NCLEX-PN Archer review QUESTIONS |\ |\ |\ |\
WITH ANSWERS |\
The nurse is caring for a client exhibiting signs of poor
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle coordination, stooped posture, and slow
|\ |\ |\ |\ |\ |\
movements. Which medication is most likely to cause |\ |\ |\ |\ |\ |\ |\ |\
these symptoms? |\
Haloperidol
Rationale:
Haloperidol is a typical antipsychotic that may adversely cause
|\ |\ |\ |\ |\ |\ |\ |\ |\
extrapyramidal side effects (EPS). These effects include akathisia, |\ |\ |\ |\ |\ |\ |\
dystonia, pseudo-parkinsonism, and/or tardive dyskinesia.
|\ |\ |\ |\ |\ |\
Tardive dyskinesia is an adverse effect that occurs with
|\ |\ |\ |\ |\ |\ |\ |\ |\
antipsychotics and has an onset of months to years while on the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication.
While reviewing the morning labs of your client, you see
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the following results from their thyroid panel. What
|\ |\ |\ |\ |\ |\ |\ |\
diagnosis does the nurse suspect? |\ |\ |\ |\
TSH: 7 mU/L |\ |\
T4: 1.0 mcg/dL
|\ |\
T3: 2.0 ng/dL
|\ |\
Hypothyroidism
Rationale:
Hypothyroidism would be manifested with an increased thyroid- |\ |\ |\ |\ |\ |\ |\
stimulating hormone level and decreased T4 and T3, as shown in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
these labs. Because of the increased TSH level, the thyroid gland
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is tricked into thinking that there is enough thyroid hormone
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,already in the body and does not secrete more. The decreased
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
T3 and T4 levels cause hypothyroidism symptoms, such as
|\ |\ |\ |\ |\ |\ |\ |\ |\
weight gain and fatigue. |\ |\ |\
The nurse reinforces teaching to a client with
|\ |\ |\ |\ |\ |\ |\ |\
hypertension about the newly prescribed furosemide. |\ |\ |\ |\ |\ |\
Which of the following should the nurse include in the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
teaching?
Take this medication in the early part of the day
|\ |\ |\ |\ |\ |\ |\ |\ |\
Rationale:
Furosemide is a loop diuretic and may be indicated for conditions |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
such as heart failure or hypertension. The client should be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
instructed to take this medication in the earlier part of the day to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
avoid nocturia.
|\ |\
The nurse is assessing a 7-month-old infant. At this age,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which of the following reflexes would the nurse expect to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
no longer be present?
|\ |\ |\ |\
Select all that apply. |\ |\ |\
Rooting
Moro
Palmar
Tonic neck |\
Rationale:
- The Rooting reflex should disappear by 3-4 months of age. It
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
occurs when the infants turn their face toward stimulation (such
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
as stroking their cheek) and make sucking (rooting) motions with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the mouth. This reflex helps to ensure successful feeding.
|\ |\ |\ |\ |\ |\ |\ |\
- The Moro reflex should disappear by 5-6 months of age. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reflex is a response to a sudden loss of support. When support is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
removed, the infant spreads out the arms and cries. |\ |\ |\ |\ |\ |\ |\ |\
,- The Palmar reflex should disappear by 2-3 months of age. When
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
an object is placed in an infant's hand, and the palm is stroked,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the fingers will close reflexively.
|\ |\ |\ |\
- The tonic neck reflex disappears around 4 months of age. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reflex is elicited by turning the infant's head to one side and is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
considered positive if the infant extends the extremities on the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
side that the head is turned toward, and flexes the extremities on
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the opposite side.
|\ |\ |\
The nurse is caring for a client with diabetes mellitus.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following laboratory data requires follow-up?
|\ |\ |\ |\ |\ |\ |\
|\
Select all that apply. |\ |\ |\
Hemoglobin A1C 8.5% [< 5.7%] |\ |\ |\ |\
Creatinine 1.9 mg/dL [0.6-1.2 mg/dL] |\ |\ |\ |\
BUN 25 mg/dL [10-20 mg/dL] |\ |\ |\ |\
Proteinuria
Rationale:
The client's hemoglobin A1C is elevated as the therapeutic goal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for a client with diabetes is to attain less than 7%. This elevated
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
level is causing the client to experience an insult to the kidneys,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which is evident by the increased BUN (normal 10-20 mg/dL) and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
creatinine (normal 0.6-1.2 mg/dL). Finally, proteinuria is further
|\ |\ |\ |\ |\ |\ |\ |\ |\
evidence that this client is experiencing diabetic nephropathy.
