NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 881:

  Which of the following attitudes is essential in a nurse who assists clients during crises?

  A. viewing crisis intervention as the first step in solving bigger problems

  B. wanting to help clients solve all problems identified

  C. taking an active role in guiding the process

  D. feeling that work requires identification with all of a client's problems

  Correct Answer: A

  Viewing crisis intervention as the first step in solving bigger problems is essential in a nurse who assists clients during crises. Assessment of the present problem should be viewed as necessary. Time and limitations of crisis work need to be remembered. Complete diagnostic assessment is unnecessary, and unrelated material should not be explored. Referrals might be necessary for other identified problems.

• Question 882:

  A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child.

  The nurse should assess the client for further signs of ___________.

  A. general anxiety disorder

  B. schizophrenia

  C. post-traumatic stress disorder

  D. bipolar disorder

  Correct Answer: C

  Childhood sexual abuse is associated with adult-onset depression and with an increased risk for lifetime and current post-traumatic stress disorder (PTSD). About one-third of all victims of sexual abuse meet the diagnostic criteria for PTSD. A person with PTSD has three main types of symptoms: ?Re-experiencing the traumatic event with flashbacks, nightmares, and exaggerated reactions to triggers that remind the person of the event. ?Emotional numbing is evidenced by avoidance of activities, places, thoughts, feelings, or conversations related to the trauma; feelings of detachment from others; and restricted or blunted emotions. ?Increased activity is seen in bursts of anger, difficulty sleeping, hypervigilence, difficulty concentrating, and an exaggerated startle response. Other problems associated with PTSD are panic attacks, suicidal thoughts and feelings, substance abuse, eating disorders, feelings of alienation and isolation, and feelings of mistrust and betrayal.

• Question 883:

  An adolescent female reports being raped at a party where alcohol was served. The client admits to drinking alcohol before being raped by an acquaintance.

  The nurse should ___________.

  A. inform the client that because she is underage, she is at fault for attending a party where alcohol was served

  B. ask the client if anyone witnessed the event because the client was intoxicated and might not remember correctly

  C. inform the client that it was not her fault, and support the client through the physical examination

  D. question whether the woman had consensual sex and now just feels guilty

  Correct Answer: C

  Acquaintance rape remains a controversial topic because of lack of agreement on the definition of consent. Most acquaintance rapes take place in either the victim's or the assailant's home or apartment. Most victims of acquaintance rape inform someone close to them, but less than 30% report the incidence to the authorities. Survivors of acquaintance rape report similar levels of depression, anxiety, complications in subsequent relationships, and difficulty attaining prerape levels of sexual satisfaction to what survivors of stranger rape report. Coping is more difficult for victims of acquaintance rape if others fail to recognize that the emotional impact is just as serious.

• Question 884:

  A nurse is teaching a group of clients with a diagnosis of Schizophrenia who are nearing discharge from a residential care facility.

  An essential topic to include is ___________.

  A. pathophysiology of the disease and expected symptoms

  B. how to recognize and manage symptoms of relapse

  C. the need to take extra medication when feeling stressed

  D. the importance of contact with follow-up care daily

  Correct Answer: B

  Clients are usually aware of the symptoms that indicate relapse is occurring. The client needs to know how to find a safe environment and to seek help. The first two stages of relapse are more difficult to recognize because they do not present symptoms that indicate psychosis. Initially, the client feels anxious and overwhelmed, and might become withdrawn. This is the crucial period to intervene. The client needs to go to a safe environment with someone who is trusted, avoid negative people, and decrease stimuli and stress.

• Question 885:

  A client with a diagnosis of Schizophrenia has been released from an acute care setting. The client had a prolonged recovery from relapse. One of the parents says to the discharge nurse, "I do not understand what is going on. The hospital said she was better, but all she does is sit around all day and smoke. We cannot get her to go to the vocational training you arranged."

  The nurse recognizes that more teaching is needed about ___________.

  A. the pathophysiology and acting out behaviors of schizophrenia.

  B. support groups that can help the parents release their feelings of frustration.

  C. the prolonged recovery time and depressive effects of medicines to prevent relapse.

  D. motivational techniques that are effective in clients with schizophrenia.

  Correct Answer: C

  The nurse conducting discharge teaching must stress the lengthy recuperation process with emphasis on

  the sedative qualities of the medication used to prevent relapse.

  Support groups are useful for caregivers.

  The emphasis during recuperation is on maintaining nutrition and hygiene.

• Question 886:

  A client is admitted with a diagnosis of Multiple Drug Use.

  The nurse should plan care based on knowledge that ___________.

  A. multiple drug use is very uncommon

  B. people might use more than one drug to enhance the effect or relieve withdrawal symptoms

  C. alcohol and barbiturates used together are not dangerous because one is a stimulant and the other is a depressant

  D. assessment and intervention are easier with multiple drug use because of the synergistic effect

  Correct Answer: B

  Simultaneous or sequential use of more than one substance is very common.

  Multiple drug use can enhance, lessen, or change the nature of the intoxication, or relive withdrawal

  symptoms. Heroin users often also use alcohol, marijuana, or benzodiazepines.

  Multiple drug use is especially dangerous if synergistic drugs are combined.

  Multiple drug use complicates assessment and intervention because the client might be demonstrating the

  effects or withdrawal from several drugs.

• Question 887:

  When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?

  A. Lifetime prevalence and intensity of alcohol use is greater in women than men.

  B. Hispanics and African Americans have higher levels of alcohol use than Caucasians.

  C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.

  D. Heavy use is more common in higher socioeconomic groups because they can afford to buy the drugs.

  Correct Answer: C

  Recent research reveals that 83% of all persons in the United States, age 12 or older, report using alcohol

  sometime in their lives.

  Use of alcohol and illicit drugs appears to increase into the mid-20s, and then levels off and decreases

  with age.

  Both lifetime prevalence and intensity of alcohol use are greater in males.

  Caucasians report higher levels of alcohol use than African Americans or Hispanics.

  Those with more education are more likely to use alcohol, but heavy use is more common among the less educated and the unemployed.

• Question 888:

  Which of the following coping mechanisms protects an individual from anxiety?

  A. denial and fantasy

  B. rationalization and suppression

  C. regression and displacement

  D. reaction formation and projection

  Correct Answer: A

  Denial, rationalization, regression, and fantasy are coping mechanisms that protect persons from anxiety.

• Question 889:

  Which activity is best employed to perform Milieu therapy?

  A. Investigating the client's view of the world.

  B. Promoting socialization skills.

  C. Focusing on inappropriate behavior.

  D. Providing repetitive ordinary experiences on a daily basis.

  Correct Answer: D

  Milieu therapy provides repetitive ordinary experiences on a daily basis, controls the environment by minimizing change as much as possible, and decreases disruptive behavior by keeping tasks simple.

• Question 890:

  The nurse who was not promoted then went to the utility room and slammed several cupboard doors while looking for Kleenex.

  This behavior exemplifies ___________.

  A. displacement

  B. sublimation

  C. conversion

  D. reaction formation

  Correct Answer: A

  Displacement unconsciously transfers emotions associated with a person, object, or situation to another less threatening person, object, or situation. The nurse slammed doors instead of striking the promoted nurse or the administrator who made the promotion decision. Sublimation is the unconscious process of substituting constructive activity for unacceptable impulses. This choice cannot be considered correct because the slamming of the cupboard doors cannot be considered a constructive activity. Conversion involves unconsciously transforming anxiety into a physical symptom. Reaction formation keeps unacceptable feelings or behaviors out of awareness by using the opposite feeling or behavior.