NCLEX Review 2. 70 Questions and Answers: The best for quick revision.

NCLEX Review 2. 70 Questions and Answers: The best for quick revision. Courtesy: Rasmussen College - NUR 2407.

NCLEX Review 2

1.      Which statement is correct about a 25-year-old client with newly diagnosed schizophrenia?

a.       Age of onset is typical for schizophrenia.

b.      Age of onset is later than usual for schizophrenia.

c.       Age of onset is earlier than usual for schizophrenia.

d.      Age of onset follows no predictable pattern in schizophrenia.

2.      Which factor is associated with increased risk for schizophrenia?

a.       Alcoholism

b.      Adolescent pregnancy

c.       Overcrowded schools

d.      Poverty

3.      Nurse Arya assesses for evidence of positive symptoms of schizophrenia in a newly admitted client. Which of the following symptoms are considered positive evidence? Select all that apply.

a.       Anhedonia

b.      Delusions

c.       Flat affect

d.      Hallucinations

e.       Loose associations

f.       Social withdrawal

4.      A client with schizophrenia is referred for psychosocial rehabilitation. Which of the following are typical of this type of program? Select all that apply.

a.       Analyzing family issues and past problems

b.      Developing social skills and supports

c.       Learning how to live independently in a community

d.      Learning job skills for employment

e.       Treating family members affected by the illness

f.       Participating in in-depth psychoanalytical counseling

5.      Which is the best indicator of success in the long term management of the client?

a.       His symptoms are replaced by indifference to his feelings

b.      He participates in diversionary activities.

c.       He learns to verbalize his feelings and concerns

d.      He states that his behavior is irrational

6.      Situation: A young woman is brought to the emergency room appearing depressed. The nurse learned that her child died a year ago due to an accident. The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that supports this diagnosis is:

a.       “I feel envious of mothers who have toddlers”

b.      “I haven’t been able to open the door and go into my baby’s room “

c.       “I watch other toddlers and think about their play activities and I cry.”

d.      “I often find myself thinking of how I could have prevented the death.

7.      The client said “I can’t even take care of my baby. I’m good for nothing.” Which is the appropriate nursing diagnosis?

a.       Ineffective individual coping related to loss.

b.      Impaired verbal communication related to inadequate social skills.

c.       Low esteem related to failure in role performance

d.      Impaired social interaction related to repressed anger.

8.      The following medications will likely be prescribed for the client EXCEPT:

a.       Prozac

b.      Tofranil

c.       Parnate

d.      Zyprexa

9.      Which is the highest priority in the post-ECT care?

a.       Observe for confusion

b.      Monitor respiratory status

c.       Reorient to time, place and person

d.      Document the client’s response to the treatment

10.  Situation: A 27-year-old writer is admitted for the second time accompanied by his wife. He is demanding, arrogant, talked fast and hyperactive. Initially, the nurse should plan this for a manic client:

a.       Set realistic limits to the client’s behavior

b.      Repeat verbal instructions as often as needed

c.       Allow the client to get out feelings to relieve tension

d.      Assign a staff to be with the client at all times to help maintain control

11.  An activity appropriate for the client is:

a.       Table tennis

b.      Painting

c.       Chess

d.      Cleaning

12.  The client is arrogant and manipulative. In ensuring a therapeutic milieu, the nurse does one of the following:

a.       Agree on a consistent approach among the staff assigned to the client.

b.      Suggest that the client take a leading role in the social activities

c.       Provide the client with extra time for one on one sessions

d.      Allow the client to negotiate the plan of care

13.  The nurse exemplifies an awareness of the rights of a client whose anger is escalating by:

a.       Taking a directive role in verbalizing feelings

b.      Using an authoritarian, confrontational approach

c.       Putting the client in a seclusion room

d.      Applying mechanical restraints

14.  A client on Lithium has diarrhea and vomiting. What should the nurse do first:

a.       Recognize this as a drug interaction

b.      Give the client Cogentin

c.       Reassure the client that these are common side effects of lithium therapy

d.      Hold the next dose and obtain an order for a stat serum lithium level

15.  Situation: A widow age 28, whose husband died one (1) year ago due to AIDS, has just been told that she has AIDS. Panky says to the nurse, “Why me? How could God do this to me?” This reaction is one of:

a.       Depression

b.      Denial

c.       anger

d.      bargaining

16.  The nurse’s therapeutic response is:

a.       “I will refer you to a clergy who can help you understand what is happening to you.”

b.      “ It isn’t fair that an innocent like you will suffer from AIDS.”

c.       “That is a negative attitude.”

d.      ”It must really be frustrating for you. How can I best help you?”

