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NCLEX-RN Exam Questions - Part 127
1. The nurse in the mental health center is instructing a depressed client about the dietary restrictions necessary in taking her medication, which is a monoamine oxidase (MAO) inhibitor. Which of the following is she restricting from the clients diet?
A) Cream cheese
B) Fresh fruits
C) Aged cheese
D) Yeast bread
2. A client suffering from schizophrenia has been taking chlorpromazine (Thorazine) for 6 months. On one of his follow-up visits to the mental health center, the nurse reports to the physician that he has developed tardive dyskinesia. Which of the following symptoms might she have observed in the client to support this conclusion?
A) High fever, tachycardia, stupor, renal failure
B) Lip smacking, chewing, blinking, lateral jaw movements
C) Photosensitivity, orthostatic hypotension, dry mouth
D) Constipation, blurred vision, drowsiness
3. On morning rounds, the nurse found a manic-depressive client who is taking lithium in a confused mental state, vomiting, twitching, and exhibiting a coarse hand tremor. Which one of the following nursing actions is essential at this time?
A) Administer her next dosage of lithium, and then call the physician.
B) Withhold her lithium, and report her symptoms to the physician.
C) Place her on NPO to decrease the excretion of lithium from her body, and call the physician.
D) Contact the lab and request a lithium level in 30 minutes, and call the physician.
4. In acute episodes of mania, lithium is effective in 12 weeks, but it may take up to 4 weeks, or even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during the first few days or weeks of an acute episode to manage severe behavioral excitement and acute psychotic symptoms.In addition to the lithium, which one of the following medications might the physician prescribe?
A) Diazepam (Valium)
B) Haloperidol (Haldol)
C) Sertraline (Zoloft)
D) Alprazolam (Xanax)
5. The healthcare team determines that an elderly client has had progressive changes in memory over the last 2 years that have interfered with her personal, social, or occupational functioning. Her memory, learning, attention, and judgment have all been affected in some way. These symptoms describe which of the following conditions?
A) Dementia
B) Parkinsonism
C) Delirium
D) Mania
A) Cream cheese
B) Fresh fruits
C) Aged cheese
D) Yeast bread
2. A client suffering from schizophrenia has been taking chlorpromazine (Thorazine) for 6 months. On one of his follow-up visits to the mental health center, the nurse reports to the physician that he has developed tardive dyskinesia. Which of the following symptoms might she have observed in the client to support this conclusion?
A) High fever, tachycardia, stupor, renal failure
B) Lip smacking, chewing, blinking, lateral jaw movements
C) Photosensitivity, orthostatic hypotension, dry mouth
D) Constipation, blurred vision, drowsiness
3. On morning rounds, the nurse found a manic-depressive client who is taking lithium in a confused mental state, vomiting, twitching, and exhibiting a coarse hand tremor. Which one of the following nursing actions is essential at this time?
A) Administer her next dosage of lithium, and then call the physician.
B) Withhold her lithium, and report her symptoms to the physician.
C) Place her on NPO to decrease the excretion of lithium from her body, and call the physician.
D) Contact the lab and request a lithium level in 30 minutes, and call the physician.
4. In acute episodes of mania, lithium is effective in 12 weeks, but it may take up to 4 weeks, or even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during the first few days or weeks of an acute episode to manage severe behavioral excitement and acute psychotic symptoms.In addition to the lithium, which one of the following medications might the physician prescribe?
A) Diazepam (Valium)
B) Haloperidol (Haldol)
C) Sertraline (Zoloft)
D) Alprazolam (Xanax)
5. The healthcare team determines that an elderly client has had progressive changes in memory over the last 2 years that have interfered with her personal, social, or occupational functioning. Her memory, learning, attention, and judgment have all been affected in some way. These symptoms describe which of the following conditions?
A) Dementia
B) Parkinsonism
C) Delirium
D) Mania
1. Right Answer: C
Explanation: (A) Cream cheese does not contain tyramine, which might cause a hypertensive crisis. (B) Fresh fruits do not contain tyramine, which might cause a hypertensive crisis. (C) Aged or matured cheese combined with a monoamine oxidase predisposes the client to a hypertensive crisis. (D) Bread products raised with yeast do not contain tyramine.
2. Right Answer: B
Explanation: (A) These symptoms are found in clients with neuroleptic malignant syndrome. (B) These symptoms are found in clients with tardive dyskinesia. (C) These are normal side effects found in clients taking antipsychotic medications. (D) These are also normal side effects found in clients taking antipsychotic medications.
3. Right Answer: B
Explanation: (A) The client has lithium toxicity, and the nurse must withhold further dosages. (B) Because of her level of toxicity, further lithium could cause coma and death.The nurse needs further orders from the physician to stabilize the clients lithium level. (C) Ensuring adequate intake of sodium chloride will promote excretion of lithium and will assist in managing the clients lithiumtoxicity. (D) A lithium blood level must be drawn immediately to determine the seriousness of the toxicity and to provide the physician with data for medical orders.
4. Right Answer: B
Explanation: (A) Diazepam is an antianxiety medication and is not designed to reduce psychotic symptoms. (B) Haloperidol is an antipsychotic medication and may be used until the lithium takes effect. (C) Sertraline is an antidepressant and is used primarily to reduce symptoms of depression. (D) Alprazolam is an antianxiety medication and is not designed to reduce psychotic symptoms.
5. Right Answer: A
Explanation: (A) These changes are common characteristics of dementia. (B) Parkinsons disease affects the muscular system. Progressive memory changes are not presenting symptoms. (C) Delirium includes an altered level of consciousness, which is not found in dementia. (D) Mania includes symptoms of hyperactivity, flight of ideas, and delusions of grandeur.
Explanation: (A) Cream cheese does not contain tyramine, which might cause a hypertensive crisis. (B) Fresh fruits do not contain tyramine, which might cause a hypertensive crisis. (C) Aged or matured cheese combined with a monoamine oxidase predisposes the client to a hypertensive crisis. (D) Bread products raised with yeast do not contain tyramine.
2. Right Answer: B
Explanation: (A) These symptoms are found in clients with neuroleptic malignant syndrome. (B) These symptoms are found in clients with tardive dyskinesia. (C) These are normal side effects found in clients taking antipsychotic medications. (D) These are also normal side effects found in clients taking antipsychotic medications.
3. Right Answer: B
Explanation: (A) The client has lithium toxicity, and the nurse must withhold further dosages. (B) Because of her level of toxicity, further lithium could cause coma and death.The nurse needs further orders from the physician to stabilize the clients lithium level. (C) Ensuring adequate intake of sodium chloride will promote excretion of lithium and will assist in managing the clients lithiumtoxicity. (D) A lithium blood level must be drawn immediately to determine the seriousness of the toxicity and to provide the physician with data for medical orders.
4. Right Answer: B
Explanation: (A) Diazepam is an antianxiety medication and is not designed to reduce psychotic symptoms. (B) Haloperidol is an antipsychotic medication and may be used until the lithium takes effect. (C) Sertraline is an antidepressant and is used primarily to reduce symptoms of depression. (D) Alprazolam is an antianxiety medication and is not designed to reduce psychotic symptoms.
5. Right Answer: A
Explanation: (A) These changes are common characteristics of dementia. (B) Parkinsons disease affects the muscular system. Progressive memory changes are not presenting symptoms. (C) Delirium includes an altered level of consciousness, which is not found in dementia. (D) Mania includes symptoms of hyperactivity, flight of ideas, and delusions of grandeur.
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