|\ |\ |\ |\ |\ |\ |\
The nurse is caring for the following assigned clients.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Which client should the nurse follow up with first?
|\ |\ |\ |\ |\ |\ |\ |\
A client requesting diphenhydramine after starting an
|\ |\ |\ |\ |\ |\ |\
intravenous antibiotic. |\
Rationale:
, A client requesting diphenhydramine following the initiation of an
|\ |\ |\ |\ |\ |\ |\ |\
antibiotic requires immediate follow-up because the client could
|\ |\ |\ |\ |\ |\ |\ |\ |\
be experiencing an allergic reaction ranging from mild to severe.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Thus, the nurse should quickly follow-up with this client.
|\ |\ |\ |\ |\ |\ |\ |\
The nurse is assessing a 6-year-old client with asthma.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following findings is of highest concern?
|\ |\ |\ |\ |\ |\ |\ |\
Silent chest |\
Rationale:
Silent chest is the assessment finding of most concern. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
refers to the inability to auscultate any lung sounds. There is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
complete obstruction of the client's airway, and therefore the
|\ |\ |\ |\ |\ |\ |\ |\ |\
inability to move air. When complete obstruction occurs, this is a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medical emergency. This assessment finding is of most concern
|\ |\ |\ |\ |\ |\ |\ |\ |\
because the client has lost their airway.|\ |\ |\ |\ |\ |\
The nurse is caring for a client with newly prescribed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
zolpidem. The nurse understands that this medication is |\ |\ |\ |\ |\ |\ |\ |\
indicated for which condition? |\ |\ |\
Insomnia
Rationale:
Zolpidem is a non-benzodiazepine indicated in the treatment of
|\ |\ |\ |\ |\ |\ |\ |\ |\
insomnia.
*NGN* The nurse is caring for a 47-year-old male in the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
outpatient clinic |\
Orders
Discharge home |\
Schedule a follow-up appointment in four weeks |\ |\ |\ |\ |\ |\
Sertraline 50 mg PO Daily |\ |\ |\ |\
Clonidine 0.1 mg PO Daily |\ |\ |\ |\
WITH ANSWERS |\
The nurse is caring for a client exhibiting signs of poor
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle coordination, stooped posture, and slow
|\ |\ |\ |\ |\ |\
movements. Which medication is most likely to cause |\ |\ |\ |\ |\ |\ |\ |\
these symptoms? |\
Haloperidol
Rationale:
Haloperidol is a typical antipsychotic that may adversely cause
|\ |\ |\ |\ |\ |\ |\ |\ |\
extrapyramidal side effects (EPS). These effects include akathisia, |\ |\ |\ |\ |\ |\ |\
dystonia, pseudo-parkinsonism, and/or tardive dyskinesia.
|\ |\ |\ |\ |\ |\
Tardive dyskinesia is an adverse effect that occurs with
|\ |\ |\ |\ |\ |\ |\ |\ |\
antipsychotics and has an onset of months to years while on the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication.
While reviewing the morning labs of your client, you see
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the following results from their thyroid panel. What
|\ |\ |\ |\ |\ |\ |\ |\
diagnosis does the nurse suspect? |\ |\ |\ |\
TSH: 7 mU/L |\ |\
T4: 1.0 mcg/dL
|\ |\
T3: 2.0 ng/dL
|\ |\
Hypothyroidism
Rationale:
Hypothyroidism would be manifested with an increased thyroid- |\ |\ |\ |\ |\ |\ |\
stimulating hormone level and decreased T4 and T3, as shown in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
these labs. Because of the increased TSH level, the thyroid gland
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is tricked into thinking that there is enough thyroid hormone
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,already in the body and does not secrete more. The decreased
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
T3 and T4 levels cause hypothyroidism symptoms, such as
|\ |\ |\ |\ |\ |\ |\ |\ |\
weight gain and fatigue. |\ |\ |\
The nurse reinforces teaching to a client with
|\ |\ |\ |\ |\ |\ |\ |\
hypertension about the newly prescribed furosemide. |\ |\ |\ |\ |\ |\
Which of the following should the nurse include in the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
teaching?
