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NCLEX-RN Exam Questions - Part 130
1. The nurse is trying to help a mother understand what is happening with her son who has recently been diagnosed with paranoid schizophrenia. At present, he is experiencing hallucinations and delusions of persecution and suffers from poor hygiene. The nurse can best help her understand her sons condition by which of the following statements?
A) 'Sometimes these symptoms are caused by an overstimulation of a chemical called dopamine in the brain.'
B) 'Has anyone in your family ever had schizophrenia?'
C) 'If your son has a twin, he probably will eventually develop schizophrenia, too.'
D) 'Some of his symptoms may be a result of his lack of a strong mother-child bonding relationship.'
2. A male client is experiencing auditory hallucinations. His nurse enters the room and he tells her that his mother is talking to him, and he will take his medicine after she leaves. The nurse looks around the room and sees that she and the client are the only ones in the room. The nurses most therapeutic response will be:
A) 'I don - t see your mother in the room. Let - s talk about how you - re feeling.'
B) 'OK, I - ll come back later when you - re feeling more like taking your medicine.'
C) 'She may be here, but I can - t see her.'
D) 'Why don - t you finish talking to her, and I - ll wait.'
3. A female client with major depression stated that 'life is hopeless and not worth living.' The nurse should place highest priority on which of the following questions?
A) 'How has your appetite been recently?'
B) 'Have you thought about hurting yourself?'
C) 'How is your relationship with your husband?'
D) 'How has your depression affected your daily livingactivities?'
4. A client presented herself to the mental health center, describing the following symptoms: a weight loss of 20 lb in the past 2 months, difficulty concentrating, repeated absences from work due to 'fatigue,' and not wanting to get dressed in the morning. She leaves her recorded message on her telephone and has lost interest in answering the phone or doorbell. The nurses assessment of her behavior would most likely be:
A) Deep depression
B) Psychotic depression
C) Severe anxiety
D) Severe depression
5. A 48-year-old male client is hospitalized with mild ascites, bruising, and jaundice. He has a 20-year history of alcohol abuse. The client is diagnosed with cirrhosis.His serum ammonia level is high, indicating hepatic encephalopathy. He has esophageal varices. Which of the following may cause the varices to rupture?
A) Lifting heavy objects
B) Walking briskly
C) Ingestion of barbiturates
D) Ingestion of antacids
A) 'Sometimes these symptoms are caused by an overstimulation of a chemical called dopamine in the brain.'
B) 'Has anyone in your family ever had schizophrenia?'
C) 'If your son has a twin, he probably will eventually develop schizophrenia, too.'
D) 'Some of his symptoms may be a result of his lack of a strong mother-child bonding relationship.'
2. A male client is experiencing auditory hallucinations. His nurse enters the room and he tells her that his mother is talking to him, and he will take his medicine after she leaves. The nurse looks around the room and sees that she and the client are the only ones in the room. The nurses most therapeutic response will be:
A) 'I don - t see your mother in the room. Let - s talk about how you - re feeling.'
B) 'OK, I - ll come back later when you - re feeling more like taking your medicine.'
C) 'She may be here, but I can - t see her.'
D) 'Why don - t you finish talking to her, and I - ll wait.'
3. A female client with major depression stated that 'life is hopeless and not worth living.' The nurse should place highest priority on which of the following questions?
A) 'How has your appetite been recently?'
B) 'Have you thought about hurting yourself?'
C) 'How is your relationship with your husband?'
D) 'How has your depression affected your daily livingactivities?'
4. A client presented herself to the mental health center, describing the following symptoms: a weight loss of 20 lb in the past 2 months, difficulty concentrating, repeated absences from work due to 'fatigue,' and not wanting to get dressed in the morning. She leaves her recorded message on her telephone and has lost interest in answering the phone or doorbell. The nurses assessment of her behavior would most likely be:
A) Deep depression
B) Psychotic depression
C) Severe anxiety
D) Severe depression
5. A 48-year-old male client is hospitalized with mild ascites, bruising, and jaundice. He has a 20-year history of alcohol abuse. The client is diagnosed with cirrhosis.His serum ammonia level is high, indicating hepatic encephalopathy. He has esophageal varices. Which of the following may cause the varices to rupture?