17.  One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is:

a.       Focusing

b.      Validating

c.       Reflecting

d.      Giving broad opening

18.  The client says to the nurse “Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:

a.       Anxiety

b.      Suicidal ideation

c.       Major depression

d.      Hopelessness

19.  Which of the following interventions should be prioritized in the care of the suicidal client?

a.       Remove all potentially harmful items from the client’s room.

b.      Allow the client to express feelings of hopelessness.

c.       Note the client’s capabilities to increase self-esteem.

d.      Set a “no suicide” contract with the client.

20.  Situation: A 14-year-old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as a nurse. The client has which of the following developmental focus:

a.       Establishing a relationship with the opposite sex and career planning.

b.      Parental and societal responsibilities.

c.       Establishing one’s sense of competence in school.

d.      Developing initial commitments and collaboration in work

21.  The personality type of Ryan is:

a.       Conforming

b.      Dependent

c.       Perfectionist

d.      Masochistic

22.  The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?

a.       A therapy that rewards adaptive behavior

b.      A cognitive approach to change behavior

c.       A living, learning or working environment.

d.      A permissive and congenial environment

23.  Included as a priority of care for the client will be:

a.       Encourage verbalization of concerns instead of demonstrating them through the body

b.      Divert attention toward activities

c.       Place in semi-fowlers position and render O2 inhalation as ordered

d.      Help her recognize that her physical condition has an emotional component

24.  The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse?

a.       “You are much better than when you were admitted so there’s no reason to worry.”

b.      “What would you like to do now that you’re about to go home?”

c.       “You seem to have concerns about going home.”

d.      “Aren’t you glad that you’re going home soon?”

25.  Situation: The nurse may encounter clients with concerns on sexuality. The most basic factor in the intervention with clients in the area of sexuality is:

a.       Knowledge about sexuality.

b.      Experience in dealing with clients with sexual problems

c.       Comfort with one’s sexuality

d.      Ability to communicate effectively

26.  Which of the following statements is true for gender identity disorder?

a.       It is a sexual pleasure derived from inanimate objects.

b.      It is a pleasure derived from being humiliated and made to suffer

c.       It is a pleasure of shocking the victim with exposure of the genitalia

d.      It is the desire to live or involve in reactions of the opposite see

27.  The sexual response cycle in which the sexual interest continues to build:

a.       Sexual Desire

b.      Sexual arousal

c.       Orgasm

d.      Resolution

28.  The inability to maintain the physiologic requirements in sexual intercourse is:

a.       Sexual Desire Disorder

b.      Sexual Arousal Disorder

c.       Orgasm Disorder

d.      Sexual Pain Disorder

29.  The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies “If you want I can go naked for you.” The most therapeutic response by the nurse is:

a.       “You’re attractive, but I’m not interested.”

b.      “You wouldn’t be the first that I will see naked.”

c.       “I will report you to the guard if you don’t control yourself.”

d.      “I only need access to your arm. Putting up your sleeve is fine.”

30.   Situation: Knowledge and skills in the care of violent clients is vital in the psychiatric unit. A nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway and making aggressive remarks. Which of the following statements is most appropriate to make to this patient?

a.       What is causing you to become agitated?

b.      You need to stop that behavior now.

c.       You will need to be restrained if you do not change your behavior.

d.      You will need to be placed in seclusion

31.  The nurse closely observes the client who has been displaying aggressive behavior. The nurse observes that the client’s anger is escalating. Which approach is least helpful for the client at this time?

a.       Acknowledge the client’s behavior

b.      Maintain a safe distance from the client

c.       Assist the client to an area that is quiet

d.      Initiate confinement measures

32.  The charge nurse of a psychiatric unit is planning the client assignment for the day. The most appropriate staff to be assigned to a client with a potential for violence is which of the following:

a.       A timid nurse

b.      A mature, experienced nurse

c.       an inexperienced nurse

d.      a soft-spoken nurse

33.  The nurse exemplifies an awareness of the rights of a client whose anger is escalating by:

a.       Taking a directive role in verbalizing feelings

b.      Using an authoritarian, confrontational approach

c.       Putting the client in a seclusion room

d.      Applying mechanical restraints

34.  The client jumps up and throws a chair out of the window. He was restrained after his behavior can no longer be controlled by the staff. Which of these documentations indicates the safeguarding of the patient’s rights?

a.       There was a doctor’s order for restraints/seclusion

b.      The patient’s rights were explained to him.

c.       The staff observed confidentiality

d.      The staff carried out less restrictive measures but were unsuccessful.

