NCLEX-PN
2024 Nclex Questions
1. The client is taking prednisone 7.5mg po each morning to treat his systemic lupus erythematosus. Which statement best explains the reason for taking the prednisone in the morning?
- A. There is less chance of forgetting the medication if taken in the morning.
- B. There will be less fluid retention if taken in the morning.
- C. Prednisone is absorbed best with the breakfast meal.
- D. Morning administration mimics the body's natural secretion of corticosteroid.
Correct answer: D
Rationale: Taking corticosteroids in the morning mimics the body's natural release of cortisol, which follows a diurnal pattern with higher levels in the morning. This timing helps regulate the body's inflammatory response and minimizes potential side effects. Answer A is not the primary reason for morning dosing, as adherence concerns can be addressed through other means. Answer B is incorrect since fluid retention is not influenced by the timing of prednisone administration. Answer C is also incorrect as prednisone absorption is not significantly affected by whether it is taken with breakfast or not.
2. Several clients are admitted to the emergency room following a three-car vehicle accident. Which clients can be assigned to share a room in the emergency department during the disaster?
- A. The schizophrenic client experiencing visual and auditory hallucinations and the client with ulcerative colitis
- B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm
- C. A child with fixed and dilated pupils and his parents, and the client with a frontal head injury
- D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain
Correct answer: B
Rationale: The correct answer is to assign the client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm to share a room. The pregnant client needs close monitoring due to the abdominal pain, and the client with facial lacerations and a broken arm requires immediate attention for wound care and possible fracture management. Choice A should not be assigned together as the schizophrenic client experiencing visual and auditory hallucinations needs a separate room for privacy and safety, and the client with ulcerative colitis may require isolation due to the risk of infection. Choice C is incorrect because the child with fixed and dilated pupils is likely in a critical condition and should be in a private room with parents, while the client with a frontal head injury needs a separate room for focused care. Choice D is also incorrect as the client with a large puncture wound to the abdomen needs immediate attention in a separate room, and the client with chest pain requires evaluation and monitoring in a separate setting as well.
3. When medications have an additive, synergistic, or antagonistic effect on a tissue, a ________ reaction has occurred.
- A. pharmaceutical
- B. pharmacodynamic
- C. pharmacokinetic
- D. drug incompatibility
Correct answer: B
Rationale: The correct answer is 'pharmacodynamic.' Pharmacodynamics pertain to the effect of a drug on receptors, explaining how drugs affect tissues. Pharmaceutical reactions refer to chemical reactions between drugs before administration or absorption, not their effect on tissues. Pharmacokinetic reactions involve how the body affects the drug, not the tissue. Drug incompatibilities are essentially pharmaceutical reactions, not the specific effects on tissues seen in pharmacodynamic reactions.
4. A nurse provides information about feeding to the mother of a 6-month-old infant. Which statement by the mother indicates an understanding of the information?
- A. Meats are really important for iron, and I should start feeding meats to my infant right away.
- B. Egg white should not be given to my infant because of the risk for an allergy.
- C. I can mix the food in my infant's bottle if he won't eat it.
- D. Fluoride supplementation is not necessary until permanent teeth come in.
Correct answer: B
Rationale: The correct answer is B: 'Egg white should not be given to my infant because of the risk for an allergy.' Egg white, even in small quantities, is not recommended for infants until the end of the first year of life due to its common allergenic potential. Choice A is incorrect because while meats are important for iron, they are not typically introduced to infants until around 6-8 months. Choice C is incorrect because food should never be mixed with formula in the bottle as it may lead to feeding difficulties and inaccurate monitoring of intake. Choice D is incorrect because fluoride supplementation may be required around 6 months depending on the infant's fluoride intake from water. Introducing solid foods like rice cereal, fruits, or vegetables is usually done around 5-6 months, following healthcare provider recommendations.
5. When assessing a client for risk of hyperphosphatemia, which piece of information is most important for the nurse to obtain?
- A. A history of radiation treatment in the neck region
- B. A history of recent orthopedic surgery
- C. A history of minimal physical activity
- D. A history of the client's food intake
Correct answer: A
Rationale: The correct answer is a history of radiation treatment in the neck region. Previous radiation to the neck may have damaged the parathyroid glands, which are crucial for calcium and phosphorus regulation. This damage can lead to disruptions in phosphorus levels, increasing the risk of hyperphosphatemia. Choices B, C, and D are not as directly related to phosphorus regulation. Orthopedic surgery, minimal physical activity, and food intake are more closely associated with calcium levels rather than phosphorus regulation. Therefore, it is essential for the nurse to focus on obtaining information about a history of radiation treatment in the neck region when assessing the risk of hyperphosphatemia in a client.
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