NCLEX-PN
NCLEX Trainer Test 3 Questions
Extract:
Question 1 of 5
A client with bipolar disorder receives Eskalith (lithium carbonate) bid. Which observation is associated with lithium toxicity?
Correct Answer: C
Rationale: Ataxia , or impaired coordination, is a sign of lithium toxicity. Hyporeflexia is not typical. Akathesia is restlessness, often linked to antipsychotics. Petechiae indicate bleeding issues, not lithium toxicity.
Extract:
A 56-year-old woman hospitalized with bipolar disorder. While the patient is in the manic phase.
Question 2 of 5
Nursing interventions should involve
Correct Answer: B
Rationale: Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) will not be effective in changing behaviors, requires an attentive listener (2) correct-patient experiences hyperactivity, poor concentration, and distractibility, redirect into activity that promotes rest, nourishment, reduce stimuli (3) isolation not required, would increase anxiety and hostility (4) disorientation usually not seen, no memory disturbance
Extract:
Question 3 of 5
The nurse should visit which of the following clients first?
Correct Answer: C
Rationale: Chest pain in a client with a history of angina suggests possible acute coronary syndrome, requiring immediate assessment to rule out myocardial infarction.
Question 4 of 5
The nurse is caring for a client with a history of asthma who is receiving montelukast (Singulair) 10 mg PO daily. Which of the following client statements would be of GREATest concern to the nurse?
Correct Answer: C
Rationale: Feeling sad and hopeless suggests depression, a rare but serious side effect of montelukast, requiring immediate evaluation. Options A, B, and D are less concerning: nighttime dosing is standard, headaches are nonspecific, and albuterol use is appropriate.
Extract:
A client is scheduled for a cardiac catheterization at 8 AM. The client's laboratory work was completed five days ago. The results were: K⺠3.0 mEq/L, Na⺠148 mEq/L, glucose 178 mg/dL. He complains of muscle weakness and cramps.
Question 5 of 5
Which of the following nursing actions is BEST?
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) Aldactone is potassium-sparing diuretic and is an oral medication, patient is NPO for procedure (2) is not feasible prior to the cardiac cath because the client is NPO (3) correct-signs and symptoms are indicative of hypokalemia; stat serum K⺠level is needed to confirm the K⺠level prior to going for cardiac catheterization (4) is unnecessary at this time