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It does not matter how slowly you go as long as you do not stop.

client says
~Confucius
C. Repeatedly discuss previous suicide attempts with the client
Topics D. Disregard decreased communication by the client because this is
Topics included in this NCLEX practice quiz are: common with suicidal clients
Alcohol Withdrawal

Anorexia Nervosa 4. Which of the following drugs should Nurse Mary prepare to

Bulimia Nervosa administer to a client with a toxic acetaminophen (Tylenol) level?

Disulfiram Therapy
A. Deferoxamine mesylate (Desferal)
Domestic Violence
B. Succimer (Chemet)
Personality Disorders
C. Flumazenil (Romazicon)
Physical Abuse
D. Acetylcysteine (Mucomyst)
Substance Abuse

Suicidal Tendencies
5. A male client is admitted to the substance abuse unit for
Tourette Syndrome
alcohol detoxification. Which of the following medications is

Nurse Alice most likely to administer to reduce the symptoms of


1. Flumazenil (Romazicon) has been ordered for a male client who alcohol withdrawal?
has overdosed on oxazepam (Serax). Before administering the

medication, nurse Gina should be prepared for which common A. Naloxone (Narcan)

adverse effect? B. Haloperidol (Haldol)

C. Magnesium sulfate
A. Seizures D. Chlordiazepoxide (Librium)
B. Shivering

C. Anxiety 6. During postprandial monitoring, a female client with bulimia

D. Chest pain nervosa tells the nurse, You can sit with me, but youre just

wasting your time. After you had sat with me yesterday, I was still
2. Nurse Tamara is caring for a client diagnosed with bulimia. The able to purge. Today, my goal is to do it twice. What is the
most appropriate initial goal for a client diagnosed with bulimia is nurses best response?
to:

A. I trust you not to purge.


A. Avoid shopping for large amounts of food B. How are you purging and when do you do it?
B. Control eating impulses C. Dont worry. I wont allow you to purge today.
C. Identify anxiety-causing situations D. I know its important for you to feel in control, but Ill monitor you for
D. Eat only three meals per day 90 minutes after you eat.

3. A female client whos at high risk for suicide needs close 7. A male client admitted to the psychiatric unit for treatment of
supervision. To best ensure the clients safety, Nurse Mary substance abuse says to the nurse, It felt so wonderful to get
should: high. Which of the following is the most appropriate response?

A. Check the client frequently at irregular intervals throughout the night A. If you continue to talk like that, Im going to stop speaking to you.
B. Assure the client that the nurse will hold in confidence anything the B. You told me you got fired from your last job for missing too many
days after taking drugs all night. A. Remaining with the client and staying calm

C. Tell me more about how it felt to get high. B. Calling a security guard and another staff member for assistance

D. Dont you know its illegal to use drugs? C. Telling the clients husband that he must leave at once

D. Determining why the husband feels so angry


8. For a female client with anorexia nervosa, Nurse Jimmy is

aware that which goal takes the highest priority? 12. Nurse Mary is caring for a client with bulimia. Strict

management of dietary intake is necessary. Which intervention is


A. The client will establish adequate daily nutritional intake also important?
B. The client will make a contract with the nurse that sets a target

weight A. Fill out the clients menu and make sure she eats at least half of

C. The client will identify self-perceptions about body size as unrealistic what is on her tray.

D. The client will verbalize the possible physiological consequences of B. Let the client eat her meals in private. Then engage her in social

self-starvation activities for at least 2 hours after each meal

C. Let the client choose her own food. If she eats everything she
9. When interviewing the parents of an injured child, which of the
orders, then stay with her for 1 hour after each meal
following is the strongest indicator that child abuse may be a
D. Let the client eat food brought in by the family if she chooses, but
problem?
she should keep a strict calorie count.

A. The injury isnt consistent with the history or the childs age 13. Nurse Mary is assigned to care for a suicidal client. Initially,
B. The mother and father tell different stories regarding what happened which is the nurses highest care priority?
C. The family is poor

D. The parents are argumentative and demanding with emergency A. Assessing the clients home environment and relationships outside

department personnel the hospital

B. Exploring the nurses own feelings about suicide


10. For a female client with anorexia nervosa, nurse Rose plans to
C. Discussing the future with the client
include the parents in therapy sessions along with the client.
D. Referring the client to a clergyperson to discuss the moral
What fact should the nurse remember to be typical of parents of
implications of suicide
clients with anorexia nervosa?

