NCLEX-PN
2024 Nclex Questions
1. When medications have an additive, synergistic, or antagonistic effect on a tissue, a ________ reaction has occurred.
- A. pharmaceutical
- B. pharmacodynamic
- C. pharmacokinetic
- D. drug incompatibility
Correct answer: B
Rationale: The correct answer is 'pharmacodynamic.' Pharmacodynamics pertain to the effect of a drug on receptors, explaining how drugs affect tissues. Pharmaceutical reactions refer to chemical reactions between drugs before administration or absorption, not their effect on tissues. Pharmacokinetic reactions involve how the body affects the drug, not the tissue. Drug incompatibilities are essentially pharmaceutical reactions, not the specific effects on tissues seen in pharmacodynamic reactions.
2. A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:
- A. is pregnant.
- B. is immunocompromised.
- C. is allergic to neomycin.
- D. has a cold.
Correct answer: D
Rationale: A client can receive the MMR vaccine if he or she has a cold. A simple cold without fever does not preclude vaccination. Pregnant women and immunocompromised individuals cannot receive the MMR vaccine due to the live rubella component, which may lead to birth defects or disease. Choice C is incorrect because individuals with anaphylactic reactions to neomycin should not receive the measles vaccine according to the American Academy of Pediatrics.
3. A client reports that he is 'talking to the voices.' The nurse observes this behavior. The nurse's next action should be:
- A. touching the client to help him return to reality
- B. leaving the client alone until reality returns
- C. asking the client to describe what is happening
- D. telling the client there are no voices
Correct answer: A
Rationale: When a client reports talking to voices, the nurse should engage in a gentle touch to help the client return to reality. It is important for the nurse to acknowledge the client's experience and attempt to redirect them gently. Touch can provide grounding and connection. Asking the client to describe what is happening can be overwhelming and might exacerbate the situation. Leaving the client alone may not be safe or therapeutic as the client may need support. Telling the client there are no voices denies their reality and is not helpful in managing their experience.
4. Tricyclics (Antidepressants) can sometimes have which of the following adverse effects on patients diagnosed with depression?
- A. Shortness of breath
- B. Fainting
- C. Large intestine ulcers
- D. Distal muscular weakness
Correct answer: B
Rationale: The correct answer is 'Fainting.' Tricyclic antidepressants can cause fainting and hypotension as adverse effects. Shortness of breath (Choice A) is not a common side effect of tricyclics. Large intestine ulcers (Choice C) are not typically associated with tricyclic antidepressants. Distal muscular weakness (Choice D) is not a common adverse effect of tricyclics but is commonly associated with other medications.
5. A client with schizophrenia says, 'I'm away for the day ... but don't think we should play "? or do we have feet of clay?' Which alteration in the client's speech does the nurse document?
- A. Neologism
- B. Word salad
- C. Clang association
- D. Associative looseness
Correct answer: D
Rationale: The correct answer is 'Associative looseness.' In the provided speech, the client shows associative looseness by making loose connections between phrases without a clear logical link. Clang association involves rhyming words without regard for their meaning. Neologism refers to made-up words with specific meaning to the client, and word salad is a jumble of words that lack coherence either to the listener or the client. Understanding these speech patterns associated with schizophrenia is crucial in identifying the specific alteration in speech displayed by the client in this scenario.
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