Exam Cram NCLEX RN Practice Questions

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The patient in the emergency room has a history of alprazolam (Xanax) abuse and abruptly stopped taking Xanax about 24 hours ago. He presents with visible tremors, pacing, fear, impaired concentration, and memory. Which intervention takes priority?

  • A. Have the patient lie down on a stretcher with bed rails raised
  • B. Offer the patient a cup of water and a small amount of food
  • C. Reassure the patient about his well-being
  • D. Inform the physician about the patient's Xanax withdrawal
Correct Answer: A

Rationale: The 1-4 day period after Xanax withdrawal is critical as it poses the highest risk of life-threatening seizures. Alprazolam is a benzodiazepine, and sudden cessation can lead to severe withdrawal symptoms. The patient's visible tremors, fear, pacing, and cognitive impairment indicate a state of heightened distress and potential seizure risk. Placing the patient on a stretcher with raised bed rails is essential for seizure precautions, ensuring safety and preventing injury during a potential seizure. Offering water and food, reassuring the patient, or informing the physician about Xanax withdrawal are not immediate priorities compared to managing the risk of seizures in this high-risk situation.

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Clinical manifestations of asthma include:

  • A. Decreased expiratory time
  • B. Increased peak expiratory flow
  • C. Increased use of accessory muscles
  • D. Increased oxygen saturation
Correct Answer: C

Rationale: Clinical manifestations of asthma include increased use of accessory muscles, increased expiratory time, increased peak expiratory flow, and decreased oxygen saturation.

Choice A, 'Decreased expiratory time,' is incorrect because asthma typically presents with increased expiratory time due to airway obstruction. Choice B, 'Increased peak expiratory flow,' is incorrect as asthma commonly leads to decreased peak expiratory flow due to airway constriction. Choice D, 'Increased oxygen saturation,' is incorrect because asthma exacerbations often result in decreased oxygen saturation levels.

The nurse is caring for a newborn infant after surgical intervention for imperforate anus. The nurse should place the infant in which position in the postoperative period?

  • A. Supine with no head elevation
  • B. Side-lying with the legs flexed
  • C. Side-lying with the legs extended
  • D. Supine with the head elevated 30 degrees
Correct Answer: B

Rationale: After surgical intervention for imperforate anus, the infant should be placed in a side-lying position with the legs flexed. This position helps reduce edema and pressure on the surgical site, preventing strain and promoting comfort. Placing the infant supine with no head elevation (Choice A) doesn't offer adequate support and may increase pressure on the area. Side-lying with the legs extended (Choice C) doesn't help reduce edema and pressure effectively. Placing the infant supine with the head elevated 30 degrees (Choice D) isn't recommended as it may not provide adequate support and comfort needed for recovery.

A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse expects to provide teaching about which client problem?

  • A. Odor
  • B. Nausea
  • C. Malaise
  • D. Diarrhea
Correct Answer: A

Rationale: Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal consistency in places not appropriate for that purpose according to the individual's own sociocultural setting. Signs of encopresis include evidence of soiled clothing, scratching or rubbing the anal area due to irritation, fecal odor without apparent awareness by the child, and social withdrawal. Teaching about odor is essential to address the issue of encopresis. Choices B, C, and D are incorrect because encopresis is not typically associated with nausea, malaise, or diarrhea. Therefore, teaching about these symptoms would not be relevant in the context of encopresis.

The nurse has provided dietary instructions to the mother of a child with celiac disease. The nurse determines that further instruction is needed if the mother states that she will include which food item in the child's nutritional plan?

  • A. Corn
  • B. Chicken
  • C. Oatmeal
  • D. Vitamin supplements
Correct Answer: C

Rationale: In celiac disease, individuals need to avoid gluten-containing foods like wheat, rye, barley, and oats. Oatmeal contains gluten unless it is specifically labeled as gluten-free. Corn and rice are safe alternatives for individuals with celiac disease as they do not contain gluten. Chicken is a naturally gluten-free protein source. While vitamin supplements may be necessary to address deficiencies due to malabsorption, oatmeal poses a risk of gluten exposure, making it an incorrect choice for a child with celiac disease.

Which of the following glands found in the skin secretes a liquid called Sebum?

  • A. Apocrine Glands
  • B. Sebaceous Glands
  • C. Lacrimal Glands
  • D. Sweat Glands
Correct Answer: B

Rationale: Sebum is a liquid secreted by glands in the skin known as sebaceous glands. Sebum's primary function is to lubricate the skin and help maintain its integrity. Apocrine glands secrete a different type of sweat that is odorless but can develop an odor when combined with bacteria on the skin. Lacrimal glands produce tears to keep the eyes moist, and sweat glands secrete sweat to regulate body temperature through evaporation. Therefore, the correct answer is Sebaceous Glands because they specifically secrete sebum, distinguishing them from the other gland types mentioned.

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