NCLEX-PN
2024 Nclex Questions
1. A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child. The nurse should assess the client for further signs of:
- A. generalized anxiety disorder.
- B. schizophrenia.
- C. post-traumatic stress disorder.
- D. bipolar disorder.
Correct answer: C
Rationale: Given the history of childhood sexual abuse and the presenting symptoms of difficulty concentrating, insomnia, and nightmares, the nurse should assess the client for post-traumatic stress disorder (PTSD). Childhood sexual abuse is strongly associated with adult-onset depression and an increased risk for PTSD. Individuals with PTSD may exhibit re-experiencing symptoms such as flashbacks, nightmares, and heightened reactions to trauma triggers. They may also display emotional numbing, avoidance behaviors, and increased arousal symptoms like difficulty sleeping and hypervigilance. Generalized anxiety disorder (Choice A) is characterized by excessive worry and anxiety about various events or activities, not necessarily tied to a specific trauma. Schizophrenia (Choice B) is a severe mental disorder characterized by distortions in thinking, perception, emotions, and behavior, unrelated to the traumatic event described. Bipolar disorder (Choice D) involves mood swings between depressive and manic episodes, and its symptoms differ from those typically seen in PTSD.
2. What type of relief behavior is Ashley using to cope with emotional conflict?
- A. acting out
- B. somatizing
- C. withdrawal
- D. problem-solving
Correct answer: B
Rationale: Ashley is somatizing by experiencing emotional conflict as physical symptoms associated with severe anxiety. Somatizing involves converting emotions into physical symptoms. Acting out involves behaviors like anger, crying, and verbal abuse, not physical symptoms. Withdrawal is when one withdraws psychic energy in response to anxiety, not converting emotions into physical symptoms. Problem-solving occurs when anxiety is identified and the underlying need is addressed, not converting emotions into physical symptoms.
3. A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Ensure adequate fluid intake 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Administer medication that affects the central nervous system as prescribed
- D. Position the client appropriately for the procedure
Correct answer: B
Rationale: The correct answer is to ask the client to void immediately before the study. For an intravenous pyelogram, the client may have orders for laxatives or enemas, so ensuring the client voids before the test is important to prevent obscuring visualization of the kidney, ureters, and bladder. Choice A is incorrect because there is no need to force fluids before the procedure. Choice C is incorrect as medications affecting the central nervous system should not be held unless specified by the healthcare provider. Choice D is incorrect as covering the reproductive organs with an x-ray shield is not necessary for an intravenous pyelogram.
4. Activities of effective supervisors can be task-related or people-related activities. An example of a task-related supervisory activity is:
- A. coaching.
- B. evaluating.
- C. delegating.
- D. facilitating.
Correct answer: C
Rationale: Delegating is the act of assigning work to those capable and competent to do the work, making it a task-related supervisory activity. Coaching, evaluating, and facilitating are people-related supervisory activities. Coaching involves guiding and developing individuals, evaluating entails assessing performance, and facilitating focuses on enabling tasks and processes. These activities are more centered on interacting with and supporting people rather than directly assigning tasks. Therefore, in the context of task-related activities, delegating stands out as the correct choice.
5. Why is the intravenous route potentially the most dangerous route of drug administration?
- A. IV infiltration may occur.
- B. it allows for rapid administration of a drug.
- C. rapid administration of a drug can lead to toxicity
- D. it is the most commonly used route in hospitals.
Correct answer: C
Rationale: The correct answer is C: rapid administration of a drug can lead to toxicity. When a drug is administered intravenously, it has 100% bioavailability, entering the bloodstream immediately and increasing the risk of toxicity if not carefully monitored. While IV infiltration (choice A) can cause tissue damage, it is not typically life-threatening. Choice B is incorrect as the speed of administration is not the primary reason for the danger; it is the immediate and full dose reaching the bloodstream. Choice D is incorrect as the popularity of the route does not inherently make it more dangerous.
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