NCLEX-PN
Nclex Questions Management of Care
1. Which of the following medications might cause upper-gastrointestinal (UGI) bleeding?
- A. Cardizem (diltiazem)
- B. Naprosyn (naproxen)
- C. Elavil (amitriptyline)
- D. Corgard (nadolol)
Correct answer: C
Rationale: Naprosyn (naproxen) is known to cause upper-gastrointestinal (UGI) bleeding due to its effects on the stomach lining. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach and increase the risk of UGI bleeding. On the other hand, Cardizem (diltiazem), Elavil (amitriptyline), and Corgard (nadolol) are not typically associated with UGI bleeding. Cardizem is a calcium channel blocker used for hypertension and angina, Elavil is a tricyclic antidepressant, and Corgard is a beta-blocker used for hypertension.
2. What is distraction therapy?
- A. Focusing one's attention on stimuli other than pain.
- B. Cognitive reappraisal.
- C. The replacement of positive images of pain with other images.
- D. The use of medication and meditation.
Correct answer: A
Rationale: Distraction therapy involves directing attention away from pain towards positive stimuli, which can help reduce the perception of pain. Choice A is the correct answer as it accurately defines distraction therapy. Cognitive reappraisal (Choice B) involves changing the way one thinks about a situation to alter its emotional impact, which is different from distraction therapy. Choice C is incorrect because distraction therapy does not involve replacing images of pain with other images, but rather focusing on something unrelated. Choice D is incorrect as distraction therapy does not necessarily involve medication or meditation, but rather the redirection of attention.
3. When a drug is listed as Category X and prescribed to women of child-bearing age/capacity, the nurse and the interdisciplinary team should counsel the client that:
- A. Pregnancy tests are not reliable while taking the drug.
- B. She must use a reliable form of birth control.
- C. She should not take the Category X drug on days she has intercourse.
- D. She must follow up with an endocrinologist.
Correct answer: B
Rationale: When a drug is categorized as Category X, it signifies that there are significant risks of fetal abnormalities if taken during pregnancy. For this reason, women of child-bearing age/capacity should use reliable forms of birth control to prevent pregnancy while on the medication. This ensures that the client avoids the potential harm to the fetus. Option A is incorrect because pregnancy tests are not unreliable due to the drug, but rather the risk is related to potential harm to the fetus. Option C is incorrect as avoiding the drug only on days of intercourse does not provide sufficient protection against pregnancy. Option D is incorrect as the need for an endocrinologist is not directly related to the use of Category X drugs.
4. What action should the emergency triage nurse take upon receiving the history that a client has a severe cough, fever, night sweats, and body wasting?
- A. Place the client in isolation until further assessment is completed.
- B. Seclude the client from other clients and visitors.
- C. Perform no intervention until test results confirm a diagnosis.
- D. Don personal protective equipment immediately.
Correct answer: B
Rationale: The correct action for the emergency triage nurse to take upon receiving the history that a client has a severe cough, fever, night sweats, and body wasting is to seclude the client from other clients and visitors. These symptoms are suggestive of tuberculosis, a highly infectious disease. By secluding the client, the nurse can prevent the potential spread of the infection to others. Donning personal protective equipment, including gown, gloves, and a mask, is crucial when providing care to the client, but the immediate priority is to prevent the spread of infection by isolating the client. Placing the client in isolation until further assessment is completed ensures that the client is kept away from others until a proper diagnosis and treatment plan can be established, reducing the risk of transmission. Performing no intervention until test results confirm a diagnosis is inappropriate as immediate isolation is necessary in suspected cases of highly infectious diseases like tuberculosis.
5. The advanced directive in a client's chart is dated August 12, 1998. The client's daughter produces a Power of Attorney for Health Care, dated 2003, which contains different care directions. What should the nurse do?
- A. Follow the 1998 version because it's part of the legal chart.
- B. Follow the 1998 version because the physician's code order is based on it.
- C. Follow the 2003 version, place it in the chart, and communicate the update appropriately.
- D. Follow neither until clarified by the unit manager.
Correct answer: C
Rationale: The document dated 2003 supersedes the previous version and should be used as a basis for care directions. The nurse should follow the 2003 version, place it in the chart, and communicate the update appropriately to ensure that the most current care directions are followed. Choices A and B are incorrect because the 1998 version is now outdated, and the nurse should not rely on it for care decisions. Choice D is incorrect because the nurse should not delay following the updated document, and seeking clarification from the unit manager can lead to avoidable delays in care.
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