NCLEX-RN Exam
Question 1 of 5.
The mother of a 7-year-old mental health center client reports that the client has refused to attend gymnastics for the past 2 weeks. Prior to that time, the child liked going to this class and was attending 3 times a week. In talking with the client, the nurse would:
A. Ask her why she doesn't like gymnastics anymore
B. Ask her to describe how things were at gymnastics before she started refusing to go
C. Ask her what happened at gymnastics 2 weeks ago
D. Encourage her to tell the nurse about her feelings toward gymnastics now
Explanation: Asking 'why' questions may put the child on the defensive and may not elicit useful information, especially in a young child who may struggle to articulate reasons. This approach is open-ended and encourages the child to describe her experiences in a non-confrontational way, which may reveal underlying issues while building trust. This question is too specific and may feel confrontational, potentially causing the child to shut down. While encouraging expression of feelings is appropriate, it is less specific and may not help uncover the specific event or change that led to her refusal to attend.
Question 2 of 5.
After attending a company picnic, several clients are admitted to the emergency room with E. coli food poisoning. The most likely source of infection is:
A. Hamburger
B. Hot dog
C. Potato salad
D. Baked beans
Explanation: Undercooked hamburger is a common source of E. coli, particularly E. coli O157:H7, which can contaminate ground beef.
Question 3 of 5.
A client with paranoid schizophrenia is brought to the hospital by her elderly parents. During the assessment, the client's mother states, 'Sometimes she is more than we can manage.' Based on the mother's statement, the most appropriate nursing diagnosis is:
A. Ineffective family coping related to parental role conflict
B. Care-giver role strain related to chronic situational stress
C. Altered family process related to impaired social interaction
D. Altered parenting related to impaired growth and development
Explanation: The mother's statement reflects caregiver role strain due to the chronic stress of managing a child with paranoid schizophrenia, impacting the parents' ability to cope.
Question 4 of 5.
A client with obsessive compulsive personality disorder annoys his co-workers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
A. Helping the client develop a plan for changing his behavior
B. Contracting with him for the time he spends on a task
C. Avoiding a discussion of his annoying behavior because it will only make him worse
D. Encouraging him to set a time schedule and deadlines for himself
Explanation: Setting time schedules and deadlines helps manage the client's perfectionism and preoccupation with details, promoting efficiency without confrontation.
Question 5 of 5.
The nurse has just received the change of shift report. Which client should the nurse assess first?
A. A client with a supratentorial tumor awaiting surgery
B. A client admitted with a suspected subdural hematoma
C. A client recently diagnosed with akinetic seizures
D. A client transferring to the neuro rehabilitation unit
Explanation: A suspected subdural hematoma is a medical emergency due to potential brain compression, requiring immediate assessment.
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