NCLEX RN Predictor Exam
Question 1 of 5.
Two hours after the second injection of haloperidol, a client complains to the nurse of a stiff neck and inability to sit still. He is experiencing symptoms consistent with:
A. Parkinsonism and dystonia
B. Dystonia and akathisia
C. Akathisia and parkinsonism
D. Neuroleptic malignant syndrome
Explanation: Stiff neck is consistent with a dystonic reaction, but the client has no symptoms of drooling, shuffling gait, or pill-rolling movements characteristic of parkinsonism. Stiff neck is consistent with a dystonic reaction, and inability to sit still with varying degrees of psychomotor agitation is characteristic of akathisia. The client has symptoms of dystonia but not of parkinsonism. The client has none of the characteristic symptoms of neuroleptic malignant syndrome: hyperpyrexia, generalized muscle rigidity, mutism, obtundation, agitation, sweating, increased blood pressure and pulse.
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.