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NCLEX RN Practice Questions Exam Cram
1. A patient has been taking mood stabilizing medication but is afraid of needles. They ask the nurse what medication would NOT require regular lab testing. What is the nurse's best response?
- A. Valproic Acid (Depakote)
- B. Clozapine (Clozaril)
- C. Lithium
- D. Risperidone (Risperdal)
Correct answer: D: Risperidone (Risperdal)
Rationale: The correct answer is Risperidone (Risperdal) because it is the only medication among the options that does not require regular lab testing. Risperidone is not associated with the need for routine blood draws to monitor medication levels or potential side effects. Choices A, B, and C (Valproic Acid, Clozapine, Lithium) are all known to require frequent lab monitoring due to various reasons such as potential toxicity, therapeutic drug levels, or adverse effects on certain organ functions. Therefore, considering the patient's fear of needles and the desire to avoid frequent blood tests, Risperidone would be the most suitable option.
2. Which of these statements best describes the characteristics of an effective reward feedback system?
- A. Specific feedback is given as close to the event as possible
- B. Staff is given feedback in equal amounts over time
- C. Positive statements precede negative statements
- D. Performance goals should be higher than what is attainable
Correct answer: Specific feedback is given as close to the event as possible
Rationale: The correct answer is that specific feedback should be given as close to the event as possible in an effective reward feedback system. This is important because feedback is most useful when provided immediately. Giving feedback promptly reinforces positive behavior and helps in modifying problem behaviors. Providing feedback close to the event helps in ensuring that standards are clearly understood and can be met. Choices B, C, and D are incorrect because staff should not be given feedback in equal amounts over time, positive statements do not necessarily have to precede negative statements, and setting performance goals higher than what is attainable can lead to demotivation and decreased performance.
3. When providing culturally competent care, nurses must incorporate cultural assessments into their health assessments. Which statement is most appropriate to use when initiating an assessment of cultural beliefs with an older American Indian patient?
- A. “Are you of the Christian faith?”
- B. “Do you want to see a medicine man?”
- C. “How often do you seek help from medical providers?”
- D. “What cultural or spiritual beliefs are important to you?”
Correct answer: “What cultural or spiritual beliefs are important to you?”
Rationale: The nurse needs to assess the cultural beliefs and practices of the patient and should ask questions in a way that communicates acceptance of their beliefs and allows for open communication. Therefore, the most appropriate question to initiate an assessment of cultural beliefs with an older American Indian patient is “What cultural or spiritual beliefs are important to you?” This question shows respect for the patient's beliefs and encourages them to share relevant information. Asking if they are of the Christian faith does not promote open communication and may not reflect the patient's actual beliefs. While some American Indians may seek assistance from a medicine man or shaman, it is not appropriate to make assumptions without direct input from the patient. Asking how often they seek help from medical providers is not directly related to understanding their cultural beliefs and may not provide relevant insights for culturally competent care.
4. A patient is being discharged from the med-surgical unit. The patient has a history of gastritis. The nurse questions the patient on their usual routine at home. Which of these statements would alert the nurse that additional teaching is required?
- A. I avoid NSAIDs. I only take a daily aspirin for my heart health.
- B. I always avoid eating hot and spicy foods.
- C. I will continue taking my antacids with or immediately after meals.
- D. I will only drink coffee once a week, if even that often.
Correct answer: I avoid NSAIDs. I only take a daily aspirin for my heart health.
Rationale: The correct answer is, 'I avoid NSAIDs. I only take a daily aspirin for my heart health.' Aspirin is classified as an NSAID and can exacerbate existing stomach problems, such as gastritis. Therefore, patients with gastritis should avoid aspirin just like any other NSAID. Choice B, 'I always avoid eating hot and spicy foods,' is a good practice for a patient with gastritis. Choice C, 'I will continue taking my antacids with or immediately after meals,' indicates understanding of the correct timing for antacid use. Choice D, 'I will only drink coffee once a week, if even that often,' shows a suitable limitation of coffee intake, which is beneficial for patients with gastritis.
5. The client starting an exercise program will progress to walking a 20-minute mile in one month.
- A. Client will walk quickly three times a day
- B. Client will be able to walk a mile
- C. Client will have no alteration in breathing during the walk
- D. Client will progress to walking a 20-minute mile in one month
Correct answer: Client will progress to walking a 20-minute mile in one month
Rationale: Outcome statements must be written in behavioral terms and identify specific, measurable client behaviors. They are stated in terms of the client with an action verb that, under identified conditions, will achieve the desired behavior. Choice A lacks specificity and does not mention a target time or goal. Choice B is vague and does not provide a specific target for improvement. Choice C focuses on a negative outcome (no alteration) rather than a positive goal. The correct answer, Choice D, is specific, measurable, and time-bound, making it a suitable outcome statement for a client starting an exercise program.
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