Free NCLEX-RN Exam Dumps

Question 111

- (Topic 5)
A 24-year-old graduate student recognizes that he has a phobia. He suffers severe anxiety when he is in darkness. It has altered his lifestyle because he is unable to go to a movie theater, concert, and other events that may require absence of light. The client is seeking assistance because he is no longer able to socialize with friends due to his phobia. The psychologist working with him is using desensitization. He has asked the nursing staff to assist the client in muscle relaxation techniques. What result would indicate client education has been successful?

A. He enters a movie theater, sits in his chair, and replaces anxiety with relaxation as the theater darkens.
B. He enters a concert, but as the lights dim, he does not experience anxiety.
C. He states that he no longer fears dark places.
D. He takes a part-time job as a photographic assistan
E. His job necessitates his working in a darkroom.

Correct Answer:A
(A) This situation provides specific evidence that the client is able to integrate muscle relaxation technique into his lifestyle to alleviate anxiety. (B) The client may not experience anxiety at the concert, but there is no evidence regarding the technique that he used to alleviate anxiety. (C) The client may state he no longer experiences anxiety, but there is no evidence demonstrating this. He may be denying anxiety to discontinue therapy prematurely. (D) Does he experience anxiety in the darkroom? He may have taken this job to force himself to deal with the phobia directly.

Question 112

- (Topic 4)
A client has begun to exhibit signs of alcohol withdrawal. Her blood pressure has risen from 120/60 to 190/100, pulse is increased from 88 to 110 bpm, and she is irritable and agitated and has gross motor tremors of the hands. The nurse notifies the doctor. The nurse can anticipate that the doctor will order which of the following?

A. An opiate such as propoxyphene napsylate (Darvocet)
B. A benzodiazepine such as chlordiazepoxide (Librium)
C. A tricyclic antidepressant such as amitriptyline (Elavil)
D. A phenothiazine such as chlorpromazine (Thorazine)

Correct Answer:B
(A) This answer is incorrect. Benzodiazepines are drugs of choice for alcohol withdrawal.
(B) This answer is correct. The drug has a sedative effect, is safe, and has an anticonvulsant effect.(C) This answer is incorrect. Amitriptyline is an antidepressant. (D) This answer is incorrect. Chlorpromazine is most effective in psychotic disorders.

Question 113

- (Topic 6)
The physician of an alcoholic client places him on a low-protein, high-carbohydrate diet. When choosing his menu, the client??s best choice from the items below would be:

A. Liver and onions, macaroni and cheese, tea with sugar
B. Baked chicken, baked potato with bacon bits, milk
C. Waffles with butter and honey, orange juice
D. Cheese omelette with ham and mushrooms, milk

Correct Answer:C
(A, B, D) These foods are high in protein, which needs to be restricted. (C) Serum ammonia levels can be decreased by restricting dietary protein intake. Waffles, honey, and orange juice are high in carbohydrate and low or completely lacking in protein. Butter, a concentrated fat, will provide extra calories.

Question 114

- (Topic 6)
A client suspected of having anorexia nervosa is placed on bed rest with an IV infusion and a high-carbohydrate liquid diet. Within 72 hours, the results of her lab work show a return to normal limits. She is transferred to the psychiatric service for further treatment. A behavior modification plan is initiated. Three days after her transfer, the client tells the nurse, ??I haven??t exercised in 6 days. I won??t be eating lunch today.?? This statement by her most likely reflects:

A. Her lack of internal awareness about the outcome of the behavior
B. Increased knowledge about personal exercise plans
C. A manipulative technique to trick the nurse into allowing her to miss a meal
D. A true desire to stay fit while in the hospital

Correct Answer:A
(A) Indirect self-destructive behavior such as that seen in anorexia nervosa is characterized by the client??s lack of insight and the awareness that the outcome of the dieting, exercising, and weight loss will ultimately result in death if uninterrupted. (B) Although the client is knowledgeable about exercise, knowledge about the balance between nutrition, exercise, and rest is absent. (C) The client??s level of denial and lack of awareness disallow this behavior as a manipulative trick. (D) The client??s illness-maintaining behaviors are inconsistent with fitness.

Question 115

- (Topic 3)
A 70-year-old client has pneumonia and has just had a respiratory arrest. He has just been intubated with an 8- mm endotracheal tube. During auscultation of his chest, breath sounds were found to be absent on the left side. The nurse identifies the most likely cause of this as:

A. Inappropriate endotracheal tube size
B. Left-sided pneumothorax
C. Right mainstem bronchus intubation
D. Pneumonia

Correct Answer:C
(A) Appropriate endotracheal tube sizes for adults range from 7.0–8.5 mm. (B) Pneumothorax could be indicated by an absence of breath sounds on the affected side. However, in a recently intubated client, the first priority would be to consider tube malposition. (C) During intubation, the right mainstem bronchus can be inadvertently entered if the endotracheal tube is inserted too far. Left mainstem bronchus intubation almost never occurs because of the angle of the left mainstem bronchus. (D) Breath sounds for someone with pneumonia may be decreased over the areas of consolidation. However, in a recently intubated client, the first priority would be to consider tube malposition.