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Questions 158

NCLEX-RN

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Question 1 of 5

A male client seeks counseling after his wife of 19 years threatened to divorce him. For most of their marriage, he has physically and verbally abused her. When asked about his behavior in the process of the nursing assessment, the client states, 'I was mean to my wife because she insists on cooking meals and wearing clothes that I do not like.' This defense mechanism is an example of:

Correct Answer: D

Rationale: Repression is blocking a desire from conscious expression. The client is conscious of his desires. Regression is returning to an earlier form of expression, which is not demonstrated here. Reaction formation is acting out the opposite of true feelings. The client felt anger concerning his wife's cooking and acted out his feelings. Rationalization is unconsciously falsifying an experience by giving a 'rational' explanation. The client is attempting to justify his behavior by giving an explanation.

Question 2 of 5

The client is admitted with a diagnosis of molar pregnancy. Which diagnostic test is most appropriate?

Correct Answer: C

Rationale: Ultrasound reveals the characteristic “snowstorm” pattern of molar pregnancy and elevated serum hCG levels confirm the diagnosis. Both tests are essential.

Question 3 of 5

The nurse is caring for a client with a history of bipolar disorder. Which medication is most likely to be prescribed for mood stabilization?

Correct Answer: B

Rationale: Lithium carbonate is a first-line mood stabilizer for bipolar disorder, preventing manic and depressive episodes. Fluoxetine treats depression, alprazolam is for anxiety, and methylphenidate is for ADHD.

Question 4 of 5

A female client has married recently. A month ago she visited her physician with complaints of burning on urination. She was given a prescription for trimethoprim-sulfamethoxazole (Bactrim) DS bid for 10 days. She was admitted through the emergency room on Saturday evening complaining of flank pain. Her temperature was 104°F. A preliminary urinalysis revealed 31 bacteria along with red and white blood cells Rankings blood cells in the urine. A preliminary diagnosis of pyelonephritis was made. During a nursing admission assessment, which statement by the client demonstrates a possible cause for pyelonephritis?

Correct Answer: C

Rationale: Although it is important that the client drink adequate fluids while treating a bladder infection with trimethoprim-sulfamethoxazole, the failure to do so will not cause pyelonephritis. A stricture or abnormality may cause the progression of bladder infection to urinary tract infection, but this is rare. There is no indication in this situation that this has occurred. The most common cause of pyelonephritis is improper treatment of bladder infections. The client typically feels better after several days, discontinues the medication, and saves the remainder for the next occurrence of a bladder infection. For this reason, it is imperative to provide client education related to completion of the prescribed medication. There is no evidence that infection in another body system could cause pyelonephritis.

Question 5 of 5

The nurse is caring for a client with a history of a fractured pelvis who is in skeletal traction. The nurse should:

Correct Answer: D

Rationale: Monitoring for infection at pin sites prevents osteomyelitis in skeletal traction. Turning is limited, weights must hang freely, and lotion is unnecessary.

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