NCLEX NCLEX-PN
Best NCLEX Next Gen Prep
1. The patient is inquiring about the use of a PCA pump for pain management. Which statement by the patient indicates a need for additional education?
- A. “I will continue to report my pain score during assessments.”
- B. “I understand that there is a maximum dose per hour that I can receive regardless of how many times I press the button.”
- C. “I believe this new PCA pump will finally alleviate my back pain.”
- D. “I have more control over when and how much medication I receive.”
Correct answer: “I believe this new PCA pump will finally alleviate my back pain.”
Rationale: The correct answer is, “I believe this new PCA pump will finally alleviate my back pain.” This statement indicates a need for additional education as it reflects an unrealistic expectation regarding pain management. It is essential for the patient to understand that while a PCA pump can provide effective pain relief, it may not completely eliminate pain. Option A is correct as it demonstrates the patient's understanding of the importance of reporting pain scores for proper pain management. Option B is correct as it shows the patient's awareness of the maximum dose limits to prevent overdose. Option D is correct as it highlights the patient's understanding of the control they have over their medication administration.
2. When treating anemia in clients with renal failure, erythropoietin should be given in conjunction with:
- A. iron, folic acid, and B12.
- B. an increase in protein in the diet.
- C. vitamins A and C.
- D. an increase in calcium in the diet.
Correct answer: iron, folic acid, and B12.
Rationale: Erythropoietin is used to stimulate red blood cell production in clients with renal failure. To effectively increase red blood cell production, adequate levels of iron, folic acid, and B12 are necessary. These nutrients play crucial roles in erythropoiesis. Choices B, an increase in protein in the diet, is not directly related to enhanced erythropoiesis and can potentially worsen uremia. Choices C and D, vitamins A and C, and an increase in calcium in the diet, are not directly involved in red blood cell production and are not essential in this context.
3. When teaching a patient with COPD pulmonary exercises, what should be done?
- A. Teach pursed-lip breathing techniques.
- B. Encourage repetitive heavy lifting exercises to increase strength.
- C. Limit exercises due to respiratory acidosis.
- D. Take breaks every 10-20 minutes during exercises.
Correct answer: Teach pursed-lip breathing techniques.
Rationale: The correct answer is to teach pursed-lip breathing techniques. Pursed-lip breathing helps to decrease the volume of air expelled by keeping the airways open longer, making it easier for patients with COPD to breathe out. Encouraging heavy lifting exercises (Choice B) is not suitable for patients with COPD as it can lead to increased shortness of breath. Limiting exercises due to respiratory acidosis (Choice C) is not correct; instead, exercises should be tailored to the patient's tolerance. Taking breaks every 10-20 minutes (Choice D) is not specific to the management of COPD pulmonary exercises.
4. Which of these statements from the caregiver of a palliative care client indicates a proper understanding?
- A. This treatment plan usually indicates a prognosis of less than 6 months.
- B. We will need to stay in the hospital to receive this level of care.
- C. The main therapeutic goals are comfort and better quality of life.
- D. The medications to treat the underlying disease will be continued.
Correct answer: The main therapeutic goals are comfort and better quality of life.
Rationale: The correct answer is 'The main therapeutic goals are comfort and better quality of life.' This statement reflects a proper understanding of palliative care, which focuses on improving the patient's quality of life and providing comfort. It does not necessarily mean a prognosis of less than 6 months or require hospitalization. Choice A is incorrect because palliative care can be provided regardless of the prognosis. Choice B is wrong as palliative care can be administered in various settings, not just hospitals. Choice D is inaccurate as palliative care aims to improve symptoms and quality of life, so medications may be adjusted but not necessarily stopped.
5. A pregnant Asian client who is experiencing morning sickness wants to take ginger to relieve the nausea. Which of the following responses by the nurse is appropriate?
- A. “I will call your physician to see if we can start some ginger.”
- B. “We don’t use home remedies in this clinic.”
- C. “Herbs are not as effective as regular medicines.”
- D. “Just eat some dry crackers instead.”
Correct answer: “I will call your physician to see if we can start some ginger.”
Rationale: The correct response is appropriate as it demonstrates cultural sensitivity. Ginger is commonly used to alleviate nausea, particularly in Asian cultures. Contacting the physician to discuss the use of ginger ensures the client's safety and respects their preferences. Choices B and C are incorrect as they disregard the client's request and fail to acknowledge their cultural beliefs. Choice D is incorrect because it does not address the client's desire to use ginger for relief.
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