NCLEX-RN
Saunders NCLEX RN Practice Questions
1. Which of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?
- A. Atypical antipsychotic drugs
- B. First-generation antipsychotic drugs
- C. Third-generation antipsychotic drugs
- D. Dopamine system stabilizers
Correct answer: B
Rationale: The correct answer is first-generation antipsychotic drugs. These drugs are potent antagonists of D2, D3, and D4 receptors, making them effective in treating target symptoms but also leading to numerous extrapyramidal side effects due to the blockade of D2 receptors. Atypical or second-generation antipsychotic drugs, as mentioned in choice A, are relatively weak D2 blockers, which results in a lower incidence of extrapyramidal side effects. Third-generation antipsychotic drugs, as in choice C, and dopamine system stabilizers, as in choice D, are not typically associated with significant extrapyramidal effects compared to first-generation antipsychotics.
2. Examples of preservation of self-integrity include all of the following except:
- A. Using assistive equipment to move bariatric clients
- B. Participating in wellness programs
- C. Accepting the challenge of caring for clients with oppositional beliefs or practices
- D. Using hand hygiene and personal protective equipment
Correct answer: C
Rationale: Preservation of self-integrity involves actions that support the nurse's well-being and ethical standards. Using assistive equipment to move bariatric clients and practicing hand hygiene and personal protective equipment are essential aspects of maintaining physical health and safety, contributing to self-care. Participating in wellness programs further enhances self-care by promoting overall well-being. However, accepting the challenge of caring for clients with oppositional beliefs or practices can be emotionally taxing and may compromise a nurse's self-integrity if it leads to significant moral distress or ethical conflicts. In such situations, it is important for nurses to prioritize their well-being and ethical values by seeking alternative solutions or support.
3. The discharge planning team is discussing plans for the dismissal of a 16-year-old admitted for complications associated with asthma. The client's mother has not participated in any of the discharge planning processes but has stated that she wants to be involved. Which of the following reasons might prohibit this mother from participating in discharge planning?
- A. The client is an emancipated minor
- B. The mother has to work and is unavailable
- C. The client has a job and a driver's license
- D. The mother does not speak English
Correct answer: A
Rationale: In this scenario, the correct answer is that the client is an emancipated minor. Emancipated minors, even if they are under the age of 18, have the legal right to make decisions about their own healthcare and planning, which may include not wanting their parent involved in the discharge planning process. This status grants them independence from parental involvement in certain situations. The other choices are incorrect because the mother's work schedule, the client's job and possession of a driver's license, and the mother's language proficiency do not inherently prevent her from participating in the discharge planning process, unlike the legal status of being an emancipated minor.
4. Which method is most appropriate for managing moral distress in the workplace?
- A. Recognizing that life is unfair and nurses cannot meet every need of every client
- B. Declining to act when clients or visitors make requests that are not justifiable
- C. Developing a new policy that would address the problematic situation
- D. Both A and B
Correct answer: C
Rationale: Moral distress involves negative feelings or frustration toward situations that are deemed unfair, unethical, or that cause the nurse to feel helpless in their work. It can lead to nurse burnout when ongoing issues are not resolved. The most appropriate method for managing moral distress is to develop new policies that address the problematic situations. By creating policies, nurses can work towards changing current standards and reducing the number of situations that lead to moral distress. Choices A and B are incorrect because recognizing life's unfairness and not taking action on unjustifiable requests do not actively address the root causes of moral distress or work towards resolving the issues.
5. A client in the emergency room enters the care area to start an IV. He finds a man sitting on the table, hunched over, and attempting to take deep breaths. He states, 'my chest hurts so much!' His wife is sitting on a chair in the corner, crying. Which of the following is the first action of the client?
- A. Bring the IV kit and quickly start an IV
- B. Assess his breathing and provide oxygen, if necessary
- C. Administer medication to control chest pain
- D. Talk with his wife and find out why she is crying
Correct answer: B
Rationale: In the above scenario, the first action of the nurse should be to assess the client's airway and breathing. It is crucial to address respiratory status first, as the client appears to be experiencing difficulty breathing. Providing oxygen if necessary can help support oxygenation and alleviate potential respiratory distress. Administering medication for chest pain or starting an IV can come after ensuring adequate oxygenation. Talking with the client's wife, though important for emotional support, is not the priority when the client's respiratory status needs to be assessed and managed promptly.
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