RN NCLEX Next Gen Questions

RN NCLEX Next Gen Questions Related

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Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 45 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do?

  • A. Call the doctor and advise them that the client's physical status has significantly changed and that they have just had a cardiopulmonary arrest.
  • B. Begin cardiopulmonary resuscitation other emergency life saving measures.
  • C. Notify the family of the client's condition and ask them what they should be done for the client.
  • D. Insure that the client is without any distressing signs and symptoms at the end of life.
Correct Answer: B

Rationale: The client's advance directive clearly states a desire for all life-saving measures, including CPR and advanced cardiac life support. Despite the nurse's professional judgment about futility, the nurse is legally and ethically obligated to follow the advance directive and initiate CPR immediately in the event of a cardiac and respiratory arrest. Notifying the doctor or family or ensuring comfort are secondary actions after initiating life-saving measures as per the client's documented wishes.

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A client with a history of anxiety disorder is prescribed buspirone (BuSpar). The nurse should explain that this medication:

  • A. Works immediately to reduce anxiety.
  • B. May take 2-4 weeks to achieve full effect.
  • C. Should be taken with grapefruit juice.
  • D. Is addictive and requires tapering.
Correct Answer: B

Rationale: Buspirone typically takes 2-4 weeks to achieve its full anti-anxiety effect, unlike benzodiazepines.

A client is being treated for severe pediculosis. The nurse should instruct the client to treat the problem in the eyebrows and eyelashes by:

  • A. Applying petroleum jelly to lashes and brows three to four times a day.
  • B. Applying a pediculicide with a cotton-tipped swab three to four times a day.
  • C. Applying lindane ointment to the lashes and eyebrows three times a day.
  • D. Applying bacitracin ointment to the lashes and brows three times a day.
Correct Answer: A

Rationale: Petroleum jelly smothers lice in the eyebrows and eyelashes, a safe and effective treatment for this sensitive area, unlike pediculicides or antibiotics.

A client with a diagnosis of hyperparathyroidism is prescribed calcitonin (Miacalcin). The nurse should monitor the client for which of the following side effects?

  • A. Hypercalcemia.
  • B. Hypocalcemia.
  • C. Hyperkalemia.
  • D. Hypoglycemia.
Correct Answer: B

Rationale: Calcitonin lowers serum calcium levels, so the nurse should monitor for hypocalcemia as a potential side effect.

A client with a diagnosis of chronic kidney disease is prescribed a low-phosphorus diet. Which of the following foods should the nurse instruct the client to avoid?

  • A. White bread.
  • B. Chicken.
  • C. Milk.
  • D. Apples.
Correct Answer: C

Rationale: Milk is high in phosphorus and should be avoided in a low-phosphorus diet for chronic kidney disease.

The nurse recognizes that a client with pain disorder is improving when the client says which of the following?

  • A. I need to have a good cry about all the pain I've been in and then not dwell on it.'
  • B. I need to find another physician who can accurately diagnose my condition.'
  • C. The pain medicine that you gave me helps me to relax.'
  • D. I'm angry with all of the doctors I've seen who don't know what they're doing.'
Correct Answer: A

Rationale: Expressing a desire to process emotions and move forward indicates improved coping, a sign of progress in managing pain disorder.

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