NCLEX Daily Ten Question Practical Exercise 6

Welcome to our NCLEX Daily Ten Practice! This practice is designed to help you solidify your knowledge, improve your skills, and prepare thoroughly for the NCLEX exam. With ten questions to tackle each day, you’ll have the opportunity to review a broad range of subjects covered in the NCLEX exam.

 

1. The nurse is caring for a client who is suspected of attempting a medication overdose. Which of the following findings would support a diagnosis of an opioid overdose?

A. Confused, diaphoretic, blood pressure is 150/90 mmHg
B. Appears agitated, pulse of 120 bpm, and reporting diarrhea
C. Pinpoint pupils, temperature is 94.8 F (34.9 C), respirations of 8 per minute
D. Slurred speech, labile mood, movements are uncoordinated with unsteady gait

Correct Answer: C

Answer Explanation:

Opioids (e.g., morphine, oxycodone) are a group of medications most commonly used for pain relief. Their effects can be addictive, causing a high potential for abuse. Overdose of these medications depresses the central nervous system. The symptoms that are most commonly associated with overdose include: Coma, Pinpoint (constricted) pupils, Severe respiratory depression which can lead to respiratory arrest and death. Additional symptoms may include hypothermia, hypotension, and bradycardia [Choice 3]. Naloxone is given to reverse the effects of an opioid overdose.

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2. The nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take?

A. Ensure the client stays seated.
B. Bring the client out into the milieu.
C. Turn off the radio and close the curtains.
D. Coach the client to practice deep, rapid breathing.

Correct Answer: C

Answer Explanation:

Panic attacks are characterized by short episodes (15-30 minutes) of intense anxiety that escalate quickly and cause fear and physiological distress. Panic attacks may be triggered by a specific event or occur spontaneously, as seen with panic disorder. During a panic attack, clients may lose the ability to think rationally, which poses a safety risk. Primary nursing interventions include staying with the client to ensure safety and decreasing environmental stimuli to prevent further escalation of anxiety (e.g., turning off the radio, closing the curtains) [Choice 3]. Anti-anxiety medications (e.g., benzodiazepines) may be considered if nonpharmacological interventions are ineffective.

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3. The charge nurse is observing the following client situations. It would require intervention if a nurse?

A. administers oral pantoprazole to a client on an empty stomach
B. requests a dose of loperamide for a client with noninfectious diarrhea
C. holds a dose of polyethylene glycol for a client who had four bowel movements today
D. applies a scopolamine patch for a nauseated client with primary open-angle glaucoma

Correct Answer: D

Answer Explanation:

Scopolamine is an anticholinergic medication used to treat motion sickness and postoperative nausea and vomiting (N/V). Anticholinergic drugs act by blocking action of the parasympathetic nervous system (i.e., “rest and digest” response). Anticholinergic medications cause mydriasis (pupillary dilation) by relaxing the muscles that constrict the pupil. Dilating the pupil blocks aqueous humor drainage, which increases intraocular pressure. Therefore, anticholinergic eye drops are contraindicated in glaucoma due to the risk for primary angle-closure glaucoma and permanent vision loss.

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4. The nurse is teaching a client who is newly prescribed inhaled beclomethasone. Which of the following statements by the client would require follow-up?

A. “I should rinse my mouth after I use my inhaler.”
B. “This medication helps reduce the inflammation in my lungs.”
C. “After inhaling the medication, I should hold my breath for 10 seconds.”
D. “I only need to use this inhaler when I don’t feel well and before I exercise.”

Correct Answer: D

Answer Explanation:

Inhaled corticosteroids (e.g., beclomethasone, budesonide) control asthma by reducing airway inflammation. They are the treatment of choice for preventing asthma exacerbation in clients with mild persistent asthma.

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5. The nurse has taught a client who is receiving newly prescribed fluoxetine. Which of the following statements by the client would indicate a correct understanding of the teaching?

A. “I should report any muscle rigidity to my health care provider right away.”
B. “I must avoid cheeses, beer, and wine because they interact with this medication.”
C. “I may experience difficulty urinating and constipation while taking this medication.”
D. “If I don’t notice an improvement in my mood within 1 week, I will stop this medication.”

Correct Answer: A

Answer Explanation:

Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine, sertraline, citalopram) are used to manage depression and anxiety disorders. They work by blocking the reuptake of serotonin, thereby increasing its availability in the brain.
Teaching was effective if the client demonstrates an understanding of these teaching points: Muscle rigidity should be immediately reported to the health care provider [Choice 1]. Blocking the reuptake of too much serotonin can result in serotonin syndrome, a potentially fatal condition that includes symptoms of muscle rigidity, myoclonus (i.e. muscle spasms), and fever. Serotonin syndrome requires emergency interventions (e.g., cooling blankets, anticonvulsants).

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