35.        Situation: Clients with personality disorders have difficulties in their social and occupational functions. Clients with a personality disorder will most likely:

a.       Recover with therapeutic intervention

b.      Respond to antianxiety medication

c.       Manifest enduring patterns of inflexible behaviors

d.      Seek treatment willingly from some personally distressing symptom

36.     A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have?

a.       Narcissistic

b.      Paranoid

c.       Histrionic

d.      Antisocial

37.  The client joins a support group and frequently preaches against abuse, is demonstrating the use of:

a.       Denial

b.      Reaction formation

c.       Rationalization

d.      Projection

38.  A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis?

a.       Lack of self-esteem, strong dependency needs, and impulsive behavior

b.      Social withdrawal, inadequacy, sensitivity to rejection and criticism

c.       Suspicious, hypervigilance and coldness

d.      Preoccupation with perfectionism, orderliness, and need for control

39.  The plan of care for clients with borderline personality should include:

a.       Limit setting and flexibility in schedule

b.      Giving medications to prevent acting out

c.       Restricting her from other clients

d.      Ensuring she adheres to certain restrictions

40.  Situation: A 42-year-old male client, is admitted to the ward because of bizarre behaviors. He was given a diagnosis of schizophrenia paranoid type. The client should have achieved the developmental task of:

a.       Trust vs. mistrust

b.      Industry vs. Inferiority

c.       Generativity vs. stagnation

d.      Ego integrity vs. despair

41.  Clients who are suspicious primarily use projection for which purpose:

a.       Deny reality

b.      To deal with feelings and thoughts that are not acceptable

c.       To show resentment towards others

d.      Manipulate others

42.  The client says “ the FBI is out to get me.” The nurse’s best response is:

a.       “The FBI is not out to catch you.”

b.      “I don’t believe that.”

c.       “I don’t know anything about that. You are afraid of being harmed.”

d.      “ What made you think of that

43.  The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:

a.       Tardive dyskinesia

b.      Pseudoparkinsonism

c.       Akinesia

d.      Dystonia

44.  The client is very hostile toward one of the staff for no apparent reason. The client is manifesting:

a.       Splitting

b.      Transference

c.       Countertransference

d.      Resistance

45.  Situation: An 18-year-old female is sexually attacked while on her way home from work. She was brought to the hospital by her mother. Rape is an example of which type of crisis:

a.       Situational

b.      Adventitious

c.       Developmental

d.      Internal

46.  During the initial care of rape victims, the following are to be considered EXCEPT:

a.       Assure privacy.

b.      Touch the client to show acceptance and empathy

c.       Accompany the client to the examination room.

d.      Maintain a non-judgmental approach.

47.  The nurse acts as a patient advocate when she does one of the following:

a.       She encourages the client to express her feeling regarding her experience.

b.      She assesses the client for injuries.

c.       She postpones the physical assessment until the client is calm

d.      Explains to the client that her reactions are normal

48.  Crisis intervention carried out to the client has this primary goal:

a.       Assist the client to express her feelings

b.      Help her identify her resources

c.       Support her adaptive coping skills

d.      Help her return to her pre-rape level of function

49.  Five months after the incident the client complains of difficulty to concentrate, poor appetite, inability to sleep and guilt. She is likely suffering from:

a.       Adjustment disorder

b.      Somatoform Disorder

c.       Generalized Anxiety Disorder

d.      Post traumatic disorder

50.  Situation: A 29-year-old client newly diagnosed with breast cancer is pacing, with rapid speech headache and inability to focus on what the doctor was saying. The nurse assesses the level of anxiety as:

a.       Mild

b.      Moderate

c.       Severe

d.      Panic

51.  Anxiety is caused by:

a.       An objective threat

b.      A subjectively perceived threat

c.       Hostility turned to the self

d.      Masked depression

52.  It would be most helpful for the nurse to deal with a client with severe anxiety by:

a.       Give specific instructions using speak in concise statements.

b.      Ask the client to identify the cause of her anxiety.

c.       Explain in detail the plan of care developed

d.      Urge the client to focus on what the nurse is saying

53.  Which of the following medications will likely be ordered for the client?”

a.       Prozac

b.      Valium

c.       Risperdal

d.      Lithium

54.  Which of the following is included in the health teachings among clients receiving Valium?:

a.       Avoid foods rich in tyramine.

b.      Take the medication after meals.

c.       It is safe to stop it anytime after long term use.

d.      Double up the dose if the client forgets her medication.

