Princeton Review NCLEX

Princeton Review NCLEX Madeline_Perrino4Top creator on Quizlet Save Princeton NCLEX 364 terms Lily-369Preview Health Promotion and Maintenance...20 terms reagan1921Preview 53 79 terms hardcorebelievers Preview 75 Free 75 terms car The nurse is preparing to administer prescribed baclofen to a client with multiple sclerosis who is experiencing bladder spasms. The client states, "I do not want to take that medication; it makes me sleepy." Which statement by the nurse would be most appropriate?

• "This medication is needed to stop the spasms."
• "We can discuss alternative interventions to treat the spasms."
• "You can discuss your concerns with your healthcare provider."
• "I can give the medication before bedtime."

B Rationale: Clients who report unpleasant side effects of medications may be reluctant to continue taking the medications. Clients have the right to refuse treatments or procedures, and the nurse should recognize and respect the client's choice. WHEN A CLIENT REFUSES TREATMENT, THE NURSE SHOULD DISCUSS ALTERNATIVE OPTIONS WITH THE CLIENT. Telling the client to discuss the concerns with the healthcare provider does not address the need to treat the spasms. Explaining what the medication is for is important but does not address the client's refusal and dismisses their concerns. This medication is prescribed three times a day; a nurse cannot change the dosing times without discussing it with the healthcare provider.You chose D

The nurse is caring for an adult client who has a new diagnosis of diabetes type 2. The client states, "What would be the best way to keep my blood sugar low and help me lose weight?" Which member of the interprofessional team should the nurse collaborate with to provide accurate information?

• Registered dietitian
• Diabetes educator
• Healthcare provider
• Exercise physiologist

A Rationale: A registered dietitian (RD) manages and plans for the dietary needs of patients based on knowledge about all aspects of nutrition.RDs can adapt specialized diets for the individual needs of patients, counsel and educate individual patients, and supervise the dietary services of an entire facility. Diabetes educators have expertise in insulin and oral hypoglycemic treatment regimens and can provide some information regarding diets. Exercise physiologists can provide techniques to exercise but do not address the need to control blood glucose levels.You chose B. You second guessed yourself A nurse is witnessing a surgical consent for a client. The client tells the surgical resident that they need time to think about the risks of the procedure. The resident tells the client there is no time to discuss the consent further. The client hesitantly signs the consent. Which action does the nurse take next?

• Signs the consent as a witness
• Informs the charge nurse of the situation
• Tells the client the consent is not valid
• Contacts the surgical attending

D Rationale: The nurse should contact the surgical resident's supervisor or attending. The client's concerns and the resident's behavior should be addressed thoroughly before the procedure occurs. Signing the consent as a witness disregards the client's concerns about the risks of the procedure. Informing the charge nurse of the situation should occur after the nurse addresses the concern with the resident's supervisor. Telling the client that the consent is not valid after it has been signed does not address the ethical issue.You chose B The nurse is providing an in-service to graduate nurses on the risk of malpractice litigation. Which is the best strategy to decrease personal risk in the healthcare environment?

• Discuss any errors with the client and family in detail
• Keep incident reports on file
• Carry personal malpractice insurance
• Maintain expertise in practice

D Rationale: Maintaining expertise in practice fosters continued competence in current knowledge and skills which is the best way to reduce personal risk and malpractice litigation. Incident reports are filed with a healthcare agency but do not decrease the risk of malpractice litigation.Discussing errors in detail with the client and family does not reduce the risk of a malpractice claim. Although a nurse can carry personal malpractice insurance, it does not decrease the risk of malpractice litigation.You chose c. But the question is asking how do you decrease your risk? Answer what the question is asking!

The nurse is working in the local health department, and over the last six months, there has been an increase in chlamydia infections. In order to help reduce the rates of infection, the nurse suggests which of the following for the next three months?

