Mock NCLEX RN Exam

Mock NCLEX RN Exam Related

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A 45-year-old client diagnosed with major depression is scheduled for electroconvulsive therapy (ECT) in the morning. Which of the following medications are routinely administered either before or during ECT?

  • A. Thioridazine (Mellaril), lithium, and benztropine
  • B. Atropine, sodium brevitol, and succinylcholine chloride (Anectine)
  • C. Sodium, potassium, and magnesium
  • D. Carbamazepine (Tegretol), haloperidol, and trihexyphenidyl (Artane)
Correct Answer: B

Rationale: Thioridazine (an antipsychotic drug), lithium (an antimanic drug), and benztropine (an antiparkinsonism agent) are generally administered to treat schizophrenic and bipolar disorders. Atropine (a cholinergic blocker), sodium brevitol (a short-acting anesthetic), and succinylcholine (a neuromuscular blocker) are administered either before or during ECT to counteract bradycardia and to provide anesthesia and total muscle relaxation. These are electrolyte substances administered to correct fluid and electrolyte imbalances in the body. Carbamazepine (an anticonvulsant), haloperidol (an antipsychotic), and trihexyphenidyl (an antiparkinsonism agent) are usually administered in psychiatric settings to control problems associated with psychotic behavior.

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The nurse is caring for a client following a myocardial infarction. Which of the following enzymes are specific to cardiac damage?

  • A. SGOT and LDH
  • B. SGOT and CK BB
  • C. LDH and CK MB
  • D. LDH and CK BB
Correct Answer: C

Rationale: CK-MB and LDH are specific to cardiac damage, with CK-MB being highly specific for myocardial infarction due to its presence in heart muscle.

The nurse is caring for a client with a history of Barrett’s esophagus. The nurse should expect the client to have:

  • A. Chronic acid reflux
  • B. Epigastric pain
  • C. Hematemesis
  • D. Dysphagia
Correct Answer: A

Rationale: Barrett’s esophagus results from chronic acid reflux, causing esophageal lining changes, a key risk factor for esophageal cancer.

Because a client is taking an MAO inhibitor, it is necessary to discuss the need for adherence to a low-tyramine diet. Which of the following are foods that she should avoid?

  • A. Pickled, aged, smoked, and fermented foods
  • B. Fresh vegetables
  • C. Broiled fresh fish and fowl
  • D. Fresh fruit such as apples and oranges
Correct Answer: A

Rationale: These foods may produce elevation in blood pressure when consumed during MAO inhibition therapy. These foods have not been pickled, fermented, smoked, or aged. They contain very little, if any, tyramine or tryptophan. As long as the meat has not been aged or smoked, it is within the dietary regimen. Fresh fruits can be consumed as desired. However, the consumption of bananas is limited.

A client is pleased about being pregnant, yet states, 'It is really not the best time, but I guess it will be OK.' The nurse's assessment of this response is:

  • A. Initial maternal-infant bonding may be poor.
  • B. Client may have a poor relationship with her husband.
  • C. This response is normal in the first trimester.
  • D. This response is abnormal, to be re-evaluated at the next visit.
Correct Answer: C

Rationale: Ambivalence is normal during the first trimester. Reva Rubin addresses the issue of 'not now' in the first trimester. The statement still leaves room for exploration. There are no data to support this. This statement by the mother still leaves room for exploration. Ambivalence is normal during the first trimester. Reva Rubin addresses the issue of 'not now.' This fact should be shared with the mother during further exploration of the comment. It is not abnormal. If it were, another month would also be too long to wait.

A client with a history of chronic renal failure is receiving hemodialysis. Which assessment finding indicates a complication during dialysis?

  • A. Mild fatigue
  • B. Hypotension
  • C. Slight headache
  • D. Stable weight
Correct Answer: B

Rationale: Hypotension during dialysis suggests fluid removal too rapid or disequilibrium syndrome, a serious complication. Fatigue (A), headache (C), and stable weight (D) are less concerning.

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