NCLEX-PN Test #12 3

Question 1

The PN is performing a mental status examination. Which question best assesses the client's orientation?

Accepted Answer

"Can you tell me what day, month, and year it is, where you are, and what your name is?"

Answer

Orientation is assessed by asking about person (name), place (where they are), and time (day/month/year). Serial subtraction tests concentration; interpretation of proverbs assesses abstract thinking; drawing tests visuospatial ability. Orientation × 3 (person, place, time) is a standard component of the mental status exam.

Question 2

A client with opioid use disorder is being treated with buprenorphine/naloxone (Suboxone). The client asks why naloxone is included. What is the correct explanation?

Accepted Answer

"Naloxone is inactive when taken sublingually but precipitates severe withdrawal if the tablet is crushed and injected, deterring misuse."

Answer

Naloxone (an opioid antagonist) in Suboxone is an abuse-deterrent. When taken as directed sublingually, naloxone has poor bioavailability and does not significantly block buprenorphine's effects. However, if the tablet is crushed and injected IV, the naloxone becomes active and precipitates acute opioid withdrawal, deterring IV misuse.

Question 3

A client with borderline personality disorder frequently says, "You are the only nurse who truly understands me — all the other nurses are awful." The nurse recognizes this as:

Accepted Answer

Splitting

Answer

Splitting is a primitive defense mechanism characteristic of borderline personality disorder in which people and situations are viewed as all good or all bad, with no middle ground. Idealization of one staff member while devaluing others is classic splitting. The therapeutic response is to maintain consistent boundaries and avoid being drawn into the idealization.

Question 4

A client on the psychiatric unit says, "I have a plan to end my life — I've been saving my medications." What is the priority nursing action?

Accepted Answer

Immediately conduct a room search for stockpiled medications and implement 1:1 continuous observation

Answer

This client has disclosed a specific suicide plan with means (stockpiled medications). This is an imminent safety crisis. Priority actions: immediate room and belongings search for stockpiled medications, implement 1:1 continuous observation, notify the provider, and document all actions. Family notification follows safety implementation.

Question 5

A client with schizophrenia is prescribed risperidone (an atypical antipsychotic). Which side effect should the nurse specifically monitor for?

Accepted Answer

Tardive dyskinesia and extrapyramidal symptoms (EPS)

Answer

Although atypical antipsychotics have lower EPS risk than typical antipsychotics, risperidone has a higher EPS profile among atypicals. Tardive dyskinesia (involuntary repetitive movements) and extrapyramidal symptoms (akathisia, parkinsonism, dystonia) require monitoring. Clozapine specifically requires weekly CBC monitoring for agranulocytosis.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #12 3