14. A 24-year old client with anorexia nervosa tells the nurse,
A. They tend to overprotect their children When I look in the mirror, I hate what I see. I look so fat and
B. They usually have a history of substance abuse ugly. Which strategy should the nurse use to deal with the
C. They maintain emotional distance from their children clients distorted perceptions and feelings?
D. They alternate between loving and rejecting their children

A. Avoid discussing the clients perceptions and feelings


11. In the emergency department, a client with facial lacerations
B. Focus discussions on food and weight
states that her husband beat her with a shoe. After the health care
C. Avoid discussing unrealistic cultural standards regarding weight
team repairs her lacerations, she waits to be seen by the crisis
D. Provide objective data and feedback regarding the clients weight
intake nurse, who will evaluate the continued threat of violence.
and attractiveness
Suddenly the clients husband arrives, shouting that he wants to

finish the job. What is the first priority of the health care worker 15. Nurse Alice is caring for a client being treated for alcoholism.

who witnesses this scene? Before initiating therapy with disulfiram (Antabuse), the nurse
teaches the client that he must read labels carefully on which of 19. A parent brings a preschooler to the emergency department

the following products? for treatment of a dislocated shoulder, which allegedly happened

when the child fell down the stairs. Which action should make the
A. Carbonated beverages nurse suspect that the child was abused?
B. Aftershave lotion

C. Toothpaste A. The child cries uncontrollably throughout the examination

D. Cheese B. The child pulls away from contact with the physician.

C. The child doesnt cry when the shoulder is examined


16. Nurse Harry is developing a plan of care for a client with
D. The child doesnt make eye contact with the nurse.
anorexia nervosa. Which action should the nurse include in the

plan? 20. When planning care for a client who has ingested

phencyclidine (PCP), nurse Wayne is aware that the following is


A. Restrict visits with the family until the client begins to eat the highest priority?
B. Provide privacy during meals

C. Set up a strict eating plan for the client A. Clients physical needs

D. Encourage the client to exercise, which will reduce her anxiety B. Clients safety needs

C. Clients psychosocial needs


17. Nurse Taylor is aware that the victims of domestic violence
D. Clients medical needs
should be assessed for what important information?

21. The nurse is aware that the outcome criteria would be


A. Reasons they stay in the abusive relationship (for example, lack of appropriate for a child diagnosed with oppositional defiant
financial autonomy and isolation) disorder?
B. Readiness to leave the perpetrator and knowledge of resources

C. Use of drugs or alcohol A. Accept responsibility for own behaviors

D. History of previous victimization B. Be able to verbalize own needs and assert rights.

C. Set firm and consistent limits with the client


18. A male client is hospitalized with fractures of the right femur
D. Allow the child to establish his own limits and boundaries
and right humerus sustained in a motorcycle accident. Police

suspect the client was intoxicated at the time of the accident. 22. A male client is found sitting on the floor of the bathroom in

Laboratory tests reveal a blood alcohol level of 0.2% (200 mg/dl). the day treatment clinic with moderate lacerations on both wrists.

The client later admits to drinking heavily for years. During Surrounded by broken glass, he sits staring blankly at his

hospitalization, the client periodically complains of tingling and bleeding wrists while staff members call for an ambulance. How

numbness in the hands and feet. Nurse Gian realizes that these should Nurse Anuktakanuk approach her initially?

symptoms probably result from:


A. Enter the room quietly and move beside him to assess his injuries

A. Acetate accumulation B. Call for staff back-up before entering the room and restraining him

B. Thiamine deficiency C. Move as much glass away from him as possible and sit next to him

C. Triglyceride buildup. quietly

D. A below-normal serum potassium level D. Approach him slowly while speaking in a calm voice, calling him

name, and telling him that the nurse is here to help him
23. A female client with anorexia nervosa describes herself as a Considering the clients history of drug abuse, nurse Greg

whale. However, the nurses assessment reveals that the client is expects the physician to prescribe:

5 8 (1.7 m) tall and weighs only 90 lb (40.8 kg). Considering the

clients unrealistic body image, which intervention should nurse A. Lidocaine (Xylocaine).

Angel be included in the plan of care? B. Procainamide (Pronestyl).

C. Nitroglycerin (Nitro-Bid IV).

A. Asking the client to compare her figure with magazine photographs D. Epinephrine.

of women her age


27. A 14-year-old client was brought to the clinic by her mother.
B. Assigning the client to group therapy in which participants provide
Her mother expresses concern about her daughters weight loss
realistic feedback about her weight
and constant dieting. Nurse Kris conducts a health history
C. Confronting the client about her actual appearance during one-on-
interview. Which of the following comments indicates that the
one sessions, scheduled during each shift
client may be suffering from anorexia nervosa?
D. Telling the client of the nurses concern for her health and desire to

help her make decisions to keep her healthy


A. I like the way I look. I just need to keep my weight down because

24. Eighteen hours after undergoing an emergency Im a cheerleader.

appendectomy, a client with a reported history of social drinking B. I dont like the food my mother cooks. I eat plenty of fast food when

displays these vital signs: temperature, 101.6 F (38.7 C); heart Im out with my friends.

rate, 126 beats/minute; respiratory rate, 24 breaths/minute; and C. I just cant seem to get down to the weight I want to be. Im so fat

blood pressure, 140/96 mm Hg. The client exhibits gross hand compared to other girls.

tremors and is screaming for someone to kill the bugs in the bed. D. I do diet around my periods; otherwise, I just get so bloated.

