NCLEX COMPREHENSIVE EXAM 1 EXAM QUESTIONS , CORRECT VERIFIED ANSWERS AND RATIONALE 100% PASS

NCLEX COMPREHENSIVE EXAM 1 EXAM QUESTIONS , CORRECT VERIFIED ANSWERS AND RATIONALE 100% PASSA nurse is reviewing the health care provider's (HCP's) admitting prescriptions for a post-menopausal woman scheduled for a dilatation and curettage. The nurse is unable to decipher the handwriting but thinks the medication prescription reads either metoprolol or topiramate. What should the nurse do next? -Ask the client if she has hypertension. -Ask the client if she has migraines. -Call the HCP to clarify the prescription. -Ask the pharmacist to interpret the prescription. Answer Call the HCP to clarify the prescription. Rational: The nurse must clarify this prescription with the admitting HCP to ensure medication accuracy and client safety. In health care settings without computerized medical records or computer prescribing, misinterpretation of handwriting remains a leading cause of medication errors. It is not safe practice to question the client regarding a diagnosis and assume the medication is correctly prescribed. The pharmacist will need clarification of the prescription as well. It is not the role of the pharmacist to interpret the prescription. A physician orders meperidine 30 mg I.M. as preoperative medication for a school-age child who weighs 66 lb (30 kg). The meperidine is supplied as 50 mg/mL. How much meperidine should the nurse administer? - 0.3 mL - 0.5 mL - 0.6 mL - 0.8 mL Answer 0.6 mL A client with acute asthma is experiencing inspiratory and expiratory wheezing, and decreased forced expiratory volume. What is the nurse's priority intervention? - Beta-adrenergic blockers - Bronchodilators - Inhaled steroids - Oral steroids Answer Bronchodilators Rational: Bronchodilators are the first line of treatment for asthma because bronchoconstriction is the cause of reduced airflow. Beta-adrenergic blockers aren't used to treat asthma, and can cause bronchoconstriction. Inhaled or oral steroids may be given to reduce inflammation but aren't used for emergency relief. A client who's at high risk for suicide needs close supervision. To best ensure the client's safety, the nurse should: - check the client frequently at irregular intervals. - assure the client that the nurse will hold in confidence anything the client says. - repeatedly discuss the client's previous suicide attempts. - disregard decreased communication by the client because decreased communication is typical of suicidal clients. Answer check the client frequently at irregular intervals. Rational: Checking the client frequently but at irregular intervals prevents the client from anticipating when observation will take place and altering behavior in a misleading way at these times. Assuring the client that information will be held in confidence may encourage the client to try to manipulate the nurse or seek attention by claiming a secret suicide plan. Repeatedly discussing previous suicide attempts may reinforce the client's suicidal ideas. Decreased communication is a sign of withdrawal that may indicate the client has decided to commit suicide; the nurse shouldn't disregard it. The nurse is assigned to care for a client with early stage Alzheimer's disease. Which nursing interventions should be included in the client's care plan? Select all that apply. -Make frequent changes in the client's routine. -Engage the client in complex discussions to help improve memory. -Furnish the client's environment with familiar possessions. -Assist the client with activities of daily living (ADLs) as necessary. -Assign tasks in simple steps. Answer -Furnish the client's environment with familiar possessions. -Assist the client with activities of daily living (ADLs) as necessary. -Assign tasks in simple steps. Rational: A client with Alzheimer's disease experiences progressive deterioration in cognitive functioning. Familiar possessions may help to orient the client. The client should be encouraged to perform ADLs as much as possible but may need assistance with certain activities. Using a step-by-step approach helps the client complete tasks independently. A client with Alzheimer's disease functions best with consistent routines. Complex discussions do not improve the memory of a client with Alzheimer's disease. A client is receiving chemotherapy and tells the nurse about also taking herbal therapy. What should the nurse do next? - Determine what substances the client is using, and make sure that the health care provider (HCP) is aware of all therapies the client is using. - Guide the client in the decision-making process to select either Western or alternative medicine. - Encourage the client to seek alternative modalities that do not require the ingestion of substances. - Recommend that the client stop using the alternative medicines immediately. Answer Determine what substances the client is using, and make sure that the health care provider (HCP) is aware of all therapies the client is using. Rational: