ncsbn nclex preparation guide questions and answers | 2023
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NCLEX-RN
EXAMINATIONS
EXAM CODE: NCLEX RN
NUMBER OF QUESTIONS: 890 QUESTIONS AND ANSWERS
DATE: 07/13/2022
,NCLEX Prep
Psychosocial integrity – lesson 4
Hospice care – clients who are at end of life, usually less than 6 months to live, no age
requirements
Most important intervention for client experiencing intense anxiety after losing home is
to determine available community and personal support resources – this is important to
focus on obtaining assistance for housing and immediate needs – clients basic need for
shelter must be met first
PTSD clients – the only 2 approved medications for treatment are the SSRIs sertraline
(Zoloft) and paroxetine (Paxil). Other treatments include psychotherapy, cognitive-
behavioural therapy, group psychotherapy, EMDR and hypnotherapy.
Alcohol withdrawal – signs and symptoms include sweating, tremors, hyperactivity,
hypertension and tachycardia. Client must be monitored closely for progression, which
includes seizures and delirium tremens (DTs).
MENTAL HEALTH
Diagnosing and treating mental illness – neuroimaging through PET, CT and MRI allow
researchers to study the brain – major neurotransmitters of the brain include
norepinephrine, dopamine, serotonin and gamma-aminobutyric acid (GABA)
CBT – thought, behaviour, emotion – focuses on the premise that a person’s thoughts
control their behaviour
Behavioural theory – symptoms on mental illness are the result of learned behaviour
GRIEF & LOSS
Loss is anything a client perceives as a loss and can trigger emotions associated with the
grieving process – response to loss depends on many factors, such as personality,
culture, previous experiences with loss, values
Grief includes many different types – anticipatory, disenfranchised and complicated grief.
Tasks of mourning: Real (accept that the loss is real), Experience the emotions, Adjust or
re-adjust to lift and activities, Let go and move on with one’s life REAL
NURSE-CLIENT RELATIONSHIP
3 phases – orientation, working and termination
Orientation is when the nurse establishes trust and rapport with the client - outline
expectation, problems, goal-setting, plan of action.
Working is once the boundaries are accepted and therapeutic relationship is established
the nurse and client can begin to work on the clients problems
STRESS MANAGEMENT
, General adaptation response: Stage 1 Alarm, Stage 2 Resistance, Stage 3 Exhaustion
Stage 1: fight or flight response – adrenaline stimulates the sympathetic nervous system
into action and reduces activity in the parasympathetic nervous system until the
perceived threat is over
Stage 2: the body resists and compensates as the parasympathetic nervous system
attempts to return to normal levels of functioning – the body remains on alert
Stage 3: If the stressor(s) continue, the body becomes exhausted – decrease in immune
response, suppression of T-cells and dysfunction in the lymphatic system – body is
susceptible to disease and death
PANIC Palpitations, Abdominal distress, Nausea, Increased perspiration, Chest pain,
chills, choking
CRISIS INTERVENTION
There are four parts of a crisis – first is that the client must be in a vulnerable state –
second is a precipitating event (maturational crisis, life change, loss of loved one or job,
environmental disaster) – third is the acute phase (client temporarily loses control and
may be in a panic state) – when the client loses all effective coping skills and cannot
continues to function this is referred to as an exhaustion crisis – shock crisis is the result
of a sudden external change that causes a release of emotions that overwhelms clients -
- fourth phase is the reorganization when client is able to integrate pain or loss into a
new way of coping
Depression
Zoloft is the drug of choice for treating depression in the elderly due to its short half-life
Prozac is better for children due to its long half life
Clients with major depression lack concentration and memory
BASIC CARE & COMFORT
IBS & controlling gas and bloating – adequate fiber is critical to controlling this, but if
fiber is added too quickly it can result in gas and bloating, therefore cutting back on fiber
and then added 2-3grams of it back into your diet will be helpful, dairy products also
contribute to bloating – 4-5 small meals would be eaten each day
Nutritional needs through the life cycle
o Newborns – 6-8 wet diapers per day
o Infants needs ~2.2g/protein per kg/day
o Whole milk should be introduced around age 1
o Pregnant women should add per day 300cals, 15 mg iron, 30g protein, 400g Ca
and 400ug folic acid in first trimester
o Lactation – add 500cals and 2 quarts extra fluid per day
Essential Nutrients
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