NCLEX-PN
Psychosocial Integrity Nclex PN Questions
1. A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:
- A. affects both genders equally.
- B. is a chronic, deteriorating disease with periods of remission.
- C. is usually diagnosed in early adulthood.
- D. does not have a clear protective hormone effect delaying diagnosis.
Correct answer: B
Rationale: The correct answer is B: 'is a chronic, deteriorating disease with periods of remission.' While choices A, C, and D contain some truths about schizophrenia, they do not directly address the prognosis aspect of the question. Schizophrenia can affect both men and women equally, is typically diagnosed in early adulthood, and does not have a known protective hormone effect that delays diagnosis. Choice B accurately reflects the chronic and fluctuating nature of the disease, which is essential for understanding its long-term course.
2. The client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept available during the test?
- A. Atropine sulfate
- B. Furosemide
- C. Prostigmin
- D. Promethazine
Correct answer: A
Rationale: During a Tensilon test to check for Myasthenia Gravis, Atropine sulfate should be kept available as it is the antidote for Tensilon and is administered to manage cholinergic crises that may occur during the test. Atropine sulfate helps counteract the excessive stimulation of the parasympathetic nervous system caused by Tensilon. Furosemide (choice B) is a diuretic and not related to managing Tensilon-induced crises. Prostigmin (choice C) is used to treat Myasthenia Gravis itself, not for managing the effects of Tensilon. Promethazine (choice D) is an antiemetic and antianxiety agent, which is not necessary for a Tensilon test. Therefore, Atropine sulfate (choice A) is the correct medication to have available during a Tensilon test, making choices B, C, and D incorrect in this context.
3. The nurse is assisting the RN with discharge instructions for a client with an implantable defibrillator. What discharge instruction is essential?
- A. "You can eat food prepared in a microwave."?
- B. "You should avoid moving the shoulder on the side of the defibrillator site for 6 weeks."?
- C. "You should use your cellphone on your right side."?
- D. "You will be able to fly on a commercial airliner with the defibrillator in place."?
Correct answer: C
Rationale: The essential discharge instruction for a client with an implantable defibrillator is to use any battery-operated machinery on the opposite side, including cellphones. This is to prevent interference with the device. Additionally, the client should monitor their pulse rate and report any dizziness or fainting, which could indicate issues with the defibrillator. Choices A, B, and D are incorrect because clients with implantable defibrillators can eat food prepared in the microwave, move their shoulder on the affected side after the initial healing period, and are allowed to fly on commercial airliners with the defibrillator in place.
4. A client with pancreatitis has been transferred to the intensive care unit. Which order would the nurse anticipate?
- A. Blood pressure monitoring every 15 minutes
- B. Insertion of a Levine tube
- C. Continuous cardiac monitoring
- D. Administration of pain medication every 4 hours
Correct answer: B
Rationale: In a client with pancreatitis who frequently experiences nausea and vomiting, insertion of a Levine tube is often anticipated to decompress the stomach and rest the bowel, helping to alleviate symptoms. This intervention is crucial in managing the gastrointestinal symptoms associated with pancreatitis. Blood pressure monitoring every 15 minutes may be necessary in some cases, but it is not a routine order for pancreatitis, making option A less likely. Continuous cardiac monitoring could be required based on the individual's condition, but it is not typically the first priority in pancreatitis management, so option C is not the most anticipated order. While pain medication administration is essential for managing discomfort, the priority in this scenario, especially considering the symptoms of nausea and vomiting, would be decompression with a Levine tube to address gastrointestinal issues, making option D less likely.
5. A contraindication for topical corticosteroid use in a client with atopic dermatitis (eczema) is:
- A. parasitic infection
- B. fungal infection
- C. spirochetal infection
- D. viral infection
Correct answer: D
Rationale: Topical corticosteroids are mainly used for their localized effects. When treating atopic dermatitis with a steroidal preparation, there is a risk of the site being vulnerable to invasion by organisms. Viruses like herpes simplex or varicella zoster pose a threat of disseminated infection. Therefore, viral infection is a contraindication for topical corticosteroid use in clients with atopic dermatitis. It is crucial to educate clients using topical corticosteroids to avoid crowds or people with infections and to promptly report any signs of infection. Choices A, B, and C (parasitic, fungal, and spirochetal infections) are not typically contraindications for topical corticosteroid use in the context of atopic dermatitis, as these agents do not pose the same risk of disseminated infection or systemic effects as viral infections.
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