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| Section | Weight | Objectives |
|---|
| Safe and Effective Care Environment | 26–38% | - Management of Care
- 1. Case Management
- 2. Advocacy
- 3. Client Rights
- 4. Delegation and Prioritization
- 5. Legal Responsibilities
- 6. Ethical Practice
- 7. Quality Improvement
- 8. Continuity of Care
- Safety and Infection Control
- 1. Hazardous Materials Handling
- 2. Use of Restraints and Safety Devices
- 3. Accident Prevention
- 4. Standard Precautions
- 5. Infection Control
- 6. Error Prevention
|
| Psychosocial Integrity | 6–12% | - Mental Health Concepts - Grief and Loss - Therapeutic Communication - Family Dynamics - Coping Mechanisms - Behavioral Interventions - Chemical Dependency and Substance Use Disorders - End-of-Life Support
|
| Health Promotion and Maintenance | 6–12% | - Physical Assessment Techniques - Health Promotion Programs - Disease Prevention and Health Screening - Aging Process - Self-Care - Antepartum, Intrapartum, Postpartum and Newborn Care - Developmental Stages and Transitions
|
| Physiological Integrity | 43–67% | - Basic Care and Comfort
- 1. Nutrition and Oral Hydration
- 2. Assistive Devices
- 3. Mobility and Immobility
- 4. Elimination
- 5. Personal Hygiene
- 6. Non-pharmacological Comfort Interventions
- Reduction of Risk Potential
- 1. Diagnostic Tests
- 2. Therapeutic Procedures
- 3. Vital Signs
- 4. Potential for Complications
- 5. Laboratory Values
- Pharmacological and Parenteral Therapies
- 1. Medication Administration
- 2. Adverse Effects and Contraindications
- 3. Dosage Calculation
- 4. Pharmacological Pain Management
- 5. IV Therapy and Blood Products
- Physiological Adaptation
- 1. Respiratory Care
- 2. Illness Management
- 3. Hemodynamics
- 4. Fluid and Electrolyte Imbalances
- 5. Pathophysiology
- 6. Medical Emergencies
|
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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q24-Q29):
NEW QUESTION # 24
The child with iron poisoning is given IV deforoxamine mesylate (Desferal). Following administration, the child suffers hypotension, facial flushing, and urticaria. The initial nursing intervention would be to:
- A. Assess urinary output, and if it is 30 mL an hour, maintain current treatment
- B. Discontinue the IV
- C. Take all vital signs, and report to the physician
- D. Stop the medication, and begin a normal saline infusion
Answer: D
Explanation:
Explanation
(A) The IV line should not be discontinued because other IV medications will be needed. (B) Stop the medication and begin a normal saline infusion. The child is exhibiting signs of an allergic reaction and could go into shock if the medication is not stopped. The line should be kept opened for other medication. (C) Taking vital signs and reporting to the physician is not an adequate intervention because the IV medication continues to flow. (D) Assessing urinary output and, if it is 30 mL an hour, maintaining current treatment is an inappropriate intervention owing to the child's obvious allergic reaction.
NEW QUESTION # 25
The usual treatment for diabetes insipidus is with IM or SC injection of vasopressin tannate in oil. Nursing care related to the client receiving IM vasopressin tannate would include:
- A. Hold the vial under warm water for 10-15 minutes and shake vigorously before drawing medication into the syringe.
- B. Store the medication in a refrigerator and allow to stand at room temperature for 30 minutes prior to administration.
- C. Limit fluid intake to 500 mL/day.
- D. Weigh once a week and report to the physician any weight gain of10 lb.
Answer: A
Explanation:
Section: Questions Set A
Explanation:
(A) Weight should be obtained daily. (B) Fluid is not restricted but is given according to urine output. (C) The medication does not have to be stored in a refrigerator. (D) Holding the vial under warm water for 10-15 minutes or rolling between your hands and shaking vigorously before drawing medication into the syringe activates the medication in the oil solution.
NEW QUESTION # 26
A client is medically cleared for ECT and is tentatively scheduled for six treatments over a 2-week period. Her husband asks, "Isn't that a lot?" The nurse's best response is:
- A. "Don't worry. Some clients have lots more than that."
- B. "Yes, that does seem like a lot."
- C. "Six to 10 treatments are common. Are you concerned about permanent effects?"
- D. "You'll have to talk to the doctor about that. The physician knows what's best for the client."
Answer: C
Explanation:
Explanation
(A) This response indicates that the nurse is unsure of herself and not knowledgeable about ECT. It also reinforces the husband's fears. (B) This response is "passing the buck" unnecessarily. The information needed to appropriately answer the husband's question is well within the nurse's knowledge base. (C) The most common range for affective disorders is 6-10 treatments. This response confirms and reinforces the physician's plan for treatment. It also opens communicationwith the husband to identify underlying fears and knowledge deficits. (D) This response offers false reassurance and dismisses the husband's underlying concerns about his wife.
NEW QUESTION # 27
When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to breathe. This behavior is most indicative of:
- A. Anxiety
- B. Angina
- C. Congestive heart failure
- D. Pericarditis
Answer: C
Explanation:
(A) Pericarditis can cause dyspnea but primarily causes chest pain. (B) Anxiety can cause dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. (C) The inability to oxygenate well without being upright is most indicative of congestive heart failure, due to alveolar drowning. (D) Angina causes primarily chest pain; any SOB associated with angina is not influenced by body position.
NEW QUESTION # 28
A 45-year-old client diagnosed with major depression is scheduled for electroconvulsive therapy (ECT) in the morning. Which of the following medications are routinely administered either before or during ECT?
- A. Atropine, sodium brevitol, and succinylcholine chloride (Anectine)
- B. Sodium, potassium, and magnesium
- C. Carbamazepine (Tegretol), haloperidol, and trihexyphenidyl (Artane)
- D. Thioridazine (Mellaril), lithium, and benztropine
Answer: A
Explanation:
Section: Questions Set G
Explanation:
(A) Thioridazine (an antipsychotic drug), lithium (an antimanic drug), and benztropine (an antiparkinsonism agent) are generally administered to treat schizophrenic and bipolar disorders. (B) Atropine (a cholinergic blocker), sodium brevitol (a shortacting anesthetic), and succinylcholine (a neuromuscular blocker) are administered either before or during ECT to coun teract bradycardia and to provide anesthesia and total muscle relaxation. (C) These are electrolyte substances administered to correct fluid and electrolyte imbalances in the body. (D) Carbamazepine (an anticonvulsant), haldoperidol (an antipsychotic), and trihexyphenydyl (an antiparkinsonism agent) are usually administered in psychiatric settings to control problems associated with psychotic behavior.
NEW QUESTION # 29
......
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