2024 Nclex Questions - Nurselytic

Correct Answer: B

Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings.
Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.

Correct Answer: A

Rationale:
To infuse a 50 ml bolus in 30 minutes, the rate should be calculated as follows: 50 ml / 30 min = 100 ml per hour.
Therefore, the correct answer is to set the pump rate at 100 ml per hour for one hour.
Choice A is the correct rate based on the calculation.

Choices B, C, and D all provide incorrect rates that do not match the physician's order.
Choice B would only deliver 30 ml in 30 minutes, not the ordered 50 ml.
Choice C would deliver 120 ml in one hour, which is 20 ml more than ordered.
Choice D would only provide 25 ml over 30 minutes, not the full 50 ml prescribed.

Correct Answer: D

Rationale: When a patient's central venous access device (CVA
D) becomes infected, administering antibiotics through the line is essential to attempt to eliminate microorganisms within the catheter. The goal is to prevent the necessity of removing the catheter, which might be required if the infection persists.
Choice A, '
To prevent infiltration of the peripheral line,' is incorrect as the priority is addressing the catheter infection, not preventing issues with a peripheral line.
Choice B, '
To reduce the pain and discomfort associated with antibiotic administration in a small vein,' is not relevant to the rationale for choosing the CVAD for antibiotic administration.
Choice C, '
To lessen the chance of an allergic reaction to the antibiotic,' is also incorrect as the main focus is managing the catheter-associated infection rather than allergy prevention.

Correct Answer: C

Rationale: The correct answer is C: rapid administration of a drug can lead to toxicity. When a drug is administered intravenously, it has 100% bioavailability, entering the bloodstream immediately and increasing the risk of toxicity if not carefully monitored. While IV infiltration (choice
A) can cause tissue damage, it is not typically life-threatening.
Choice B is incorrect as the speed of administration is not the primary reason for the danger; it is the immediate and full dose reaching the bloodstream.
Choice D is incorrect as the popularity of the route does not inherently make it more dangerous.

Correct Answer: C

Rationale: Estrogen antagonists are commonly used to treat estrogen hormone-dependent cancers such as breast carcinoma. One well-known estrogen antagonist used in breast cancer therapy is Tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs, reduces breast cancer recurrence by 30%. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history. Thyroxine is a thyroid hormone used to treat hypothyroidism, not thyroid cancer. ACTH is an anterior pituitary hormone that stimulates the adrenal glands to release glucocorticoids; it does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone that stimulates glycogenolysis and gluconeogenesis; it does not treat pancreatic cancer.