NCLEX-PN
Best NCLEX Next Gen Prep
1. 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.
2. While assisting with data collection, the nurse asks the client to close their jaws tightly. Subsequently, the nurse tries to open the closed jaws. In this technique, the nurse is assessing the motor function of which nerve?
- A. Trochlear nerve
- B. Abducens nerve
- C. Trigeminal nerve
- D. Oculomotor nerve
Correct answer: C
Rationale: The correct answer is C: Trigeminal nerve. To test the motor function of the trigeminal nerve (cranial nerve V), the nurse assesses the muscles of mastication by asking the client to clench their teeth. By trying to separate the client's jaws, the nurse evaluates the strength of the temporal and masseter muscles innervated by the trigeminal nerve. This technique helps assess if the trigeminal nerve is functioning properly. Choices A, B, and D are incorrect because they relate to other cranial nerves that are not involved in the specific motor function being tested in this scenario. These nerves are usually assessed through different examinations such as assessing the pupils and extraocular movements, which are not part of the jaw clenching and opening technique described in the question.
3. What is the intent of the Patient Self Determination Act (PSDA) of 1990?
- A. Enhance personal control over healthcare decisions.
- B. Encourage medical treatment decision making prior to need.
- C. Establish a federal standard for living wills and durable powers of attorney.
- D. Emphasize client education.
Correct answer: B
Rationale: The correct answer is B: The purpose of the PSDA is to encourage medical treatment decision-making before it becomes necessary. This legislation aims to empower individuals to make their own healthcare choices in advance. Choice A is incorrect because while enhancing personal control over healthcare decisions is important, the primary goal of the PSDA is to facilitate medical decision-making before the need arises. Choice C is incorrect as the PSDA does not establish a federal standard for living wills and durable powers of attorney; instead, it encourages individuals to create their own advance directives according to state-specific regulations. Choice D is incorrect because while client education is valuable, the main focus of the PSDA is on empowering individuals to plan for their future healthcare needs.
4. During a routine health screening, the nurse should talk to the parents of a 1-year-old child about which of the following?
- A. the potential hazards of accidents
- B. appropriate nutrition now that the child has been weaned from breastfeeding
- C. toilet training
- D. how to prevent accidents in the house
Correct answer: A
Rationale: During a routine health screening for a 1-year-old child, discussing the potential hazards of accidents is crucial. Accidents are the primary source of injury in children and can be life-threatening. Addressing appropriate nutrition now that the child has been weaned from breastfeeding should have already been discussed. Toilet training is important but is typically addressed at a later age as one year is too early for this milestone. While preventing accidents in the house is important, focusing on the potential hazards of accidents in general is more comprehensive and critical for the child's safety.
5. When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?
- A. family history of stroke
- B. ovaries removed before age 45
- C. frequent hot flashes and/or night sweats
- D. unexplained vaginal bleeding
Correct answer: D
Rationale: When obtaining a health history on a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication for hormone replacement therapy. This is because it can be a sign of underlying issues that need to be addressed before starting hormone therapy. A family history of stroke is not a contraindication for hormone replacement therapy unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 is not a contraindication for hormone replacement therapy. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy; therefore, they are not contraindications.
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