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. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
- A. naloxone (Narcan)
- B. labetalol (Normodyne)
- C. neostigmine (Prostigmin)
- D. thiothixene (Navane)
Correct answer: A
Rationale: In this scenario, the client is experiencing respiratory depression due to opiate overdose. Naloxone (Narcan) is an opioid antagonist that can rapidly reverse the effects of opiates by competitively binding to opioid receptors and displacing the opiates. This action can restore normal respiration and consciousness. Labetalol (Normodyne) is a non-selective beta-blocker used to manage hypertension, not opioid-induced respiratory depression. Neostigmine (Prostigmin) is a cholinesterase inhibitor used to reverse neuromuscular blockade, not opioid overdose. Thiothixene (Navane) is an antipsychotic medication used to manage psychotic disorders, not opioid toxicity.
3. Regarding maternal and infant mortality and morbidity, a concern is that:
- A. a segment of the population is not receiving prenatal care.
- B. families may not prioritize quality health care.
- C. there might be an increase in the shortage of personnel in the maternity field.
- D. maternal-child health workers may lack adequate preparation.
Correct answer: A
Rationale: The correct answer is that a segment of the population is not receiving prenatal care. This is a significant concern as lack of access to prenatal care can lead to adverse outcomes for both the mother and the infant. Choice B is incorrect as it generalizes families as unconcerned, which may not be the case for all families. Choice C is also incorrect as there is no evidence or indication in the prompt to suggest an increase in the shortage of personnel. Choice D is not directly related to the concern mentioned in the prompt, which specifically focuses on the lack of prenatal care.
4. A middle-aged woman tells the nurse that she has been experiencing irregular menses for the past six months. The nurse should assess the woman for other symptoms of:
- A. climacteric
- B. menopause
- C. perimenopause
- D. postmenopause
Correct answer: C
Rationale: Perimenopause refers to a period in which hormonal changes occur gradually, ovarian function diminishes, and menses become irregular. It typically lasts around five years. In the case of the middle-aged woman experiencing irregular menses for six months, she aligns with perimenopause as it involves irregular menstrual cycles, one of the common symptoms during this transitional phase. Climacteric is a term describing the period of life with physiologic changes leading to the end of a woman's reproductive ability but not specifically characterized by irregular menses. Menopause marks the permanent cessation of menses and does not involve the transitional irregularities seen in perimenopause. Postmenopause is the phase after the completion of menopausal changes.
5. During a voice test, how should the nurse provide words for the client to repeat?
- A. Spoken in a soft tone of voice by the nurse about 5 feet in front of the client
- B. Whispered by the nurse from the client's side at a distance of 1 to 2 feet from the ear being tested
- C. Spoken by the nurse from the client's side in a normal tone of voice about 10 feet from the ear being tested
- D. Whispered at a distance of 20 feet by the nurse while he or she is standing in front of the client
Correct answer: B
Rationale: During a voice test, the nurse should whisper words from the client's side at a distance of 1 to 2 feet from the ear being tested. This distance helps prevent transmission around the head and ensures accurate testing of one ear at a time. By standing close to the client and whispering, the nurse prevents lip-reading and compensatory actions by the client. The client with normal hearing should be able to repeat each word correctly. Choices A, C, and D are incorrect. Choice A is wrong as the voice should be whispered, not spoken in a soft tone. Choice C is inaccurate because a distance of 10 feet is too far for precise testing. Choice D is incorrect as whispering from a distance of 20 feet would not effectively test the client's hearing.
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