NCLEX-RN
NCLEX RN Predictor Exam Questions
Extract:
Question 1 of 5
A female client has experienced varying degrees of depression throughout her life. Now that she is postmenopausal, her depression has increased. She is unable to motivate herself to clean her house or even to get out of bed and get dressed in the morning. The client was begun on fluoxetine (Prozac) therapy. When educating her about fluoxetine, what might the nurse caution her about?
Correct Answer: C
Rationale: A daily dose of fluoxetine should be taken in the morning. Afternoon doses may cause nervousness and insomnia. Although fluoxetine is less sedating than other antidepressants, it may still cause dizziness or drowsiness, requiring caution with driving or hazardous activities. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication. Fluoxetine can interact with other medications, including over-the-counter drugs, and should be reviewed by the healthcare provider to avoid harmful interactions.
Question 2 of 5
Endotracheal tube cuff pressure should never exceed:
Correct Answer: B
Rationale: Pressure in the endotracheal tube cuff should never exceed 20 mm Hg, because higher pressure places the client at risk for tracheal erosion.
Question 3 of 5
The nurse will be alert to the most potentially life-threatening side effect associated with the administration of monoamine oxidase (MAO) inhibitor. This is:
Correct Answer: B
Rationale: Oculogyric crisis, involuntary upward deviation and fixation of the eyeballs, is usually associated with either postencephalitic parkinsonian or drug-induced extrapyramidal symptoms (EPS). Hypertensive crisis is a potentially life-threatening side effect. This may occur if the client ingests foods, beverages, or medications containing tyramine. Orthostatic hypotension, a drop in blood pressure resulting from a rapid change of body position, can occur with the administration of antidepressants. Tardive dyskinesia, characterized by slow, rhythmical, automatic or stereotyped muscular movements, usually is associated with the administration of certain antipsychotic medications.
Question 4 of 5
A client's record from the ED indicates that she overdosed on phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor. Which diet would be the most appropriate at this time?
Correct Answer: D
Rationale: Tyramine is an amino acid activated by MAO in the liver and intestinal wall. It is released as proteins are hydrolyzed through aging, pickling, smoking, or spoilage of foods. When MAO is inhibited, tyramine levels rise, stimulating the adrenergic system to release large amounts of norepinephrine, which can produce a hypertensive crisis.
Question 5 of 5
A schizophrenic is admitted to the psychiatric unit. What affect would the nurse expect to observe?
Correct Answer: B
Rationale: Schizophrenia is characterized by apathy and flat affect, reflecting emotional disengagement from the environment.