Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 153

1. When preparing insulin for IV administration, the nurse identifies which kind of insulin to use?

A) NPH
B) Human or pork
C) Regular
D) Long acting

2. A 33-year-old client is diagnosed with bipolar disorder, acute phase. This is her first psychiatric hospitalization, and she is being evaluated for treatment with lithium. Which of the following diagnostic tests are essential prior to the initiation of lithium therapy with this client?

A) Hematocrit, hemoglobin, and white blood cell (WBC) count
B) Blood urea nitrogen, electrolytes, and creatinine
C) Glucose, glucose tolerance test, and random blood sugar
D) X-rays, electroencephalogram, and electrocardiogram(ECG)

3. A client has been taking lithium 300 mg po bid for the past two weeks. This morning her lithium level was 1 mEq/L. The nurse should:

A) Notify the physician immediately
B) Hold the morning lithium dose and continue to observe the client
C) Administer the morning lithium dose as scheduled
D) Obtain an order for benztropine (Cogentin)

4. A 23-year-old male client is admitted to the chemical dependency unit with a medical diagnosis of alcoholism. He reports that the last time he drank was 3 days ago, and that now he is starting to 'feel kind of shaky.' Based on the information given above, nursing care goals for this client will initially focus on:

A) Self-concept problems
B) Interpersonal issues
C) Ineffective coping skills
D) Physiological stabilization

5. One afternoon 3 weeks into his alcohol treatment program, a client says to the nurse, 'It - s really not all my fault that I have a drinking problem. Alcoholism runs in my family. Both my grandfather and father were heavy drinkers.' The nurse - s best response would be:

A) 'That might be a problem. Tell me more about them.'
B) 'Risk factors can often be controlled by self-responsibility.'
C) 'It sounds like you - re intellectualizing your drinking problem.'
D) 'Your grandfather and father were both alcoholics?'

1. Right Answer: C
Explanation: (A, B, D) Intermediate-acting and long-acting preparations contain materials that increase length of absorption time from the subcutaneous tissues but cause the preparation to be cloudy and unsuitable for IV use. Human insulin must be given SC. (C) Only regular insulin can be given IV.

2. Right Answer: B
Explanation: (A) These are general diagnostic blood studies (usually done on admission), but they are not reliable indicators of lithium therapy clearance. (B) These are the primary diagnostic tests to determine kidney functioning. Because lithium is excreted through the kidneys and because it can be very toxic, adequate renal function must be ascertained before therapy begins. (C) These are diagnostic blood tests used to determine the presence of endocrine (not renal) dysfunction. (D)These are other types of diagnostic procedures used to determine musculoskeletal, neural, and cardiac (rather than renal) functioning.

3. Right Answer: C
Explanation: (A) There is no need to phone the physician because the lithium level is within therapeutic range and because there are no indications of toxicity present. (B)There is no reason to withhold the lithium because the blood level is within therapeutic range. Also, it is necessary to give the medication as scheduled to maintain adequate blood levels. (C) The lab results indicate that the clients lithium level is within therapeutic range (0.21.4 mEq/L), so the medication should be given as ordered. (D) Benztropine is an antiparkinsonism drug frequently given to counteractextrapyramidal symptoms associated with the administration of antipsychotic drugs (not lithium).

4. Right Answer: D
Explanation: (A) Self-concept and self-esteem problems may emerge during the clients treatment, but these are not immediate concerns. (B) Interpersonal issues may become evident during the course of the clients treatment, but these are also not immediate areas of concern. (C) Improving individual coping skills is generally a primary focus in the treatment and nursing care of persons with substance abuse problems. However, this is still not the immediate concern in this client situation. (D)Correction of fluid and electrolyte status and vitamin deficiencies, as well as prevention of delirium, is the immediate concern in the care of this client.

5. Right Answer: B
Explanation: (A) Focusing is an effective therapeutic strategy. This response, however, allows the client to 'defocus' off the topic of learning how to accept responsibility for his behavior and future growth. (B) The nurse can educate the client about both the 'genetic risk' for the development of alcoholism and ways to make long-term healthy lifestyle changes. (C) This response is inappropriately confrontational and condescending to the client. (D) Reflection of content can be an effective verbal therapeutic technique. It is used inappropriately here.

80% DISCOUNT: NCLEX-RN PRACTICE EXAMS