NCLEX-PN Test #12 3 Flashcards
6 cards from real NCLEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 NCLEX-PN Test #12 3 flashcards as text
The PN is performing a mental status examination. Which question best assesses the client's orientation?
Answer: "Can you tell me what day, month, and year it is, where you are, and what your name is?"
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.
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?
Answer: "Naloxone is inactive when taken sublingually but precipitates severe withdrawal if the tablet is crushed and injected, deterring misuse."
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.
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:
Answer: Splitting
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.
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?
Answer: Immediately conduct a room search for stockpiled medications and implement 1:1 continuous observation
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.
A client with schizophrenia is prescribed risperidone (an atypical antipsychotic). Which side effect should the nurse specifically monitor for?
Answer: Tardive dyskinesia and extrapyramidal symptoms (EPS)
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.
The nurse is caring for a client withdrawing from cocaine. Which symptoms should the nurse anticipate?
Answer: Fatigue, dysphoria, increased sleep, increased appetite, and cocaine cravings
Cocaine withdrawal (crash phase) is characterized by fatigue, hypersomnia, increased appetite, depression/dysphoria, irritability, and intense cocaine cravings. Unlike opioid or alcohol withdrawal, cocaine withdrawal is not physically dangerous (no seizures or delirium) but poses high risk of relapse due to severe psychological craving.