The nurse observes a coworker acting erratically.

Extract:

Question 1 of 5

The nurse observes a coworker acting erratically. The clients assigned to this coworker don’t seem to get relief when pain medications are administered. Which action should the nurse implement?

A. Try to help the coworker by confronting the coworker with the nurse’s suspicions. B. Tell the coworker that the nurse will give all narcotic medications from now on. C. Report the nurse’s suspicions to the nurse’s supervisor or the facility’s peer review. D. Do nothing until the nurse can prove the coworker has been using drugs.

Correct Answer: C

Rationale: Erratic behavior and ineffective pain relief suggest possible drug diversion. Reporting to the supervisor or peer review (
C) ensures proper investigation while protecting patients. Confronting (
A) may escalate, taking over medications (
B) doesn’t address the issue, and waiting for proof (
D) risks harm.

Question 2 of 5

The wife of the client diagnosed with chronic alcoholism tells the nurse, 'I have to call his work just about every Monday to let them know he is ill or he will lose his job.' Which would be the nurse’s best response?

A. I am sure that this must be hard for you. Tell me about your concerns.' B. You are afraid he will lose his source of income.' C. Why would you call in for your husband? Can’t he do this?' D. Are you aware that when you do this you are enabling him?'

Correct Answer: A

Rationale: Reflecting and inviting discussion (
A) validates the wife’s feelings and encourages therapeutic communication. Assuming fear (
B) is less open-ended, questioning her actions (
C) may seem judgmental, and labeling enabling (
D) could alienate her.

Question 3 of 5

Which diagnostic test is used to confirm the diagnosis of Amyotrophic Lateral Sclerosis (ALS)?

A. Electromyogram (EMG). B. Muscle biopsy. C. Serum creatine kinase (CK). D. Pulmonary function test.

Correct Answer: A

Rationale: EMG (
A) detects abnormal muscle electrical activity characteristic of ALS, confirming the diagnosis. Muscle biopsy (
B) is less specific, CK (
C) may be elevated but isn’t diagnostic, and pulmonary tests (
D) assess complications, not diagnosis.

Question 4 of 5

The client with ALS is admitted to the medical unit with shortness of breath, dyspnea, and respiratory complications. Which intervention should the nurse implement first?

A. Elevate the head of the bed 30 degrees. B. Administer oxygen via nasal cannula. C. Assess the client’s lung sounds. D. Obtain a pulse oximeter reading.

Correct Answer: B

Rationale: Dyspnea in ALS indicates respiratory distress. Administering oxygen (
B) addresses hypoxia immediately. Elevating HOB (
A), assessing lung sounds (
C), and pulse oximetry (
D) follow to support respiratory status.

Question 5 of 5

The client is in the terminal stage of ALS. Which intervention should the nurse implement?

A. Perform passive ROM every two (2) hours. B. Maintain a negative nitrogen balance. C. Encourage a low-protein, soft-mechanical diet. D. Turn the client and have him cough and deep breathe every shift.

Correct Answer: A

Rationale: In terminal ALS, passive ROM every 2 hours (
A) prevents contractures and maintains comfort. Negative nitrogen balance (
B) is undesirable, low-protein diets (
C) are not indicated, and coughing/deep breathing (
D) may be infeasible.

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NCLEX Neurological Disorders Questions

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