NCLEX-PN
NCLEX PN Exam Cram
1. Which of the following is not typically considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct answer: D
Rationale: Continuous Insulin is not typically considered one of the main mechanisms for treating Type II Diabetes. While medications, nutrition, and increased activity play crucial roles in managing Type II Diabetes, continuous insulin therapy is more common in Type I Diabetes or in specific cases of Type II Diabetes where other treatments are ineffective. Therefore, the correct answer is Continuous Insulin. Choices A, B, and C are mainstays in the treatment of Type II Diabetes, making them incorrect answers.
2. A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:
- A. a maintenance dose.
- B. a loading dose.
- C. a medication with no first-pass effect.
- D. the medication to be given intravenously.
Correct answer: B
Rationale: To rapidly achieve a therapeutic plasma drug concentration, a loading or priming dose is ordered. This dose quickly establishes the desired drug level. It is calculated by multiplying the volume of distribution by the desired plasma drug concentration. A maintenance dose, like choice A, is used to maintain the therapeutic level after the loading dose. Waiting for steady state without a loading dose would take five drug half-lives. Choice C, a medication with no first-pass effect, does not directly address the need for rapid attainment of therapeutic levels. While intravenous administration (choice D) offers excellent bioavailability, a single dose by this route may not achieve the desired therapeutic plasma concentration as rapidly as a loading dose.
3. 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: A
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.
4. Which reported symptom would indicate a client with Addison's disease has received too much fludrocortisone (Florinef) replacement?
- A. Oily skin and hair
- B. Weight gain of 6 pounds in one week
- C. Loss of muscle mass in arms and legs
- D. Increased blood glucose level
Correct answer: B
Rationale: Fludrocortisone (Florinef) replacement in Addison's disease involves mimicking aldosterone to retain sodium and water. This retention can lead to weight gain due to increased fluid retention. Rapid weight gain, such as 6 pounds in one week, is a concerning sign of excessive fluid retention, indicating a potential overdose of fludrocortisone. Choices A, C, and D are incorrect because oily skin and hair, loss of muscle mass, and increased blood glucose levels are not specific symptoms of excessive fludrocortisone replacement in Addison's disease.
5. The death of a beloved spouse places the surviving partner in which type of crisis?
- A. maturational
- B. reactive
- C. nonreactive
- D. situational
Correct answer: D
Rationale: The correct answer is 'situational.' A situational crisis is an unexpected, unplanned event, such as the death of a spouse, which can lead to significant distress. Option A is incorrect because a maturational crisis is related to normal life transitions like getting married or retiring. Choices B and C are incorrect as they do not represent recognized crisis states in the context of the scenario provided.
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