NCLEX-PN
Best NCLEX Next Gen Prep
1. During a health assessment interview, the client tells the nurse that she has some vaginal drainage. The client is concerned that it may indicate a sexually transmitted infection (STI). Which statement should the nurse make to the client?
- A. 'When was your last gynecological checkup?'
- B. 'Have you been engaging in unprotected sexual intercourse?'
- C. Don't worry about the discharge. Some vaginal discharge is normal.'
- D. 'I need some more information about the discharge. What color is it?'
Correct answer: D
Rationale: If the client reports having vaginal drainage and concerns about a possible STI, it is essential for the nurse to gather more information about the discharge. Asking about the color of the discharge helps in determining its characteristics, which can be crucial in identifying potential causes. The color, consistency, odor, and associated symptoms can provide valuable insights into the underlying issue. Statements A and B are relevant questions but not as immediate or specific to addressing the client's concern about the discharge. Statement C dismisses the client's worries and does not encourage further assessment, which is not appropriate in this context.
2. When removing hard contact lenses from an unresponsive client, what should the nurse do?
- A. Gently irrigate the eye with an irrigating solution from the inner canthus outward.
- B. Grasp the lens with a gentle pinching motion.
- C. Don sterile gloves before attempting the procedure.
- D. Ensure that the lens is centered on the cornea before gently manipulating the lids to release the lens.
Correct answer: D
Rationale: When removing hard contact lenses, it is crucial to ensure that the lens is correctly positioned on the cornea before removal. Directly grasping the lens can potentially scratch the cornea, so it is essential to gently manipulate the lids to release the lens safely. Gently irrigating the eye is unnecessary and could be harmful, especially without the client's cooperation. Wearing sterile gloves is also unnecessary for this specific procedure. Therefore, the correct approach is to ensure the proper positioning of the lens and then gently manipulate the lids to release it. Options A and C are incorrect because irrigating the eye and wearing sterile gloves are not necessary for contact lens removal. Option B is incorrect as directly grasping the lens can be harmful to the cornea.
3. What is the therapeutic range for carbamazepine (Tegretol)?
- A. 7-12 mcg/mL
- B. 4-10 mcg/mL
- C. 10-14 mcg/mL
- D. 1-5 mcg/mL
Correct answer: B
Rationale: The therapeutic range for carbamazepine (Tegretol) is 4-10 mcg/mL. This range is established based on the optimal balance between effectiveness and safety. Choices A, C, and D are outside the therapeutic range for carbamazepine, which could lead to suboptimal treatment outcomes or increased risk of toxicity. Choice B (4-10 mcg/mL) is the correct range recommended for therapeutic efficacy while minimizing adverse effects.
4. When evaluating a kinetic family drawing, which of the following actions is most effective?
- A. asking the child to draw their family doing something
- B. offering specific suggestions of what to include in the drawing
- C. discouraging the child from talking about the drawing
- D. noting the omission of any family members
Correct answer: D
Rationale: When evaluating a kinetic family drawing, noting the omission of any family members is an effective action. It is crucial to observe and analyze all aspects of the drawing, including what is missing. This can provide valuable insights into the child's perception and relationships within the family. Asking the child to draw their family doing something (Choice A) is more related to initial instruction rather than evaluation. Offering specific suggestions (Choice B) can influence the child's drawing and should be avoided to maintain the authenticity of the representation. Discouraging the child from talking about the drawing (Choice C) is counterproductive as verbal expression can provide additional context and understanding.
5. Which of the following home-care strategies is most likely to negatively impact the body image of a client with Cushing's syndrome?
- A. providing safety measures to prevent falls
- B. taking medications as prescribed
- C. wearing a medical ID indicating Cushing's syndrome
- D. having regular health assessments
Correct answer: C
Rationale: All of the strategies listed are essential components of home care for a client with Cushing's syndrome. However, wearing a medical ID indicating Cushing's syndrome is the correct answer as it can have a negative impact on body image. This choice may constantly remind the client of their condition, potentially affecting their self-image and confidence. On the contrary, providing safety measures to prevent falls (Choice A) would enhance body image by promoting safety and preventing injuries. Taking medications as prescribed (Choice B) is likely to improve body image by managing symptoms effectively. Having regular health assessments (Choice D) demonstrates good self-care and can positively contribute to body image by showing a commitment to maintaining health.
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