Instant Access NCLEX.NCLEX-RN.v2022-11-21.q662 Actual Practice Test Engine for Free (Page 40)

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NCLEX-RN Exam
NCLEX.NCLEX-RN.v2022-11-21.q662 Dumps

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Question 191

Which of the following symptoms might the nurse observe in a client with a lithium blood level over 2.0?

A.Fine hand tremor, headache, mental dullness
B.Vomiting, impaired consciousness, decreased blood pressure
C.Polyuria, polydipsia, edema
D.Gastric irritation, nausea, diarrhea

Correct Answer: B

Explanation
(A) These symptoms are acute, common, and usually harmless central nervous system side effects of lithium.
(B) These symptoms of lithium toxicity are usually dose related. (C) These symptoms are acute, common, and usually harmless renal side effects of lithium. (D) These symptoms are acute, common, and usually harmless gastrointestinal side effects of lithium.

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Question 192

The nurse working with a client who is out of control should follow a model of intervention that includes which of the following?

A.Approach the client on a continuum of least restrictive care.
B.Challenge client's behavior immediately with steps to prevent injury to self or others.
C.Leave the aggressive client to himself or herself, and take other clients away.
D.To ensure safety of other clients, place client in seclusion immediately when he or she begins shouting.

Correct Answer: A

Explanation/Reference:
Explanation:
(A) Approaching a client's aggressive behavior on a continuum of least restrictive care is in agreement with his or her rights (i.e., verbal methods to help maintain control, medication, seclusion, and restraints, as necessary). (B) Approaching a client in a challenging manner is threatening and inappropriate. A nonchallenging and calm approach reflects staff in control and may increase client's internal control. (C) It is inappropriate to leave an aggressive client who is acting out alone. The nurse should acquire qualified help to prevent client from harm or injury to self or others. (D) Moving a client to seclusion immediately for shouting is inappropriate. The nurse should offer the client an opportunity to control self with limit setting.
The client should understand that the staff will assist with control if necessary (i.e., quietly accompany out of environment to decrease stimulation and allow for verbalization) employing the least restrictive care model of intervention.

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Question 193

The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be exhibiting a toxic reaction to:

A.Digoxin (Lanoxin)
B.Lidocaine (Xylocaine)
C.Quinidine gluconate or sulfate (Quinaglute, Quinidex)
D.Nitroglycerin IV (Tridil)

Correct Answer: B

(A) Side effects of digoxin include headache, hypotension, AV block, blurred vision, and yellow-green halos. (B) Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor, lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity, thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include postural hypotension, headache, dizziness, and flushing.

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Question 194

A client is experiencing muscle weakness and lethargy. His serum K+is 3.2. What other symptoms might he exhibit?

A.Tetany
B.Dysrhythmias
C.Numbness of extremities
D.Headache

Correct Answer: B

Explanation/Reference:
Explanation:
(A) Tetany is seen with low calcium. (B) Low potassium causes dysrhythmias because potassium is responsible for cardiac muscle activity. (C) Numbness of extremities is seen with high potassium. (D) Headache is not associated with potassium excess or deficiency.

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Question 195

Decreased pulmonary blood flow, right-to-left shunting, and deoxygenated blood reaching the systemic circulation are characteristic of:

A.Tetralogy of Fallot
B.Ventricular septal defect
C.Patent ductus arteriosus
D.Transposition of the great arteries

Correct Answer: A

(A) Tetralogy of Fallot is the most common cyanotic heart defect, which includes a VSD, pulmonary stenosis, an overriding aorta, and ventricular hypertrophy. The blood flow is obstructed because the pulmonary stenosis decreases the pulmonary blood flow and shunts blood through the VSD, creating a right-to-left shunt that allows deoxygenated blood the reach the systemic circulation. (B) A VSD alone creates a left-to-right shunt. The pressure in the left ventricle is greater than that of the right; therefore, the blood will shunt from the left ventricle to the right ventricle, increasing the blood flow to the lungs. No deoxygenated blood will reach the systemic circulation. (C) In patent ductus arteriosus, the pressure in the aorta is greater than in the pulmonary artery, creating a left-to-right shunt. Oxygenated blood from the aorta flows into the unoxygenated blood of the pulmonary artery. (D) Transposition of the great arteries results in two separate and parallel circulatory systems. The only mixing or shunting of blood is based on the presence of associated lesions.

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