Free Learning Questions of NCLEX PN with Answer pdf 71th Edition

Free Learning Questions of NCLEX PN with Answer pdf 71th Edition (Mental Health/Adult Health/Eye/Respiratory/Fundamental Skills)

1. A psychiatric clinical nurse specialist tells a nursing student that the technique of paradoxical intention is being planned to treat a client who experiences panic attacks. The student understands that which of the following describes the intervention that the nurse employs for the client?

A. Having the client confront the anxiety provoking stimuli and providing support during the episode
B. Using progressive relaxation toward the client's anxiety and pairing relaxation with the gradual exposure to reduce the client's anxiety
C. Presenting the anxiety provoking stimuli without any preparation of the client and having the client remain exposed until the anxiety subsides
D. Instructing the client to hyperventilate to create a panic attack

Answer: D. Instructing the client to hyperventilate to create a panic attack

Rationale: In cognitive behavioral therapy, the client with panic attacks will receive a mix of cognitive restructuring, exposure therapy, and paradoxical intention. In paradoxical intention, the client is instructed by the therapist to hyperventilate to cause a panic attack. When this occurs, the nurse teaches the client to stop struggling to prevent the anxiety by a variety of coping mechanisms. This assists the client to regain an internal locus of control or feeling of empowerment or mastery regarding the anxiety-provoking issue, situation, or person.

Test-Taking Strategy: This question tests your knowledge of the cognitive behavioral therapies that are used to treat clients who suffer from panic attacks. Option 1 describes a type of exposure therapy. Option 2 describes systematic desensitization, another type of exposure therapy. Option 3 describes flooding, which is probably the most intensive therapy. Note the relation between the words “paradoxical intention” in the question and the description in option D. Review the components of paradoxical intention if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process/Planning
Content Area: Mental Health
References: Morrison-Valfre, M. (2005). Foundations of mental health care (3rd ed.). St. Louis: Mosby, p. 185.
Stuart, G., & Laraia, M. (2005). Principles & practice of psychiatric nursing (8th ed.). St.
Louis: Mosby, p. 281.

2. A nurse is inserting soft contact lenses into the eyes of a client. The nurse tells the client to look:

A. Straight ahead
B. Downward and outward
C. Upward and outward
D. Downward and inward

Answer: A. Straight ahead

Rationale: When inserting contact lenses for a client, the nurse tells the client to look straight ahead. This applies to both rigid and soft contact lenses. The other options are incorrect.

Test-Taking Strategy: Use basic principles of eye care to answer this question. Visualize each of the eye positions in the options to assist in answering the question. Review this procedure if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Fundamental Skills
Reference: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, pp. 297-298.

3. A nurse is reviewing the arterial blood gas results of an assigned client. Which of the following arterial blood gases indicates metabolic alkalosis?

A. pH of 7.35, pCO2 of 50 mm Hg, HCO3 of 32 mEq/L
B. pH of 7.45, pCO2 of 35 mm Hg, HCO3 of 22 mEq/L
C. pH of 7.38, pCO2 of 45 mm Hg, HCO3 of 32 mEq/L
D. pH of 7.48, pCO2 of 40 mm Hg, HCO3 of 36 mEq/L

Answer: D. pH of 7.48, pCO2 of 40 mm Hg, HCO3 of 36 mEq/L

Rationale: In a metabolic alkalosis, the pH is elevated along with the bicarbonate level. Option 4 is the only option that reflects these values.

Test-Taking Strategy: Use the process of elimination. Remember that when an alkalotic condition exists, the pH will be elevated. Next, recall that in a metabolic condition, the HCO3 will move in the same direction as the pH. The only option that represents these conditions is option D. Review the process of blood gas analysis if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Adult Health/Respiratory
Reference: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, p. 430.

4. A nursing student is caring for a client scheduled for cataract surgery. The student reviews the preoperative orders with the nursing instructor and notes that cyclopentolate (Cyclogyl) eye drops are prescribed to be administered preoperatively. The nursing instructor asks the student about the action of the eye drops. The student appropriately responds by telling the instructor that the action of these eye drops is to:

A. Provide the necessary lubrication to the operative eye
B. Initiate miosis in the operative eye
C. Dilate the pupil of the operative eye
D. Constrict the pupil of the operative eye

Answer: C. Dilate the pupil of the operative eye

Rationale: Cyclopentolate (Cyclogyl) is a rapidly acting mydriatic and cycloplegic medication. It is effective in 25 to 75 minutes, and accommodation returns in 6 to 24 hours. Cyclopentolate (Cyclogyl) is used for preoperative mydriasis to dilate the eye. Options 1, 2, and 4 are incorrect actions for use of this medication.

Test-Taking Strategy: Use the process of elimination. Options 2 and 4 identify similar information and are eliminated first. Remember miosis refers to a constricted pupil. Note that the question identifies a client being prepared for eye surgery. The pupil would need to be dilated for the surgical procedure. Review the action and purpose of this medication if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Adult Health/Eye
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1104.

Source : NCLEX Questions and answer

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