Nclex Practice Questions NURS MISC Laney College 2022/2023 updated with rationale

Nclex Practice Questions NURS MISC Laney College 2022/2023 updated with rationale CHAPTER 1 PAIN 1. A chronic pain client reports to you, the charge nurse, that the nurse have not been responding to requests for pain medication. What is your initial action? a. Check the MARs and nurses’ notes for the past several days. b. Ask the nurse educator to give an in-service about pain management. c. Perform a complete pain assessment and history on the client. d. Have a conference with the nurses responsible for the care of this client 2. Family members are encouraging your client to “tough it out” rather than run the risk of becoming addicted to narcotics. The client is stoically abiding by the family’s wishes. Priority nursing interventions for this client should target which dimension of pain? a. Sensory b. Affective c. Sociocultural d. Behavioral e. Cognitive 3. A client with diabetic neuropathy reports a burning, electrical-type in the lower extremities that is not responding to NSAIDs. You anticipate that the physician will order which adjuvant medication for this type of pain? a. Amitriptyline (Elavil) b. Corticosteroids c. Methylphenidate (Ritalin) d. Lorazepam (Ativan) 4. Which client is most likely to receive opioids for extended periods of time? a. A client with fibrolyalgia b. A client with phantom limb pain c. A client with progressive pancreatic cancer d. A client with trigeminal neuralgia 5. As the charge nurse, you are reviewing the charts of clients who were assigned to a newly graduated RN. The RN has correctly charted dose and time of medication, but there is no documentation regarding non- pharmaceutical measures. What action should you take first? a. Make a note in the nurse’s file and continue to observe clinical performance b. Refer the new nurse to the in-service education department. c. Quiz the nurse about knowledge of pain management d. Give praise for the correct dose and time and discuss the deficits in charting. 6. In caring for a young child with pain, which assessment tool is the most useful? a. Simple description pain intensity scale b. 0-10 numeric pain scale c. Faces pain-rating scale d. McGill-Melzack pain questionnaire 7. In applying the principles of pain treatment, what is the first consideration? a. Treatment is based on client goals. b. A multidisciplinary approach is needed. c. The client must be believed about perceptions of own pain. d. Drug side effects must be prevented and managed. 8. Which route of administration is preferred if immediate analgesia and rapid titration are necessary? a. Intraspinal b. Patient-controlled analgesia (PCA) c. Intravenous (IV) d. Sublingual 9. When titrating an analgesic to manage pain, what is the priority goal? a. Administer smallest dose that provides relief with the fewest side effects. b. Titrate upward until the client is pain free. c. Titrate downwards to prevent toxicity. d. Ensure that the drug is adequate to meet the client’s subjective needs. 10. In educating clients about non-pharmaceutical alternatives, which topic could you delegate to an experienced LPN/LVN, who will function under your continued support and supervision? a. Therapeutic touch b. Use of heat and cold applications c. Meditation d. Transcutaneous electrical nerve stimulation (TENS) 11. Place the examples of drugs in the order of usage according to the World Health Organization (WHO) analgesic ladder. a. Morphine, hydromorphone, acetaminophen and lorazepam b. NSAIDs and corticosteroids c. Codeine, oxycodone and diphenhydramine , , 12. Which client is at greater risk for respiratory depression while receiving opioids for analgesia? a. An elderly chronic pain client with a hip fracture b. A client with a heroin addiction and back pain c. A young female client with advanced multiple myeloma d. A child with an arm fracture and cystic fibrosis 13. A client appears upset and tearful, but denies pain and refuses pain medication, because “my sibling is a drug addict and has ruined out lives.” What is the priority intervention for this client? a. Encourage expression of fears on past experiences b. Provide accurate information about use of pain medication c. Explain that addiction is unlikely among acute care clients. d. Seek family assistance in resolving this problem.