Nurse Melinda should suspect:


28. Nurse Fey is aware that the drug of choice for treating

Tourette syndrome?
A. A postoperative infection

B. Alcohol withdrawal
A. Fluoxetine (Prozac)
C. Acute sepsis.
B. Fluvoxamine (Luvox)
D. Pneumonia.
C. Haloperidol (Haldol)

25. Clonidine (Catapres) can be used to treat conditions other D. Paroxetine (Paxil)

than hypertension. Nurse Sally is aware that the following


29. A male client tells the nurse he was involved in a car accident
conditions might the drug be administered?
while he was intoxicated. What would be the most therapeutic

response from nurse Julia?


A. Phencyclidine (PCP) intoxication

B. Alcohol withdrawal
A. Why didnt you get someone else to drive you?
C. Opiate withdrawal
B. Tell me how you feel about the accident.
D. Cocaine withdrawal
C. You should know better than to drink and drive.

26. A male client with a history of cocaine addiction is admitted to D. I recommend that you attend an Alcoholics Anonymous meeting.

the coronary care unit for evaluation of substernal chest pain. The
30. A male adult client voluntarily admits himself to the substance
electrocardiogram (ECG) shows a 1-mm ST-segment elevation the
abuse unit. He confesses that he drinks one (1) qt or more of
anteroseptal leads and T-wave inversion in leads V3 to V5.
vodka each day and uses cocaine occasionally. Later that 34. A male client is brought to the psychiatric clinic by family

afternoon, he begins to show signs of alcohol withdrawal. What members, who tell the admitting nurse that the client repeatedly

are some early signs of this condition? drives while intoxicated despite their pleas to stop. During an

interview with the nurse Linda, which statement by the client


A. Vomiting, diarrhea, and bradycardia most strongly supports a diagnosis of psychoactive substance
B. Dehydration, temperature above 101 F (38.3 C), and pruritus abuse?
C. Hypertension, diaphoresis, and seizures

D. Diaphoresis, tremors, and nervousness A. Im not addicted to alcohol. In fact, I can drink more than I used to

without being affected.


31. When monitoring a female client recently admitted for
B. I only spend half of my paycheck at the bar.
treatment of cocaine addiction, nurse Aaron notes sudden
C. I just drink to relax after work.
increases in the arterial blood pressure and heart rate. To correct
D. I know Ive been arrested three times for drinking and driving, but
these problems, the nurse expects the physician to prescribe:
the police are just trying to hassle me.

A. Norepinephrine (Levophed) and Lidocaine (Xylocaine) 35. A female client with borderline personality disorder is
B. Nifedipine (Procardia) and Lidocaine. admitted to the psychiatric unit. Initial nursing assessment
C. Nitroglycerin (Nitro-Bid IV) and Esmolol (Brevibloc) reveals that the clients wrists are scratched from a recent suicide
D. Nifedipine and Esmolol attempt. Based on this finding, the nurse Lenny should formulate

a nursing diagnosis of:


32. A 25 year old client experiencing alcohol withdrawal is upset

about going through detoxification. Which of the following goals


A. Ineffective individual coping related to feelings of guilt.
is a priority?
B. Situational low self-esteem related to feelings of loss of control

C. Risk for violence: Self-directed related to impulsive mutilating acts


A. The client will commit to a drug-free lifestyle
D. Risk for violence: Directed toward others related to verbal threats
B. The client will work with the nurse to remain safe

C. The client will drink plenty of fluids daily 36. A male client recently admitted to the hospital with sharp,
D. The client will make a personal inventory of strength substernal chest pain suddenly complains of palpitations. Nurse

Ryan notes a rise in the clients arterial blood pressure and a


33. A male client is admitted to a psychiatric facility by court order
heart rate of 144 beats/minute. On further questioning, the client
for evaluation for antisocial personality disorder. This client has a
admits to having used cocaine recently after previously denying
long history of initiating fights and abusing animals and recently
use of the drug. The nurse concludes that the client is at high risk
was arrested for setting a neighbors dog on fire. When evaluating
for which complication of cocaine use?
this client for the potential for violence, nurse Perry should

assess for which behavioral clues?


