NCLEX-PN
Nclex Questions Management of Care
1. A nurse provides instructions to a mother about crib safety for her infant. Which statement by the mother indicates a need for further instructions?
- A. ''Wood surfaces on the crib need to be free of splinters and cracks.''
- B. ''I need to keep large toys out of the crib.''
- C. ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.''
- D. ''The drop side needs to be impossible for my infant to release.''
Correct answer: C
Rationale: The correct answer is, ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.'' This statement indicates a need for further instructions as the distance between the slats should be no more than 2⅜ inches to prevent entrapment of the infant's head and body, not 4 inches. Allowing a larger gap can pose a risk of entrapment or injury to the infant. Keeping large toys out of the crib is essential to prevent the infant from using them to climb out, which could result in serious injuries. Ensuring the drop side of the crib is impossible for the infant to release is crucial to prevent falls and injuries. Additionally, maintaining wood surfaces on the crib free of splinters, cracks, and lead-based paint is vital for the infant's safety and well-being.
2. Which of the following conditions has a severe complication of respiratory failure?
- A. Bell's palsy
- B. Guillain-Barré syndrome
- C. Trigeminal neuralgia
- D. Tetanus
Correct answer: B
Rationale: Guillain-Barré syndrome is characterized by a severe complication of respiratory failure due to the involvement of the peripheral nerves that control breathing. While Bell's palsy, trigeminal neuralgia, and tetanus are also conditions affecting peripheral nerves, they do not typically lead to respiratory failure like Guillain-Barré syndrome. Bell's palsy causes facial muscle weakness, trigeminal neuralgia results in severe facial pain, and tetanus leads to muscle stiffness and spasms, but none of these conditions directly involve respiratory failure.
3. A client states, 'I can leave the diaphragm in place as long as I want after intercourse.' Which statement indicates to the nurse that the client needs further information on how to use the diaphragm?
- A. 'I need to reapply spermicidal cream with repeated intercourse.'
- B. 'The diaphragm needs to be filled with spermicidal cream before insertion.'
- C. 'I can leave the diaphragm in place as long as I want after intercourse.'
- D. 'The diaphragm can be inserted as long as 6 hours before intercourse.'
Correct answer: C
Rationale: The correct answer is the statement, 'I can leave the diaphragm in place as long as I want after intercourse.' This statement indicates a lack of understanding about the correct use of the diaphragm. The diaphragm must be left in place for at least 6 hours after intercourse to ensure effectiveness and reduce the risk of pregnancy. Leaving the diaphragm in place for an extended period can lead to toxic shock syndrome. Choice A is correct as spermicidal cream needs to be reapplied before each act of intercourse for optimal contraceptive efficacy. Choice B is a correct statement as the diaphragm should be filled with spermicidal cream before insertion to increase its effectiveness. Choice D is also accurate as the diaphragm can be inserted up to 6 hours before intercourse to allow time for proper placement and effectiveness.
4. When a client's postoperative pain seems to be getting worse due to grief over the recent death of their spouse, what should the nurse consider?
- A. calling the physician for an increased dosage of pain medication
- B. calling the physician for a sedative
- C. referring the client for a psychiatric consult
- D. developing interventions for grief and loss
Correct answer: D
Rationale: The correct answer is developing interventions for grief and loss. In this scenario, the client's pain is not solely sensory but also affective due to grieving over the death of their spouse. It is essential to address the emotional component of pain by providing support and interventions for grief and loss. Referring the client for a psychiatric consult may not be necessary as grieving is a normal response to such a significant loss. Calling the physician for an increased dosage of pain medication or a sedative solely focuses on the sensory aspect of pain and does not address the underlying emotional distress.
5. Which of the following NSAIDs is most commonly used for a brief period for acute pain?
- A. Advil
- B. Aleve
- C. Toradol
- D. Bextra
Correct answer: C
Rationale: Toradol is the correct answer because it is an NSAID known for its effectiveness in managing acute pain for short durations. It can be administered via intramuscular (IM), intravenous (IV), or oral (PO) routes. Advil (choice A) and Aleve (choice B) are commonly used for mild to moderate pain but may not be as effective for acute pain requiring immediate relief. Bextra (choice D) was withdrawn from the market due to safety concerns, making it an inappropriate choice for acute pain management.
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