A) Lifting heavy objects
B) Walking briskly
C) Ingestion of barbiturates
D) Ingestion of antacids
1. Right Answer: A
Explanation: (A) The most plausible theory to date is that dopamine causes an overstimulation in the brain, which results in the psychotic symptoms. (B) This statement will only create anxiety in the mother, and the genetic theory is only one of the etiological factors. (C) This statement will cause the mother much alarm, and nothing was mentioned about any other child. (D) The motherchild relationship is one of the previous theories examined, but it is not one to be emphasized, thereby causing a lot of anxiety for the mother.
2. Right Answer: A
Explanation: (A) This response uses the principle of reality orientation by the nurse telling the client that he or she does not see anything, but it does recognize his feelings. (B)This response does not make it clear that the nurse does not see anyone else in the room, and the nurse leaves the client alone to continue hallucinating. (C) This response leaves room for doubt; the nurse is further confusing the client by this statement. (D) This response reinforces the hallucination and implies that the nurse sees his mother, too.
3. Right Answer: B
Explanation: (A) Although eating habits are important to assess, they are less important than suicidal intent. (B) Maintenance of the clients life is the priority; assessment of suicidal intent is imperative. (C) Relationships and support systems are an important part of assessment, but they are less important than suicidal intent. (D) Daily living activities will give additional information about the level of depression, and are less significant than suicidal intent, although this information may give additional information about the actual plan for a suicidal attempt.
4. Right Answer: D
Explanation: (A) A client in deep depression would have been brought to the mental health center and would not be physically able to seek help for herself. (B) She is not manifesting psychotic symptoms in her behaviors. (C) The clients symptoms are more indicative of depression than anxiety. (D) Although the client was able to bring herself to the mental health center, the extent of her weight loss and the interference of symptoms with activities of daily living indicate that she is severely depressed.
5. Right Answer: A
Explanation: (A) Lifting heavy objects will increase intrathoracic pressure, thus placing the client at risk for rupturing esophageal varices. (B, C, D) This activity will not cause an increase in intrathoracic pressure.
Explanation: (A) The most plausible theory to date is that dopamine causes an overstimulation in the brain, which results in the psychotic symptoms. (B) This statement will only create anxiety in the mother, and the genetic theory is only one of the etiological factors. (C) This statement will cause the mother much alarm, and nothing was mentioned about any other child. (D) The motherchild relationship is one of the previous theories examined, but it is not one to be emphasized, thereby causing a lot of anxiety for the mother.
2. Right Answer: A
Explanation: (A) This response uses the principle of reality orientation by the nurse telling the client that he or she does not see anything, but it does recognize his feelings. (B)This response does not make it clear that the nurse does not see anyone else in the room, and the nurse leaves the client alone to continue hallucinating. (C) This response leaves room for doubt; the nurse is further confusing the client by this statement. (D) This response reinforces the hallucination and implies that the nurse sees his mother, too.
3. Right Answer: B
Explanation: (A) Although eating habits are important to assess, they are less important than suicidal intent. (B) Maintenance of the clients life is the priority; assessment of suicidal intent is imperative. (C) Relationships and support systems are an important part of assessment, but they are less important than suicidal intent. (D) Daily living activities will give additional information about the level of depression, and are less significant than suicidal intent, although this information may give additional information about the actual plan for a suicidal attempt.
4. Right Answer: D
Explanation: (A) A client in deep depression would have been brought to the mental health center and would not be physically able to seek help for herself. (B) She is not manifesting psychotic symptoms in her behaviors. (C) The clients symptoms are more indicative of depression than anxiety. (D) Although the client was able to bring herself to the mental health center, the extent of her weight loss and the interference of symptoms with activities of daily living indicate that she is severely depressed.
5. Right Answer: A
Explanation: (A) Lifting heavy objects will increase intrathoracic pressure, thus placing the client at risk for rupturing esophageal varices. (B, C, D) This activity will not cause an increase in intrathoracic pressure.
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