NCLEX Select All That Apply Practice Exam 11

Question 1

A client has a diagnosis of primary insomnia. Before assessing this client, the nurse recalls the numerous causes of this disorder. Select all that apply:

Accepted Answer

Chronic stress

Answer

Primary insomnia is often influenced by various lifestyle and environmental factors. Chronic stress and excessive caffeine intake are known to disrupt sleep patterns, making it difficult to fall or stay asleep. Environmental noise can also directly interfere with sleep, contributing to the development of primary insomnia.

Question 2

Select all that apply to the use of barbiturates in treating insomnia:

Accepted Answer

Barbiturates deprive people of REM sleep

Answer

Barbiturates are known to suppress REM sleep. When these medications are discontinued, a rebound effect occurs, leading to an increase in REM sleep, often accompanied by vivid dreams or nightmares. This rebound REM sleep and associated nightmares are common withdrawal symptoms when discontinuing barbiturates.

Question 3

Select all that apply that is appropriate when there is a benzodiazepine overdose:

Accepted Answer

Gastric lavage

Answer

For a benzodiazepine overdose, interventions focus on reducing absorption and reversing the drug's effects. Gastric lavage and activated charcoal with a saline cathartic help remove unabsorbed medication from the GI tract. Flumazenil is a specific benzodiazepine receptor antagonist that can reverse the sedative effects of an overdose.

Question 4

A nurse has reinforced instructions to the client with hyperparathyroidism regarding home care measures related to exercise. Which statement by the client indicates a need for further instruction? Select all that apply.

Accepted Answer

"I need to limit playing football to only the weekends."

Answer

Clients with hyperparathyroidism are at increased risk for bone demineralization and fractures, so high-impact activities like football should be avoided. Additionally, exercising in the evening can stimulate the body and interfere with sleep, making it an inappropriate recommendation for encouraging good sleep patterns.

Question 5

A nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the registered nurse and expects which interventions to be prescribed? Select all that apply.

Accepted Answer

Administering oxygen

Answer

In pulmonary edema, immediate interventions aim to improve oxygenation, reduce fluid overload, and decrease cardiac workload. Administering oxygen addresses dyspnea, furosemide (Lasix) promotes diuresis to reduce fluid, morphine sulfate reduces anxiety and venous return, and a Foley catheter allows for accurate monitoring of urine output and fluid balance.

NCLEX Practice Test

NCLEX Practice Test

NCLEX Select All That Apply Practice Exam 11