A. Coronary artery spasm

B. Bradyarrhythmias
A. A rigid posture, restlessness, and glaring
C. Neurobehavioral deficits
B. Depression and physical withdrawal
D. Panic disorder
C. Silence and noncompliance

D. Hypervigilance and talk of past violent acts 37. A male client is being admitted to the substance abuse unit for

alcohol detoxification. As part of the intake interview, the nurse

asks him when he had his last alcoholic drink. He says that he
had his last drink six (6) hours before admission. Based on this 41. Nurse Amy is aware that the client is at highest risk for

response, nurse Lorena should expect early withdrawal suicide?

symptoms to:
A. One who appears depressed frequently thinks of dying and gives

A. Begin after seven (7) days away all personal possessions

B. Not occur at all because the time period for their occurrence has B. One who plans a violent death and has the means readily available

passed C. One who tells others that he or she might do something if life

C. Begin anytime within the next one (1) to two (2) days doesnt get better soon

D. Begin within two (2) to seven (7) days D. One who talks about wanting to die

38. Nurse Helen is assigned to care for a client with anorexia 42. Nurse Penny is aware that the following medical conditions is

nervosa. Initially, which nursing intervention is most appropriate commonly found in clients with bulimia nervosa?

for this client?


A. Allergies

A. Providing one-on-one supervision during meals and for one (1) hour B. Cancer

afterward C. Diabetes mellitus

B. Letting the client eat with other clients to create a normal mealtime D. Hepatitis A

atmosphere
43. Kellan, a high school student is referred to the school nurse
C. Trying to persuade the client to eat and thus restore nutritional
for suspected substance abuse. Following the nurses
balance
assessment and interventions, what would be the most desirable
D. Giving the client as much time to eat as desired
outcome?

39. A female client begins to experience alcoholic hallucinosis.

Nurse Joy is aware that the best nursing intervention at this time? A. The student discusses conflicts over drug use

B. The student accepts a referral to a substance abuse counselor

A. Keeping the client restrained in bed C. The student agrees to inform his parents of the problem

B. Checking the clients blood pressure every 15 minutes and offering D. The student reports increased comfort with making choice

juices
44. A male client who reportedly consumes one (1) qt of vodka
C. Providing a quiet environment and administering medication as
daily is admitted for alcohol detoxification. To try to prevent
needed and prescribed
alcohol withdrawal symptoms, Dr. Smith is most likely to
D. Restraining the client and measuring blood pressure every 30
prescribe which drug?
minutes

40. Nurse Bella is aware that assessment finding is most A. Clozapine (Clozaril)

consistent with early alcohol withdrawal? B. Thiothixene (Navane)

C. Lorazepam (Ativan)

A. Heart rate of 120 to 140 beats/minute D. Lithium carbonate (Eskalith)

B. Heart rate of 50 to 60 beats/minute


45. A male client is being treated for alcoholism. After a family
C. Blood pressure of 100/70 mmHg
meeting, the clients spouse asks the nurse about ways to help
D. Blood pressure of 140/80 mmHg
the family deal with the effects of alcoholism. Nurse Lily should indicates that his childhood was marred by an abusive

suggest that the family join which organization? relationship with his father. When intervening with this couple,

nurse Gerry knows they are at risk for repeated violence because
A. Al-Anon the husband:
B. Make Today Count

C. Emotions Anonymous A. Has only moderate impulse control

D. Alcoholics Anonymous B. Denies feelings of jealousy or possessiveness

C. Has learned violence as an acceptable behavior


46. A female client is admitted to the psychiatric clinic for
D. Feels secure in his relationship with his wife
treatment of anorexia nervosa. To promote the clients physical

health, nurse Tair should plan to: 49. A client whose husband just left her has a recurrence of

anorexia nervosa. Nurse Vic caring for her realizes that this
A. Severely restrict the clients physical activities exacerbation of anorexia nervosa results from the clients effort
B. Weigh the client daily, after the evening meal to:
C. Monitor vital signs, serum electrolyte levels, and acid-base balance

D. Instruct the client to keep an accurate record of food and fluid intake A. Manipulate her husband

B. Gain control of one part of her life


47. Kevin is remanded by the courts for psychiatric treatment. His
C. Commit suicide
police record, which dates to his early teenage years, includes
D. Live up to her mothers expectations
delinquency, running away, auto theft, and vandalism. He dropped

out of school at age 16 and has been living on his own since then. 50. A male client has approached the nurse asking for advice on

His history suggests maladaptive coping, which is associated how to deal with his alcohol addiction. Nurse Sally should tell the

with: client that the only effective treatment for alcoholism is:

A. Antisocial personality disorder A. Psychotherapy

B. Borderline personality disorder B. Total abstinence

C. Obsessive-compulsive personality disorder C. Alcoholics Anonymous (AA)

D. Narcissistic personality disorder D. Aversion therapy

48. Macoy and Helen seek emergency crisis intervention because

he slapped her repeatedly the night before. The husband