Who wants to pass NCLEX?

And be a knowledgeable nurse

A nurse has received report on her assigned clients. Which of the following clients should the

nurse see first? The client with:

A: Alcohol withdrawal and a BP of 112/78.

B: Anorexia who has gained 2 lbs this week.

C: Anxiety who is being discharged today.

D: Schizophrenia who is suspicious of staff.

A 57-year-old woman volunteers 3 days a week at a homeless shelter, assists grandmothers raising grandchildren, and reads to

clients at a nursing home. According to Erickson’s Theories of Personality Development, this woman’s behaviors are age

appropriate for which developmental crisis?

A: Industry and inferiority

B: Intimacy and isolation

C: Generativity and self-absorption

D: Trust and mistrust

In order for a nurse to effectively use Peplau’s theory of interpersonal relations, the nurse must

first:

A: Care about the client with problems.

B: Have a baccalaureate level of education.

C: Demonstrate comprehensive knowledge about therapeutic communication.

D: Deal effectively with personal feelings.

A psychiatric nurse is conducting a skills group. The focus of the agenda for the group is to practice assertive behavior skills and

enhance their self-esteem. For a client who has exhibited poor self-esteem, the psychiatric nurse would evaluate cognitive behavior as

successful if the client states

A: “I believe that I am stupid.”

B: “I believe I can master that situation.”

C: “I believe that everyone knows I will fail.”

D: “I believe that this is much too difficult for me.”

A client states, “I feel so sad. I don’t think I can go on anymore.” Which of the following is the most therapeutic response by the nurse to this client?

A: “I will tell your doctor about your feelings.”

B: “You feel like you can’t go on anymore?”

C: “Things will look better tomorrow.”

D: “Why do you feel like that?”

What is the first step the nurse should take to assist a family who recently experienced the loss

of a family member?

A: Assist the process of reordering the family structure.

B: Teach the family the steps of the grieving process.

C: Establish support systems outside of the family.

D: Assess the family’s coping stage.

The family of a client with schizophrenia is struggling to cope with the effects of the client’s illness on

family function. Which of the following treatments is most helpful to the family as it deals with a family

member with mental illness?

A: Medication management for the client with schizophrenia.

B: Family education groups

C: Counseling for each of the family members

D: A family member talking with the pastor about the family’s spiritual needs

An advance practice psychiatric nurse and a basic level nurse are caring for families in the mental health clinic.

Which of the following nursing interventions can be implemented only by the advanced practice nurse?

A: Health teaching

B: Psychotherapy

C: Case management

D: Counseling

A nurse is providing secondary crisis care to clients in the community. The nurse

recognizes that which of the following clients is experiencing an adventitious crisis?

A: A man who has lost his job

B: A woman attending a rock concert where rioting resulted in many injuries

C: The family who has lost a child

D: The couple having marital problems

A 17-year-old client comes to the community crisis clinic. She has multiple superficial cuts on her wrist. She is crying

uncontrollably and states that her boyfriend has left her and she doesn’t want to live without him. The nurse’s initial

response should be:

A: “Let’s set some boundaries on your behavior here.”

B: “Don’t worry, at your age you will find another boyfriend.”

C: “Many boyfriends change their mind about relationships.”

D: “I know that you are feeling anxious. I will stay with you until you feel better.”

A psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. One understanding utilized in planning client care is that the client is:

A: Able to refuse medication

B: Able to demand and obtain release

C: Considered to be incompetent

D: In need of a guardian

A client with a history of aggression and violence is admitted to the hospital. Which of the following

principles guide the health care provider to inform nurses about the client’s danger to them?

A: Right to confidentiality

B: Adult abuse laws

C: Duty to disclose/protect

D: Patient Self-Determination Act

After three days on the unit a client says to the nurse, “I would like to date you; tell me how I can reach you outside of the hospital.” Which response by the nurse

is most appropriate?

A: “It is against hospital policy for me to date you.”

B: “I can date you after you leave the hospital.”

C: “My relationship with you is professional and not social.”

D: “I would like to date you. Give me your phone number.”

An elderly client falls out of bed. The nurse leaves the injured client and tells the nurse

aide to stay and care for the client. The nurse:

A: Can be charged false imprisonment.

B: Can be charged with assault

C: Can be charged with negligence

D: Can be charged with battery

The nurse is caring for a 16-year-old client with a history of anorexia nervosa. The nurse is aware of the theories that

suggest a specific area of brain is involved in anorexia nervosa. Which of the following areas of the brain does the

nurse know influences a person’s eating and drinking?

A: Midbrain

B: Thalmus

C: Hypothalmus

D: Pineal gland

The nurse is assessing the mental status of a client in the manic phase who claims to have special powers.

Which of the following questions would be least effective in gathering information?

A: “Would you tell me more about your special powers?”

B: “Are you seeing things that other’s don’t see?”

C: “Do you hear voices telling you to do things?”

D: “Are you having thoughts of wanting to hurt yourself or someone else?”

A recent lab report on a client taking olanzapine (Zyprexa) reveals a triglyceride level of 300 mg/dL, high-density lipoprotein (HDL)

cholesterol level of 30 mg/dL, and a fasting blood glucose level of 215 mg/dL. In addition, the client has an abdominal girth of 41

inches. Which of the following syndromes does the client exhibit?

