NCLEX-PN
PN Nclex Questions 2024
1. A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:
- A. the client's body has developed tolerance, requiring more drug to produce the same effect.
- B. the client is preoccupied with getting the drug and is experiencing loss of control, indicating drug dependence.
- C. addiction is the term used to describe physical dependence with withdrawal symptoms and tolerance.
- D. the client has a dual diagnosis of substance abuse and chronic back pain
Correct answer: A
Rationale: Drug tolerance is characterized by the ability to ingest a larger dose without adverse effects and decreased sensitivity to the substance. In this scenario, the client needing an increased dose of hydrocodone to achieve the same pain relief indicates tolerance developing, not addiction. Choice B is incorrect as it describes drug dependence, where the individual is preoccupied with the drug and has a loss of control. Choice C is incorrect because addiction involves psychological behaviors related to substance use, not just physical dependence with withdrawal symptoms and tolerance. Choice D is incorrect as it refers to a dual diagnosis, which is the coexistence of substance abuse and psychiatric disorders, not the development of tolerance to a drug.
2. The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
- A. That can be assessed
- B. That is in situ
- C. With increasing lymph node involvement
- D. With distant metastasis
Correct answer: B
Rationale: The correct answer is B: 'That is in situ.' Cancer in situ means that the cancer is still localized to the primary site. Cancer is graded in terms of tumor, grade, node involvement, and metastasis. Answer A is incorrect because Tis indicates a tumor that is in situ and can be assessed. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrect because a tumor that is in situ is not metastasized.
3. How does the ANA define the psychiatric nursing role?
- A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art
- B. assisting the therapist to relieve the symptoms of clients
- C. to solve clients' problems and give them the answers
- D. having a client committed to long-term therapy with the nurse
Correct answer: A
Rationale: The correct answer aligns with the ANA's definition of the psychiatric nursing role. According to the ANA, psychiatric nursing is a specialized area of nursing practice that incorporates theories of human behavior as its foundational science and utilizes the self as its essential art. This definition emphasizes the importance of understanding human behavior and leveraging therapeutic communication and relationships to provide effective care for individuals with mental health concerns. Choices B, C, and D are incorrect because they do not accurately represent the ANA-defined role of psychiatric nursing. Psychiatric nurses primarily focus on delivering holistic care, promoting mental health, and supporting individuals with mental health challenges using evidence-based practices and therapeutic interventions.
4. 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: The correct answer is that the client should take three pills per day next week, then two pills for one week, and then one pill for one week. This statement indicates a gradual tapering schedule, which is crucial when discontinuing alprazolam (Xanax) to prevent withdrawal symptoms. Choice A is incorrect because alcohol should be avoided while tapering off benzodiazepines due to the increased risk of respiratory depression. Choice B is incorrect because abruptly stopping alprazolam can lead to withdrawal symptoms. Choice D is incorrect because while drowsiness can be a side effect of alprazolam, it is not the primary concern when discontinuing the medication; preventing withdrawal symptoms is the priority.
5. Lidocaine is a medication frequently ordered for the client experiencing
- A. Atrial tachycardia
- B. Ventricular tachycardia
- C. Heart block
- D. Ventricular bradycardia
Correct answer: B
Rationale: Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electrical stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because lidocaine does not slow the heart rate, so it is not used for heart block or bradycardia.
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