• Giving handouts to sexually active clients on discharge
• Making condoms accessible to clients on discharge
• Assessing the client's knowledge of sexually transmitted infections
• Assessing each client's knowledge of safe sex practices

B Rationale: Everyone who is sexually active is at risk for sexually transmitted infections. For the nurse to help decrease the instances of infection, providing condoms would be a noninvasive and private way to assist clients in safer sex practices. This would also allow non-clinical staff to assist with the intervention. Giving handouts, especially to minors, could induce shame or embarrassment. Assessing a client's knowledge could be difficult due to less-than-truthful responses due to confidentiality concerns. Intervention that does not require the client to engage their personal information is most helpful.You chose D A nurse is performing psychosocial assessments on several clients in an obstetric clinic. Based on the history obtained, which client is at risk for impaired coping during pregnancy?

• A client who verbalizes feeling irritable and has lost sexual desire towards her partner
• A client who lives in a multi-generational household and believes pregnancy is a transitional period of illness
• A client with a history of sexual abuse who is highly involved in her church community
• A client with a history of depression who is married and has two other children

B.Rationale: Hormonal changes during pregnancy and cultural norms can decrease the client's ability to cope. Strong social support from family, friends, and community members can assist the client during overwhelming mood swings. A client who believes pregnancy is an illness will have difficulty coping and adjusting to her new lifestyle. Cultural beliefs should be assessed, and unsafe practices should be further evaluated. Mood swings and loss of sexual desire are common responses to hormonal changes during pregnancy. The nurse should encourage stress relieving strategies. While previous history of sexual assault may cause anxiety during the birthing process, a strong social support system can help the client cope. Although the client has a history of depression, the client has a support system as indicated by a partner and children.You chose D The nurse is caring for a client who is 28 weeks pregnant. Which of the following physical changes should the nurse identify as an expected finding?

• Facial edema
• Kyphosis
• Lower extremity erythema
• Linea nigra

D.Rationale: Extra integumentary pigmentation during pregnancy can create a darkened vertical line down the abdomen called linea nigra. Facial edema is an abnormal finding that requires follow-up from the healthcare provider. Lordosis is expected in pregnancy, kyphosis is not, and erythema of the lower extremities is an abnormal finding.You chose B

The nurse is teaching a parenting class to clients at a community center. Which information should be included in the education related to infant growth and development?

• "Most babies gain about 2 pounds every month until they reach 6 months old."
• "Your baby should double birth height by their first birthday."
• "Babies don't start to hold their head up until about 4 months of age."
• "You should see a doctor if your baby is not able to walk by 11 months old."

A.Rationale: In the first six months of life, infants gain about 2 pounds per month; weight gain then slows to about 1 pound per month for months 6-12. Height at one year old is typically 1.5 times the infant's birth height. Infants begin holding their head up around 2 months of age, and while some infants may walk at 11 months old, it is not a cause for concern if the baby is not walking at this age.You chose B During a clinic visit, a 49-year-old female client tells the nurse, "I think I am beginning to experience hot flashes." The client asks the nurse what she can do to minimize menopausal symptoms. Which of the following is an appropriate nursing response?

• "Incorporate yoga into your exercise routine."
• "Long-term use of soy supplements can help you with your symptoms."
• "Eat raw flaxseed with plenty of water."
• "Acupuncture can provide the same benefits as hormone therapy."

A.Rationale: Research has shown that yoga and other meditation-based exercises can reduce the frequency and intensity of menopausal symptoms, such as hot flashes, joint pain, and mood disturbances. Long-term use of soy supplements has been associated with thickening of the lining of the uterus. There are conflicting studies on whether flaxseed is effective in lowering menopausal symptoms. Additionally, raw flaxseed can contain potentially toxic ingredients. Research has shown that acupuncture is less effective than hormone therapy. Additionally, acupuncture can cause infections and tissue damage if not performed correctly.You chose D The nurse is screening clients for risk factors for glaucoma. Which of the following ethnicities would have the highest risk?

• Caucasian
• Hispanic
• African American
• American Indian

C.Rationale: The African American race has the highest risk for glaucoma compared to Hispanics, American Indians, and Caucasians.You chose A