NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 841:

  A man expresses surprise that his wife has become very withdrawn during hospitalization for pneumonia.

  Which response helps the husband understand how some people cope with hospitalization?

  A. "Hospitalization might cause a crisis. Has your wife had to cope with problems before this?"

  B. "Some people react that way. She will be more talkative when she feels better."

  C. "Your wife might be feeling concern that she cannot fulfill her normal roles."

  D. "This is typical behavior for someone who is as ill as your wife."

  Correct Answer: A

  Hospitalization might precipitate a crisis in either the client or family.

  Clients might become demanding or withdrawn.

  Family members might become demanding to help them cope with insecurity.

• Question 842:

  When planning intervention for a client during a crisis, which of the following outcomes is most appropriate?

  A. The client should explore deep psychological problems.

  B. The client should express positive feelings about event.

  C. The client should identify needs that are threatened by the event.

  D. The client should use constructive coping mechanisms.

  Correct Answer: D

  The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping.

  Previous psychological issues might recur during crisis, but the focus is on short-term resolution of the

  current problem.

  At the end, the nurse credits a client for positive changes and helps him or her understand what was

  learned. This allows the client to use the learned coping mechanisms when new problems arise.

• Question 843:

  A woman seeks assistance because she recently remembered childhood sexual abuse.

  The nurse should include which of the following goals for this client?

  A. prosecuting the perpetrator

  B. managing symptoms of anxiety and fear

  C. determining if the memories are real

  D. collaborating the client's story

  Correct Answer: B

  At least 10% of victims of childhood sexual abuse have periods of complete amnesia about the abuse, followed by delayed recall. Controversial evidence suggests that people who have recovered memories have had part of those memories reconstructed by therapists. The nurse's role is not to determine if the memories are real, but to help the client deal with the stress caused by the remembered abuse.

• Question 844:

  During a well-baby check of a 6-month-old infant, the nurse notes abrasions and petechaie of the palate.

  The nurse should __________.

  A. inquire about foods the child is eating

  B. ask about the possibility of sexual abuse

  C. request to see the type of bottle used for feedings

  D. question the parent about objects the child plays with

  Correct Answer: B

  Generally oral sex leaves little physical evidence.

  Injury to the soft palate (such as bruising, abrasions, and petechaie) and pharyngeal gonorrhea are the

  only signs.

  Infants are at risk for sexual abuse.

• Question 845:

  A client diagnosed with Borderline Personality Disorder frequently attempts to burn herself.

  The best intervention to facilitate behavior change is __________.

  A. constantly observing the client to prevent self-harm

  B. enlisting the client in defining and describing harmful behaviors

  C. checking on the client every 15 minutes to ensure she is not engaging in harmful behavior

  D. removing all items from the environment that the client could use to harm herself

  Correct Answer: B

  The challenge when intervening with clients who might harm themselves is to maintain client safety while

  facilitating behavior change.

  Enlisting the client to identify the triggers for self-harm makes the client an active participant in treatment.

  Nurses are less judgmental when they understand the source of the behavior and can be sensitive to client

  feelings.

• Question 846:

  The nurse observes a staff member not following the plan of care for a client with an antisocial personality disorder.

  The nurse should __________.

  A. confront the staff member immediately and say, "You know that is not the treatment plan"

  B. write an incident report to create a paper trail of the staff member's failure to follow the planned program

  C. ask the staff member to talk in private, and reinforce how antisocial clients try to divide staff

  D. bring up the incident during the weekly conference so that this staff member is not assigned to work with antisocial persons again

  Correct Answer: C

  It is essential that the treatment program be followed exactly for clients with antisocial personality disorder because they are very manipulative and attempt to divide staff. However, confronting the staff member in front of the client enhances the division of staff. Talking with the staff member in private allows the person to develop skills to work with this client population.

• Question 847:

  When planning care of a client who has a been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that __________.

  A. amphetamines increase energy by increasing dopamine levels at neural synapses

  B. amphetamines have a low risk of tolerance or addiction

  C. amphetamines produce a 10-20-second rush followed by a 2-4-hour high

  D. addiction to barbiturates and amphetamines is rare because they have opposite effects

  Correct Answer: A

  Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse.

  The increased catecholamines at the receptors causes increased stimulation. Clear patterns of tolerance

  and withdrawal have not been described. Prolonged or excessive use of amphetamines can lead to

  psychosis.

  People use amphetamines for the feelings of euphoria, relief from fatigue, energy, and alertness.

  Overdose can cause seizures, cardiac arrhythmias, hypertension, and hyperthermia. When abstaining, the

  client might experience fatigue, depression, and irritability lasting for several weeks.

  Drug cravings are common and might lead to relapse.

• Question 848:

  While admitting a client to an acute-care psychiatric unit, the nurse asks about substance abuse based on knowledge that __________.

  A. psychiatric illness is more prevalent in addicted populations

  B. people with psychiatric disorders are more prone to substance abuse

  C. substance disorders are easily detected and diagnosed in acute-care psychiatric settings

  D. undetected substance problems have no real effect on treatment of psychiatric disorders

  Correct Answer: B

  The failure to address substance abuse among clients with psychiatric disorders interferes with treatment effectiveness and contributes to relapse. Misdiagnosis of a psychiatric disorder, suboptimal pharmacological treatment, neglect of appropriate interventions, or an inappropriate referral might also occur.

• Question 849:

  How does the ANA define the psychiatric nursing role?

  A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art

  B. assisting the therapist to relieve the symptoms of clients

  C. to solve clients' problems and give them the answers

  D. having a client committed to long-term therapy with the nurse

  Correct Answer: A

  The ANA sets standards of practice for psychiatric and mental health nursing roles.

  Quality of care, performance appraisal, education, ethics, collaboration, and research are covered through

  the use of the Nursing Process.

• Question 850:

  The Token Economy is a type of therapy that focuses on __________.

  A. play therapy

  B. behavior modification

  C. milieu therapy

  D. associative

  Correct Answer: B

  Behavior modification gives positive feedback and rewards for appropriate behavior. Behavior modification requires negative behavior if it's not destructive or life threatening.