A: Serotonin syndrome

B: Cushing’s syndrome

C: Metabolic syndrome

D: Parkinson’s syndrome

The mother of an 8 year old boy with attention deficit hyperactivity disorder (ADHD) is concerned about the

effects of atomoxetine (Strattera) on her son. Which of the following statements would the nurse use as basis for

providing the mother the information she is requesting?

A: Strattera is the first nonstimulant medication for ADHD and has no side effects

B: Children taking Strattera do not have to avoid caffeine.

C: Long-term use of Strattera can lead to the development of substance abuse in later life

D: Children taking Strattera may exhibit an increase in suicidal behavior

An intoxicated client, with injuries sustained from a motor vehicle accident, is admitted to the hospital at

10:00 p.m. What time of the following day will the nurse expect signs and symptoms of withdrawal?

A: 10:00am

B: 5:00pm

C: 5:00am

D: 10:00pm

The daughter of an 82 year-old depressed client asks the nurse why her mother has developed depression so late in life without a

previous history of depression. Which of the following responses by the nurse is most appropriate?

A: “Women and older adults have higher levels of a thyroid hormone which can lead to irritability, mood swings, and depression.”

B: “Women and older adults have higher levels of chemical messengers in the brain that results in faster signals in the brain causing depression.”

C: “Women and older adults have higher levels of an enzyme called monoamine oxidase that results in slower signals in the brain, causing depression.”

D: “Women and older adults have enlarged ventricles of the brain, which can lead to problems with emotional regulation and depression.”

Which of the following outcomes indicates that a client taking lithium is responding effectively to

therapy?

A: The client completes a crossword puzzle in the daily newspaper.

B: The client reports an increase in sexual desire.

C: The client verbalizes complete understanding of bipolar disorder

D: The client reports feeling refreshed after sleeping for 3 hours.

A client is admitted with a diagnosis of major depression. The client expresses feelings of worthlessness and a feeling of being

abandoned by significant persons in her life. Which of the following replies by the nurse conveys empathy to this client?

A: “This must be a difficult time for you.”

B: “I can understand what is going on with you.”

C: “Can you tell me what you are thinking right now?”

D: “Are you feeling like others have abandoned you?”

Which of the following physical symptoms is not typical for a client with severe depression?

A: Fatigue

B: Catatonia

C: Insomnia

D: Constipation

A client who has paranoid personality disorder is participating in a treatment group. Which behavior should the nurse be most aware of as the client participates in the

group?

A: Hypervigilance

B: Indecisiveness

C: Exploitative

D: Passive resistance

In what phase of the nurse-client relationship should the nurse introduce the issue of termination

to the client?

A: Orientation phase

B: Termination phase

C: Working phase

D: When the client is ready

A nurse is providing counseling to a group of teenagers who have lost 2 friends in a car accident. One of the teenagers walks out of the group and states, “I don’t want to talk about this, there is no

fairness in life.” The nurse recognizes this behavior as:

A: Anger

B: Bargaining

C: Denial

D: Depression

A teen, attending a substance abuse group, threatens other clients and swears at the nurse. Which response by the

nurse is the most helpful to the client?

A: “I will tell the doctor about your anger.”

B: “Why are you angry at the group?”

C: “What does the group think about this behavior?”

D: “Sit down and join the group.”

The nurse expects to see which of the following behaviors in a 12 year old child diagnosed with

Asperger’s syndrome

A: Impulsivity

B: Limited sense of social skills

C: Lack of communication

D: Twitches and tics

A client presented to the ED with suicidal thoughts and a long standing history of major depression. The nurse completes a mental status assessment and then

leaves the exam room to page the physician. While the nurse is away, the client leaves the ED and walks in front of a car. Which of the following actions would

have prevented this suicide attempt?

A: Call the physician from a phone in the exam room.

B: Arrange for another nurse to check on the client in 10 min.

C: Restrain the client to the gurney in the exam room

D: Ask the client to agree to remain in the room until the nurse returns.

The nurse is assessing a client who is at risk for suicide. Which of the following is the least

significant assessment data when determining whether hospitalization is needed for this client?

A: Presence of command hallucinations

B: Alcohol intoxication

C: The age of the client

D: An organized plan

Which of the following individuals is at the highest risk for physical abuse?

A: A 20 year-old college student on a first date with her sister and sister’s fiancé.

B: A 30 year-old female who receives repeated unwelcomed emails from a stranger

C: A 16 year-old male who is the oldest of 4 children being raised by a single mother

D: A 17 year-old pregnant woman who did not seek prenatal care until her 7th month

Which of the following behaviors does the school nurse recognize is an indicator that a school-age

child has been physically abused?

A: The child tells other children that they will get a “time-out” if then continue to misbehave.

B: The child acts obediently when a parent scolds him to be quiet.

C: The child bullies other children and threatens them to “keep quiet about it or else.”

D: The child sits quietly with a friend in the school yard instead of playing kickball

A 1st grade student comes to the school nurse with a stomach ache and fever. During an assessment of the student, the nurse notes several unusual marks on the child’s abdomen. The child does not respond to the nurse’s questions about

how these marks occurred. The nurse suspects that the child has been physically abused. What is the priority action for the nurse?

A: Document the size, shape and appearance of the unexplained injuries.

B: Question the student’s parents about the unexplained marks on the child’s stomach

C: Talk with the student’s teacher about other possible signs of abuse.

D: Notify the state child protective agency