Exam 2 - NCLEX Exam Questions & Answers

Exam 2 - NCLEX Exam Questions & Answers-A patient comes to the clinic for a 4-week follow-up after starting fluoxetine. What is the highest priority assessment question the nurse should ask? A. "How have you been slee ...

Exam 2 - NCLEX Exam Questions & Answers-A patient comes to the clinic for a 4-week follow-up after starting fluoxetine. What is the highest priority assessment question the nurse should ask? A. "How have you been sleeping?" B. "Did you drive to the clinic today?" C. "Has your stomach felt uncomfortable?" D. "Have you experienced thoughts of hurting yourself?" - D. "Have you experienced thoughts of hurting yourself?" Prior to initiating a tricyclic antidepressant (TCA), the nurse should evaluate which of the patient's diagnostic tests? A. Electroencephalogram (EEG) B. Electrocardiogram C. Lipids D. Complete blood count (CBC) - B. Electrocardiogram Which breakfast selections demonstrate that a patient understands the nurse's dietary instructions while taking monoamine oxidase inhibitor (MAOI) antidepressants? A. Bacon, eggs, cheddar cheese, and avocado slices in a flour tortilla B. Banana slices and raisins in whole-grain cereal with milk C. Blueberry pancakes with yogurt D. Oatmeal with almonds and milk - D. Oatmeal with almonds and milk Which depressed patient could most benefit from a trial prescription of bupropion? A. An older female adult with a history of epilepsy B. An underweight teenager C. A young male adult with a nicotine addiction D. A young female adult taking risperidone - C. A young male adult with a nicotine addiction A patient prescribed a tricyclic antidepressant (TCA) for chronic depression is recovering from a myocardial infarction. Which intervention will the nurse anticipate as a result of the patient's medical condition? A. Preparing to wean the patient off of the prescribed TCA medication B. Increasing the dose of the patient's prescribed TCA medication C. Adding a monoamine oxidase inhibitors (MAOIs) to the patient's medication regime D. Discontinuing the patient from all antidepressant medications temporarily - A. Preparing to wean the patient off of the prescribed TCA medication It has been determined that a patient is experiencing life-threatening toxicity related to tricyclic antidepressant (TCA) use. Which intervention will the nurse anticipate? A. Frequently assessing for suicidal ideations B. Administering the acetylcholinesterase inhibitor physostigmine (Antilirium) C. Inserting an indwelling urinary catheter D. Preparing the patient for an EEG - B. Administering the acetylcholinesterase inhibitor physostigmine (Antilirium) A chronically depressed patient tells the nurse, "My antidepressant just doesn't seem to be working as well as it did." What is the nurse's initial assessment intervention? A. Determining whether the patient has been taking the medication as prescribed B. Asking the patient how long he or she has been taking this particular antidepressant C. Determining if the patient has been experiencing any physical side effects D. Asking the patient to describe what he or she means by "not working as well" - B. Asking the patient how long he or she has been taking this particular antidepressant A patient asks, "Why have I been prescribed a selective serotonin reuptake inhibitor (SSRI) rather than one of the other kinds of antidepressants?" The nurse addresses the patient's question best when providing which response? A. "This classification is usually effective and generally causes fewer side effects." B. "SSRIs are far less expensive than any other antidepressant." C. "Your mental health provider has determined that your symptoms will be best managed with this classification of antidepressants." D. "It sounds like you have some doubts about the effectiveness of this classification of antidepressants." - A. "This classification is usually effective and generally causes fewer side effects." Which side effect of monoamine oxidase inhibitor (MAOI) therapy will the nurse be particularly concerned about when this classification of antidepressants is prescribed to an older adult patient? A. Orthostatic hypotension resulting in falls B. Hypertension-induced strokes C. Hypertensive crisis resulting from eating tyramine-rich foods D. Drug-induced reflex tachycardia - A. Orthostatic hypotension resulting in falls Medication teaching regarding lithium is regarded as successful when the nurse hears the patient makes which statement? A. "Potassium can be dangerous in my diet." B. "My body treats lithium just like salt." C. "A multivitamin each day will be important." D. "I won't have to see the doctor for 3 months." - B. "My body treats lithium just like salt." The patient who will require further teaching while on lithium would make what statement? A. "I know I need to eat and drink sensibly." B. "My dietician appointment is next week." C. "My last lithium level was 0.6." D. "I am really enjoying my aerobics dance class." - D. "I am really enjoying my aerobics dance class." The patient refuses lithium for acute mania but is agreeable to another medication. The nurse will expect the prescriber to respond with