NCLEX-RN V12.35 2022/2023 update

NO.1 A depressed client is seen at the mental health center for follow-up after an attempted suicide

1 week ago. She has taken phenelzine sulfate (Nardil), a monoamine oxidase

(MAO) inhibitor, for 7 straight days. She states that she is not feeling any better. The nurse explains

that the drug must accumulate to an effective level before symptoms are totally relieved. Symptom

relief is expected to occur within:

A. 10 days

B. 2-4 weeks

C. 2 months

D. 3 months

Answer: B

Explanation:

(A) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication.

(B) This answer is correct. Because MAO inhibitors are slow to act, it takes 2-4 weeks before

improvement of symptoms is noted.

(C) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication.

(D) This answer is incorrect. Therapeutic effects of the medication are noted within 1 month of drug

therapy.

NO.2 Cystic fibrosis is transmitted as an autosomal recessive trait. This means that:

A. Mothers carry the gene and pass it to their sons

B. Fathers carry the gene and pass it to their daughters

C. Both parents must have the disease for a child to have the disease

D. Both parents must be carriers for a child to have the disease

Answer: D

Explanation:

(A) Cystic fibrosis is not an X-linked or sex-linked disease. (B) The only characteristic on the Y

chromosome is the trait for hairy ears. (C) Both parents do not need to have the disease but must be

carriers. (D) If a trait is recessive, two genes (one from each parent) are necessary to produce an

affected child.

NO.3 A 24-year-old client presents to the emergency department protesting "I am God." The nurse

identifies this as a:

A. Delusion

B. Illusion

C. Hallucination

D. Conversion

Answer: A

Explanation:

(A) Delusion is a false belief. (B) Illusion is the misrepresentation of a real, external sensory

experience. (C) Hallucination is a false sensory perception involving any of the senses. (D) Conversion

is the expression of intrapsychic conflict through sensory or motor manifestations.

NO.4 In acute episodes of mania, lithium is effective in 1-2 weeks, but it may take up to 4 weeks, or

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even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during

the first few days or weeks of an acute episode to manage severe behavioral excitement and acute

psychotic symptoms. In addition to the lithium, which one of the following medications might the

physician prescribe?

A. Diazepam (Valium)

B. Haloperidol (Haldol)

C. Sertraline (Zoloft)

D. Alprazolam (Xanax)

Answer: B

Explanation:

(A) Diazepam is an antianxiety medication and is not designed to reduce psychotic symptoms. (B)

Haloperidol is an antipsychotic medication and may be used until the lithium takes effect. (C)

Sertraline is an antidepressant and is used primarily to reduce symptoms of depression. (D)

Alprazolam is an antianxiety medication and is not designed to reduce psychotic symptoms.

NO.5 A violent client remains in restraints for several hours. Which of the following interventions is

most appropriate while he is in restraints?

A. Give fluids if the client requests them.

B. Assess skin integrity and circulation of extremities before applying restraints and as they are

removed.

C. Measure vital signs at least every 4 hours.

D. Release restraints every 2 hours for client to exercise.

Answer: D