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Nclex Exam Cram Practice Questions
1. A Hispanic client brings her father to the clinic because he is becoming more forgetful. He is diagnosed with Alzheimer’s disease. The woman tells the nurse that she wants to try ginkgo biloba for her father before using prescription medications. Which of the following is an appropriate response by the nurse?
- A. “It is wiser to start with a prescription.”
- B. “That herb may not be effective for your father.”
- C. “You can’t expect an herb to cure Alzheimer’s.”
- D. “I will let the physician know of your wishes.”
Correct answer: “I will let the physician know of your wishes.”
Rationale: The appropriate response is to acknowledge the client's wishes and communicate them to the physician for consideration. It is important to be culturally sensitive and respect the client's preferences. Ginkgo biloba has shown some benefits in treating dementia, so it is essential to involve the healthcare provider in the decision-making process. Choices A, B, and C are dismissive and fail to consider the client's perspective and cultural beliefs. It is crucial for healthcare professionals to engage in open communication and collaboration with clients to provide patient-centered care.
2. When helping a client gain insight into anxiety, the nurse should:
- A. help the client relate anxiety to specific triggers.
- B. ask the client to describe events that precede increased anxiety.
- C. encourage the client to practice relaxation techniques.
- D. address the client's resistive behavior.
Correct answer: ask the client to describe events that precede increased anxiety.
Rationale: When assisting a client in gaining insight into anxiety, it is crucial to explore the events that lead to increased anxiety. By asking the client to describe these events, the nurse can help the client recognize patterns and triggers, leading to a better understanding of their anxiety. Option A is incorrect because it refers to triggers rather than exploring the events leading to anxiety. Option C is incorrect as it focuses on relaxation techniques rather than delving into the root causes of anxiety. Option D is inappropriate as addressing resistive behavior may not foster a supportive therapeutic environment for the client.
3. The client is being discharged with a prescription for an inhaled glucocorticoid for asthma. Which of the following statements indicates additional education is needed prior to discharge?
- A. “I will hold my breath for 10 seconds after each puff.”
- B. “I will wait five minutes after taking this medication and then gargle water.”
- C. “I will wait at least one minute between each puff.”
- D. “I will take this medication daily even if I am not having symptoms.”
Correct answer: “I will wait five minutes after taking this medication and then gargle water.”
Rationale: The correct answer is, 'I will wait five minutes after taking this medication and then gargle water.' After using an inhaled glucocorticoid, it is essential to wait for 5 minutes and then gargle water to remove any residue from the mouth, which can reduce the risk of developing thrush, a fungal infection. Choice A is correct as holding the breath for 10 seconds after each puff helps the medication reach deep into the lungs. Choice C is also correct as waiting at least one minute between puffs ensures proper delivery of the medication. Choice D is incorrect because it is important to take the medication daily as prescribed to control asthma symptoms, even if the person is not experiencing any at that moment.
4. A child with newly diagnosed leukemia is receiving chemotherapy. Which would be included in his plan of care by the nurse?
- A. Place the child in a negative pressure isolation room
- B. Administer prophylactic IV antibiotics
- C. Avoid high protein food intake
- D. Teach family and visitors handwashing techniques
Correct answer: D
Rationale: The correct answer is to teach family and visitors handwashing techniques. Any client on chemotherapy should have good infection control measures in place, such as handwashing by all who they encounter. Placing the child in a negative pressure isolation room (Choice A) is not necessary unless specifically indicated for a certain condition. Administering prophylactic IV antibiotics (Choice B) may not be part of the standard care plan for a child with leukemia receiving chemotherapy. Avoiding high protein food intake (Choice C) is not directly related to infection control and may not be necessary unless there are specific dietary restrictions.
5. When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?
- A. family history of stroke
- B. ovaries removed before age 45
- C. frequent hot flashes and/or night sweats
- D. unexplained vaginal bleeding
Correct answer: unexplained vaginal bleeding
Rationale: When obtaining a health history on a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication for hormone replacement therapy. This is because it can be a sign of underlying issues that need to be addressed before starting hormone therapy. A family history of stroke is not a contraindication for hormone replacement therapy unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 is not a contraindication for hormone replacement therapy. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy; therefore, they are not contraindications.
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