what intervention? A. Reinforcing that lithium is the only reasonable choice B. Prescribing a selective serotonin reuptake inhibitor (SSRI). C. Substituting the lithium with an anticonvulsant medication. D. Offering to prescribe a monoamine oxidase inhibitor (MAOI). - C. Substituting the lithium with an anticonvulsant medication. Which assessment question will the nurse ask to help identify the cause of a patient's decreased lithium levels? A. "How much coffee do you drink daily?" B. "How much salt do you consume daily?" C. "Have you been prescribed a daily diuretic medication?" D. "Have you been taking any anti-inflammatory medications?" - A. "How much coffee do you drink daily?" A patient's lithium level is 2.3 mEq/L. Which nursing intervention will the nurse be prepared to implement when ordered? A. Managing the administration of parenteral normal saline B. Increasing the daily dose of lithium C. Limiting the patient's intake of sodium D. Preparing to administer an oral diuretic - A. Managing the administration of parenteral normal saline What presents the greatest postnatal risk to a newborn whose mother is now managing her bipolar disorder with lithium? A. Potential maternal neglect B. Breastfeeding C. Potential maternal abuse D. Infections - B. Breastfeeding What is the nurse's best response when asked by a patient who will begin lithium therapy, "When can I expect to see improvement in my symptoms?" A. "The response is very individualized and dependent on the severity of the symptoms." B. "I can see you are anxious. Let's talk about what's causing you all the worry." C. "We generally see symptom improvement in 7 to 10 days after beginning treatment." D. "Lithium is excellent at managing symptoms like yours. Try to be patient." - C. "We generally see symptom improvement in 7 to 10 days after beginning treatment." When a patient is prescribed carbamazepine when lithium is ineffective at managing the symptoms of bipolar disorder, the nurse will include what information in the patient education plan? A. The possible development of a skin rash B. Symptom recognition of Stevens-Johnson syndrome C. May prevent weight loss D. Initially, complete blood counts (CBCs) will be scheduled weekly - D. Initially, complete blood counts (CBCs) will be scheduled weekly An individual has taken Valium for the past 4 years and is considering discontinuing the medication. To ensure the patient's safety, what information should the nurse reinforce? A. "Anxiety seldom gets better without medication." B. "Diazepam should not be discontinued abruptly." C. "Buspirone is a better choice when anxiety also occurs." D. "It is important to remember not to mix alcohol with diazepam." - B. "Diazepam should not be discontinued abruptly." Teaching a patient and family about buspirone would include which statement? A. "Expect some relief from your anxiety in about 7 to 10 days, but the full effect of this medication may take up to 6 weeks." B. "Be certain that you do not take more than your prescriber has ordered because this medication can be addicting." C. "Your diazepam will be stopped immediately while the buspirone takes effect." D. "Buspirone will probably make you feel sleepy." - A. "Expect some relief from your anxiety in about 7 to 10 days, but the full effect of this medication may take up to 6 weeks." What is the rationale for using benzodiazepines to detoxify patients diagnosed with chronic alcoholism? A. They prepare the patient for using prescribed drugs rather than alcohol. B. They allow for the gradual introduction of a less addictive substance. C. They permit the detoxification process to occur in a hospital setting. D. They significantly help manage the withdrawal symptoms. - D. They significantly help manage the withdrawal symptoms An individual taking benzodiazepines demonstrates an understanding of dietary consideration when expressing the need to avoid consuming what food or beverage? A. Dairy products B. Leafy green vegetables C. Grapefruit juice D. Cured meats - C. Grapefruit juice When prescribed a benzodiazepine, a patient is considered to be at risk for falls mostly because of what common medication-related side effect? A. Ataxia B. Dysarthria C. Lassitude D. Retrograde amnesia - A. Ataxia Which population is at greatest risk for experiencing a paradoxical reaction when prescribed a benzodiazepine? A. Males B. Those with a history of depression C. Older adults D. Those of Asian heritage - C. Older adults What symptom is associated with benzodiazepine withdrawal? A. Visual hallucinations B. Convulsions C. Cardiac arrest D. Respiratory arrest - B. Convulsions The nurse learns that a patient prescribed a benzodiazepine for anxiety has been self-medicating with over-the-counter antacids for recurring indigestion. Which statement will the nurse make to initially assess the patient? A. "Do you believe your antianxiety medicine has been working as effectively?" B. "Could the indigestion be related to your anxiety issues?" C. "When did the indigestion first present as a problem?" D. "How many doses of antacids do you usually take each day?" - D. "How many doses of antacids do you usually take each day?"