NCLEX RN Predictor Exam
Question 1 of 5.
A 26-year-old client is in a treatment center for alprazolam (Xanax) abuse and continues to manifest moderate levels of anxiety 3 weeks into the rehabilitation program, often requesting medication for 'his nerves.' Included in the client's plan of care is to identify alternate methods of coping with stress and anxiety other than use of medication. After intervening with assistance in stress reduction techniques, identifying feelings and past coping, the nurse evaluates the outcome as being met if:
A. Client promises that he will not abuse alprazolam after discharge
B. Client demonstrates use of exercise or physical activity to handle nervous energy following conflicts of everyday life
C. Client is able to verbalize effects of substance abuse on the body
D. Client has remained substance free during hospitalization and is discharged
Explanation: This client response does not address stress reduction techniques. Verbal response focuses only on the problem. Exercise or physical activity is a common strategy or coping technique used to reduce stress and anxiety. Verbalizing effects of substance abuse on the body may help with insight and break through denial, but it is not a strategy to reduce anxiety. Remaining substance-free does indicate motivation to change lifestyle of substance abuse or dependence, and it is not a stress reduction strategy in itself.
Question 2 of 5.
A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?
A. Resting tremors
B. Double vision
C. Flaccid paralysis
D. Pill-rolling tremors
Explanation: Double vision (diplopia) is a common early symptom of multiple sclerosis due to demyelination affecting the optic nerves or brainstem.
Question 3 of 5.
A child with Down syndrome has a developmental age of four years. According to the Denver Developmental Assessment, the four-year-old should be able to:
A. Draw a man in six parts
B. Give his first and last name
C. Dress without supervision
D. Define a list of words
Explanation: Per the Denver Developmental Screening Test, a four-year-old should be able to state their first and last name, a milestone achievable despite Down syndrome delays.
Question 4 of 5.
Parents of a toddler are dismayed when they learn that their child has Duchenne's muscular dystrophy. Which statement describes the inheritance pattern of the disorder?
A. An affected gene is located on one of the 21 pairs of autosomes.
B. The disorder is caused by an over-replication of the X chromosome in males.
C. The affected gene is located on the Y chromosome of the father.
D. The affected gene is located on the X chromosome of the mother.
Explanation: Duchenne's muscular dystrophy is an X-linked recessive disorder, with the affected gene on the mother's X chromosome, primarily affecting males.
Question 5 of 5.
The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
A. Increased pulse rate
B. Increased urinary output
C. Decreased diastolic blood pressure
D. Increased pupil size
Explanation: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid from the brain.
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