55.  Low plasma PaCO2

a.       Metabolic Acidosis

b.      Respiratory Alkalosis

c.       Metabolic Alkalosis

d.      Respiratory Acidosis

56.  High plasma PaCO2

a.       Metabolic Acidosis

b.      Respiratory Alkalosis

c.       Metabolic Alkalosis

d.      Respiratory Acidosis

57.  Decreased plasma bicarbonate (HCO3-)

a.       Metabolic Acidosis

b.      Respiratory Alkalosis

c.       Metabolic Alkalosis

d.      Respiratory Acidosis

58.  Increased plasma bicarbonate (HCO3-)

a.       Metabolic Acidosis

b.      Respiratory Alkalosis

c.       Metabolic Alkalosis

d.      Respiratory Acidosis

59.  What two organs in the body serve as a compensatory function to maintain acid base balance?

a.       Kidneys and Lungs

b.      Lungs and Spleen

c.       Heart and Liver

d.      Gallbladder and Appendix

60.  Arterial blood gas (ABG) measurement will give the information needed to determine if the primary disturbance of acid-base balance is respiratory or metabolic in nature.

a.       True

b.      False

c.       Both Carbonic Acid Excess and Deficit Only

d.      Both Bicarbonate Excess and Deficit Only

61.  The major effect of acidosis is overexcitement of the central nervous system.

a.       True

b.      False

c.       Maybe

d.      Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

62.  Alkalosis is characterized by overexcitement of the nervous system.

a.       True

b.      False

c.       The major effect of Alkalosis is a depression of the central nervous system.

d.      Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

63.  The human body functions optimally in a state of homeostasis.

a.       True

b.      False

c.       Maybe

d.      Homeostasis has nothing to do with metabolic balance.

64.  Acids have no hydrogen ions and are able to bind in a solution.

a.       True

b.      False

c.       Acid is a substance that is not capable of donating hydrogen ions.

d.      Acids and bases have nothing to do with hydrogen ions.

65.  pH 7.57, PaCO2 22, HCO3- 17

a.       Respiratory Acidosis, Partially Compensated

b.      Respiratory Alkalosis, Uncompensated

c.       Metabolic Acidosis, Partially Compensated

d.      Respiratory Alkalosis, Partially Compensated

66.  pH 7.39, PaCO2 44, HCO3- 26

a.       Respiratory Acidosis

b.      Metabolic Acidosis

c.       Respiratory Alkalosis

d.      Normal

67.  pH 7.55, PaCO2 25, HCO3- 22

a.       Respiratory Acidosis, Partially Compensated

b.      Respiratory Alkalosis, Uncompensated

c.       Metabolic Alkalosis, Partially Compensated

d.      Metabolic Acidosis, Uncompensated

68.  pH 7.17, PaCO2 48, HCO3- 36

a.       Respiratory Acidosis, Uncompensated

b.      Metabolic Acidosis, Partially Compensated

c.       Respiratory Alkalosis, Partially Compensated

d.      Respiratory Acidosis, Partially Compensated

69.   pH 7.34, PaCO2 24, HCO3- 20

a.       Respiratory Acidosis, Partially Compensated

b.      Metabolic Acidosis, Partially Compensated

c.       Metabolic Acidosis, Uncompensated

d.      Metabolic Alkalosis, Partially Compensated

70.  pH 7.64, PaCO2 25, HCO3- 19

a.       Respiratory Acidosis, Uncompensated

b.      Respiratory Alkalosis, Partially Compensated

c.       Respiratory Alkalosis, Uncompensated

d.      Metabolic Alkalosis, Partially Compensated

References:

Vera, M. (June 29, 2014). Personality Disorders Practice Quiz. Retrieved from https://nurseslabs.com/nclex-exam-psychiatric-nursing-personality-disorders-2-50-items/

Wayne, G. (January 5, 2015). ABG Analysis NCLEX Exam #3. Retrieved from https://nurseslabs.com/abg-analysis-nclex-exam-3-20-items/