Free NCLEX PN Practice Test 87th Edition (4 Questions)

Free NCLEX PN Practice Test 87th Edition (4 Questions)

1. Fluoxetine hydrochloride (Prozac) is prescribed for a client being treated for depression, and the nurse provides instructions to the client regarding the medication. Which statement by the client would indicate that the client understands this medication therapy?

A. “I will need a stronger dose if I don’t feel results in a few days.”
B. “If I don’t feel better in 1 week, I should stop the medication.”
C. “If my mouth becomes dry, I should stop the medication.”
D. “It takes approximately 2 to 4 weeks before improvement is noted.”

Answer: D. “It takes approximately 2 to 4 weeks before improvement is noted.”

Rationale: The time frame in which the therapeutic effects of fluoxetine hydrochloride are seen is usually 2 to 4 weeks after initiation of therapy. It is important to advise clients to comply with the prescribed regimen so that therapeutic levels are maintained. Dry mouth is a side effect of the medication, and the client should be instructed to relieve the dry mouth by chewing sugarless gum or sipping tepid water.

Test-Taking Strategy: Note the key words client understands. Eliminate options 2 and 3 because the client should not stop medication without consulting the health care provider. Next eliminate option 1, knowing that it will take longer than a few days for effectiveness to occur. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 453.

2. A nurse is caring for a client who received electroconvulsive therapy (ECT) for a major depressive disorder. On data collection, the nurse notes that the client’s blood pressure is elevated at 160/100 mm Hg. Based on this finding, the appropriate nursing action would be to:

A. Document the blood pressure
B. Reassess the blood pressure in 30 minutes
C. Notify the registered nurse
D. Lower the head of the bed

Answer: C. Notify the registered nurse

Rationale: The major side effects of ECT are confusion, disorientation, and memory loss. An elevation in blood pressure would not be an anticipated side effect and would be a cause for concern. If hypertension occurred following ECT, the nurse would notify the registered nurse who would then notify the physician. Options 1, 2, and 4 are incorrect nursing actions.

Test-Taking Strategy: Use the process of elimination and knowledge of ECT and its side effects to assist you in answering this question. Eliminate option 4 first because this action may cause a further increase in blood pressure. When selecting from the remaining options, noting that the blood pressure is elevated and is higher than the normal range should assist in directing you to option C. Review the adverse effects of ECT if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Reference: Morrison-Valfre, M. (2005). Foundations of mental health care (3rd ed.). St. Louis: Mosby, p. 218.

3. A nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which of the following, if noted in the first few hours following the procedure, indicates the need to notify the registered nurse?

A. Pink-tinged urine
B. Yellow-colored urine
C. Clear urine
D. Bloody urine with clots

Answer: D. Bloody urine with clots

Rationale: The client may have clear, yellow, or pink-tinged urine after cystoscopy. Bloody urine with clots is always an abnormal finding and should be reported immediately.

Test-Taking Strategy: Use the process of elimination. Begin to answer this question by eliminating options 2 and 3 since these are normal findings. Eliminate option 1 next, knowing that minor trauma from the procedure could cause blood-tinged urine to occur. Remember that bloody urine with clots indicates active, current bleeding. Review postprocedure expected findings if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Renal
Reference: Chernecky, C., & Berger, B. (2004). Laboratory tests and diagnostic procedures (4th ed.). Philadelphia: W.B. Saunders, p. 450.

4. A nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse would maintain the flow rate of the continuous bladder infusion to maintain a urine output that is:

A. Red
B. Yellow with small clots
C. Colorless
D. Pale yellow or slightly pink

Answer: D. Pale yellow or slightly pink

Rationale: Bladder irrigant is not infused at a preset rate, but rather it is increased or decreased to maintain urine that is clear or pale yellow or that has just a slight pink tinge. The infusion rate should be increased if the drainage is red or if clots are seen. Correspondingly the rate can be slowed slightly if the returns are as clear as water.

Test-Taking Strategy: Begin to answer this question by eliminating option 2 as the least realistic of all the urine characteristics described in the options. You would then eliminate options 1 and 3 as reflecting inadequate and excessive flow, respectively. This leaves option 4 as the correct option. With proper flow rate of bladder irrigant, the urine should be pale yellow or pale pink. Review care to the client receiving continuous bladder irrigation if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Adult Health/Renal
Reference: Black, J., & Hawks, J. (2005). Medical-surgical nursing: Clinical management for positive outcomes (7th ed.). Philadelphia: W.B. Saunders,
pp. 1023-1024.

Source : NCLEX Questions and answer

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