A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?
- A. "I can drink alcohol now that I am decreasing my Xanax."?
- B. "I should not take another Xanax pill. Here is what is left of my last prescription."?
- C. "I should take three pills per day next week, then two pills for one week, then one pill for one week."?
- D. "I can expect to be sleepy for several days after stopping the medicine."?
Correct answer: C
Rationale: Explanation: When discontinuing alprazolam (Xanax) after long-term use, it is crucial to taper the dosage gradually to prevent withdrawal symptoms. The correct statement indicates an understanding of this by planning a structured decrease in dosage over time. Choice A is incorrect as drinking alcohol while decreasing Xanax can be dangerous and is not recommended. Choice B is incorrect as abruptly stopping Xanax is not safe and can lead to withdrawal symptoms. Choice D is incorrect as expecting to be sleepy for several days after stopping the medication does not address the need for a gradual tapering process to avoid withdrawal symptoms.
2. A client is 2 days post-operative colon resection. After a coughing episode, the client's wound eviscerates. Which nursing action is most appropriate?
- A. Reinsert the protruding organ and cover with 4x4s
- B. Cover the wound with a sterile 4x4 and ABD dressing
- C. Cover the wound with a sterile saline-soaked dressing
- D. Apply an abdominal binder and manual pressure to the wound
Correct answer: B
Rationale: In the scenario where a client's wound eviscerates, the most appropriate nursing action is to cover the wound with a sterile saline-soaked dressing. Reinserting the protruding organ, as mentioned in choice A, is incorrect because it can lead to further complications requiring the client to return to surgery. Choice B, covering the wound with a sterile 4x4 and ABD dressing, is not ideal as it may not provide adequate protection and moisture for the exposed tissue. Choice D, applying an abdominal binder and manual pressure to the wound, is inappropriate as it does not address the specific needs of wound evisceration. Covering the wound with a sterile saline-soaked dressing helps maintain a moist environment, protects the exposed tissue, and prevents infection, promoting optimal wound healing and reducing the risk of complications.
3. The healthcare provider recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?
- A. Mask
- B. Gown
- C. Gloves
- D. Shoe covers
Correct answer: A
Rationale: When providing care to a client with a cough, it is crucial to wear a mask to protect oneself from inhaling respiratory droplets containing infectious agents. The primary mode of transmission for coughs is through airborne droplets, making a mask the most appropriate choice to prevent the spread of respiratory infections. Gloves and gowns are more relevant when there is a risk of contact with bodily fluids, which is not the main concern with a cough. Shoe covers are not necessary in this scenario as the transmission of respiratory infections is not linked to footwear. Therefore, wearing a mask is the best choice to prevent airborne transmission and ensure the safety of the healthcare provider.
4. The client with diverticulosis is being assisted by the nurse in selecting appropriate foods. Which food should be avoided?
- A. Bran
- B. Fresh peaches
- C. Cucumber salad
- D. Yeast rolls
Correct answer: C
Rationale: The food that should be avoided for a client with diverticulosis is Cucumber salad. Foods with seeds should be avoided as they can aggravate diverticulosis by causing irritation and inflammation in the diverticula. Choices A, B, and D are allowed and even beneficial. Bran cereal and fruit like fresh peaches can help prevent constipation, which is beneficial for individuals with diverticulosis. Yeast rolls are also acceptable unless the client has specific dietary restrictions related to yeast or gluten.
5. A client is admitted to the acute care unit. Initial laboratory values reveal serum sodium of 170meq/L. What behavior changes would be most common for this client?
- A. Anger
- B. Mania
- C. Depression
- D. Psychosis
Correct answer: B
Rationale: The correct answer is 'Mania.' A client with a serum sodium level of 170 meq/L has hypernatremia, which can lead to manic behavior. Hypernatremia is associated with irritability, restlessness, confusion, and in severe cases, manic symptoms. Choices A, C, and D (Anger, Depression, Psychosis) are not typically associated with hypernatremia and are, therefore, incorrect in this context.
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