NCLEX NCLEX-RN
NCLEX RN Exam Prep
1. Which of the following is NOT an acceptable abbreviation?
- A. D/C
- B. tid
- C. bid
- D. qid
Correct answer: A: D/C
Rationale: The correct answer is A: D/C. D/C is not an acceptable abbreviation as it can be easily confused with both 'discharge' and 'discontinue.' The abbreviations 'tid' (three times a day), 'bid' (twice a day), and 'qid' (four times a day) are commonly used in medical contexts to indicate dosing frequencies and are widely accepted in healthcare settings.
2. The nurse prepares a patient with a left-sided pleural effusion for a thoracentesis. How should the nurse position the patient?
- A. Supine with the head of the bed elevated 30 degrees
- B. In a high-Fowler's position with the left arm extended
- C. On the right side with the left arm extended above the head
- D. Sitting upright with the arms supported on an overbed table
Correct answer: D: Sitting upright with the arms supported on an overbed table
Rationale: The correct position for a patient with a left-sided pleural effusion undergoing thoracentesis is sitting upright with the arms supported on an overbed table. This position helps increase lung expansion, allows fluid to collect at the lung bases, and expands the intercostal space making access to the pleural space easier. Placing the patient supine, in a high-Fowler's position, or on the right side with the left arm extended above the head could increase the work of breathing for the patient and complicate the thoracentesis procedure for the healthcare provider.
3. During the first meeting of a therapy group, members exhibit frequent periods of silence, tense laughter, and nervous movements. Which conclusion would the nurse make?
- A. The group requires an active leader who will intervene to relieve signs of obvious stress.
- B. The group process is unhealthy and there is unwillingness to openly relate.
- C. The members are displaying expected behaviors because relationships are not yet established.
- D. The behaviors should be immediately addressed so members will not become too uncomfortable.
Correct answer: The members are displaying expected behaviors because relationships are not yet established.
Rationale: During the initial stages of a therapy group, it is common for members to exhibit behaviors such as silence, tense laughter, and nervous movements. These behaviors indicate anxiety and insecurity due to the lack of established relationships and trust among the group members. This is a normal part of group development, and it does not necessarily mean that the group process is unhealthy. Intervening or addressing these behaviors immediately is not required as they are expected in the early stages of group interaction. As the group progresses and relationships are built, these behaviors are likely to diminish naturally without the need for active leader intervention. Therefore, the correct conclusion is that the members are displaying expected behaviors because relationships are not yet established. Choices A, B, and D are incorrect because active leader intervention is not necessary, the group process is not unhealthy, and addressing the behaviors immediately is not required as they are part of the early group dynamics and are expected to subside as relationships develop.
4. A patient with severe mitral regurgitation and decreased cardiac output is being cared for by a nurse. The nurse assesses the patient for mental status changes. What is the rationale for this intervention?
- A. Decreased cardiac output can cause hypoxia to the brain
- B. Mental status changes may be a side effect of the patient's medication
- C. Mitral regurgitation is a complication associated with some neurological disorders
- D. The patient may be confused about his diagnosis
Correct answer: Decreased cardiac output can cause hypoxia to the brain
Rationale: When caring for a patient with severe mitral regurgitation and decreased cardiac output, assessing for mental status changes is crucial. Decreased cardiac output can lead to inadequate perfusion and oxygenation of vital organs, including the brain, resulting in hypoxia. This hypoxia can manifest as mental status changes such as confusion, restlessness, or lethargy. Therefore, monitoring mental status helps in identifying potential hypoxic states and guiding appropriate interventions. The other options are incorrect as they do not directly correlate decreased cardiac output with potential hypoxia-induced mental status changes.
5. What is the most common complication of chest wall injury?
- A. Hemothorax
- B. Atelectasis
- C. Pneumonia
- D. Pneumothorax
Correct answer: C: Pneumonia
Rationale: Pneumonia is the most common complication of chest wall injury. Chest wall trauma can lead to impaired lung function, making patients more susceptible to pneumonia due to reduced ability to clear secretions and impaired breathing. While hemothorax and pneumothorax are potential complications of chest wall injury, pneumonia is more commonly encountered. Atelectasis, although a common pulmonary complication, is not typically the most common complication seen in chest wall injuries.
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