a patient is being admitted to the icu with a severe case of encephalitis which of these drugs would the nurse not expect to be prescribed for this co
Logo

Nursing Elites

NCLEX-RN

NCLEX RN Exam Review Answers

1. A patient is being admitted to the ICU with a severe case of encephalitis. Which of these drugs would the nurse not expect to be prescribed for this condition?

Correct answer: C

Rationale: In the treatment of encephalitis, medications like Acyclovir and Phenytoin are commonly prescribed. Acyclovir is an antiviral medication used to treat viral infections like herpes simplex virus, which can cause encephalitis. Phenytoin is an antiepileptic drug that may be used to manage seizures associated with encephalitis. Mannitol is a diuretic used to reduce intracranial pressure (ICP) by decreasing cerebral edema. Lactated Ringer's solution, on the other hand, is primarily used in fluid replacement therapy and may not be indicated if a patient is at risk for high ICP, as excessive fluid administration could worsen cerebral edema and increase ICP.

2. Which client is at highest risk for developing a pressure ulcer?

Correct answer: C

Rationale: Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.

3. A patient is on bedrest 24 hours after a hip fracture. Which regular assessment or intervention is essential for detecting or preventing the complication of Fat Embolism Syndrome?

Correct answer: B

Rationale: In detecting or preventing Fat Embolism Syndrome (FES), assessing the patient's mental status for drowsiness or sleepiness is crucial. Decreased level of consciousness is an early sign of FES due to decreased oxygen levels. Performing passive, light range-of-motion exercises on the hip may not directly relate to FES. Assessing pedal pulse and capillary refill in the toes is essential for assessing circulation but not specific to detecting FES. Administering a stool softener, while important for preventing constipation in immobilized patients, is not directly related to detecting or preventing FES.

4. A couple asks the nurse about risks of several birth control methods. What is the most appropriate response by the nurse?

Correct answer: B

Rationale: The correct answer is that oral contraceptives should not be used by smokers. The use of oral contraceptives in a woman who smokes increases the risk of cardiovascular problems, such as thromboembolic disorders. This is due to the combined effect of smoking and hormonal contraceptives. Choices A, C, and D are incorrect because they do not address the specific risk associated with smoking and oral contraceptives. Norplant's safety and ease of removal, Depo-Provera's convenience with few side effects, and the IUD's protection against pregnancy and infection are important points but not directly related to the increased risks for smokers using oral contraceptives.

5. Which of the following interventions should the nurse use when working with a Jackson-Pratt drain?

Correct answer: C

Rationale: A Jackson-Pratt drain is a type of active wound drain that may be placed following a surgical procedure. This drain actively draws excess blood and fluid out of the wound. If clots develop within the tubing, the nurse should strip the tubing by milking it in a direction away from the client. This action helps to ensure the drain remains patent and effective. Option A is incorrect because the tubing should be milked away from the client, not towards. Option B is incorrect as the drain should be emptied based on the healthcare provider's orders, not at a fixed volume. Option D is incorrect because the level of the drain should be below the level of the incision to allow drainage by gravity.

Similar Questions

A man has been taking lisinopril for CHF. The patient is seen in the emergency room for persistent diarrhea. The nurse is concerned about which side effect of lisinopril?
The nurse admits a patient who has a diagnosis of an acute asthma attack. Which statement indicates that the patient may need teaching regarding medication use?
A patient is found unconscious in their room with rhythmic jerking of all four extremities and heavy foaming at the mouth. The patient was on seizure precautions with bedrails up and padded. What is the priority action for the nurse to take?
A mother has recently been informed that her child has Down syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down syndrome?
The nurse is taking the health history of a patient being treated for Emphysema and Chronic Bronchitis. After being told the patient has been smoking cigarettes for 30 years, the nurse expects to note which assessment finding?

Access More Features

NCLEX RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • Comprehensive NCLEX coverage
  • 30 days access

NCLEX RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • Comprehensive NCLEX coverage
  • 30 days access

Other Courses