Take this medication in the early part of the day
|\ |\ |\ |\ |\ |\ |\ |\ |\
Rationale:
Furosemide is a loop diuretic and may be indicated for conditions |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
such as heart failure or hypertension. The client should be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
instructed to take this medication in the earlier part of the day to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
avoid nocturia.
|\ |\
The nurse is assessing a 7-month-old infant. At this age,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which of the following reflexes would the nurse expect to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
no longer be present?
|\ |\ |\ |\
Select all that apply. |\ |\ |\
Rooting
Moro
Palmar
Tonic neck |\
Rationale:
- The Rooting reflex should disappear by 3-4 months of age. It
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
occurs when the infants turn their face toward stimulation (such
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
as stroking their cheek) and make sucking (rooting) motions with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the mouth. This reflex helps to ensure successful feeding.
|\ |\ |\ |\ |\ |\ |\ |\
- The Moro reflex should disappear by 5-6 months of age. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reflex is a response to a sudden loss of support. When support is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
removed, the infant spreads out the arms and cries. |\ |\ |\ |\ |\ |\ |\ |\
,- The Palmar reflex should disappear by 2-3 months of age. When
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
an object is placed in an infant's hand, and the palm is stroked,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the fingers will close reflexively.
|\ |\ |\ |\
- The tonic neck reflex disappears around 4 months of age. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reflex is elicited by turning the infant's head to one side and is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
considered positive if the infant extends the extremities on the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
side that the head is turned toward, and flexes the extremities on
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the opposite side.
|\ |\ |\
The nurse is caring for a client with diabetes mellitus.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following laboratory data requires follow-up?
|\ |\ |\ |\ |\ |\ |\
|\
Select all that apply. |\ |\ |\
Hemoglobin A1C 8.5% [< 5.7%] |\ |\ |\ |\
Creatinine 1.9 mg/dL [0.6-1.2 mg/dL] |\ |\ |\ |\
BUN 25 mg/dL [10-20 mg/dL] |\ |\ |\ |\
Proteinuria
Rationale:
The client's hemoglobin A1C is elevated as the therapeutic goal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for a client with diabetes is to attain less than 7%. This elevated
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
level is causing the client to experience an insult to the kidneys,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which is evident by the increased BUN (normal 10-20 mg/dL) and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
creatinine (normal 0.6-1.2 mg/dL). Finally, proteinuria is further
|\ |\ |\ |\ |\ |\ |\ |\ |\
evidence that this client is experiencing diabetic nephropathy.
|\ |\ |\ |\ |\ |\ |\
The nurse is caring for the following assigned clients.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Which client should the nurse follow up with first?
|\ |\ |\ |\ |\ |\ |\ |\
A client requesting diphenhydramine after starting an
|\ |\ |\ |\ |\ |\ |\
intravenous antibiotic. |\
Rationale:
, A client requesting diphenhydramine following the initiation of an
|\ |\ |\ |\ |\ |\ |\ |\
antibiotic requires immediate follow-up because the client could
|\ |\ |\ |\ |\ |\ |\ |\ |\
be experiencing an allergic reaction ranging from mild to severe.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Thus, the nurse should quickly follow-up with this client.
|\ |\ |\ |\ |\ |\ |\ |\
The nurse is assessing a 6-year-old client with asthma.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following findings is of highest concern?
|\ |\ |\ |\ |\ |\ |\ |\
Silent chest |\
Rationale:
Silent chest is the assessment finding of most concern. This
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
refers to the inability to auscultate any lung sounds. There is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
complete obstruction of the client's airway, and therefore the
|\ |\ |\ |\ |\ |\ |\ |\ |\
inability to move air. When complete obstruction occurs, this is a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medical emergency. This assessment finding is of most concern
|\ |\ |\ |\ |\ |\ |\ |\ |\
because the client has lost their airway.|\ |\ |\ |\ |\ |\
The nurse is caring for a client with newly prescribed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
zolpidem. The nurse understands that this medication is |\ |\ |\ |\ |\ |\ |\ |\
indicated for which condition? |\ |\ |\
Insomnia
Rationale:
Zolpidem is a non-benzodiazepine indicated in the treatment of
|\ |\ |\ |\ |\ |\ |\ |\ |\
insomnia.
*NGN* The nurse is caring for a 47-year-old male in the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
outpatient clinic |\
Orders
Discharge home |\
Schedule a follow-up appointment in four weeks |\ |\ |\ |\ |\ |\
Sertraline 50 mg PO Daily |\ |\ |\ |\
Clonidine 0.1 mg PO Daily |\ |\ |\ |\
