NCLEX Question Trainer Explanations Test 7

1. The father of a one-day-old son works the evening shift (3 PM to 11 PM) at another hospital. Which of the following plans would be a priority to meet the needs of this father? 1. Encourage the father to call his wife after work. 2. Instruct the father about visiting policy and suggest AM visitation. 3. Adjust visiting hours to meet the new parents’ needs. 4. Present a change of visiting hours to the appropriate hospital committee. Strategy: Answers are implementation. Determine the outcome of each answer. Is it desired? (1) inflexible (2) inflexible (3) correct–role of nurse is to be a family and client advocate; this provides individualized care not a priority, although it may be an appropriate long-range goal (4) not a priority, although it may be an appropriate long-range goal 2. The nurse believes a coworker is diverting narcotics. The nurse approaches the nurse manager to report the suspicions. Which of the following statements by the nurse is BEST? 1. “After my coworker has been on duty, the patients often need repeated doses of pain medication. I have seen her/him sleeping on duty three times.” 2. “I saw my coworker downtown after work. S/he was acting really strange, like s/he didn’t even recognize me.” 3. “I think my coworker is stealing narcotics because s/he is always acting euphoric and seems high.” 4. “My coworker is hanging around with drug dealers, and I think I saw tracks on her/his arms.” Strategy: All answers are assessment. Determine how each relates to the situation. (1) correct—report objective information that can be verified; clues to possible substance abuse by staff include memory lapses, frequent absences from the floor, increased number of clients reporting unrelieved pain or insomnia (2) subjective observation (3) subjective observation (4) “hanging around with drug dealers” is subjective NCLEX Question Trainer Explanations Test 7 50 . 3. A woman with chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation. Her vital signs are: BP 162/100, pulse 78, respirations 30 and labored with wheezing. The nurse should question which of the following orders? 1. Theophylline (Somophyllin) 0.7 mg/kg/hr IV. 2. Tetracycline hydrochloride (Sumycin) 250 mg IM qd. 3. Ipratropium bromide (Atrovent) inhaler 2 inhalations qid. 4. Propranolol hydrochloride (Inderal) 40 mg PO bid. Strategy: You are looking for an incorrect medication. Think about the action of each drug. (1) drug of choice for acute asthma (2) broad spectrum antibiotic, not contraindicated (3) blocks parasympathetic stimulation and decreases mucus; used with asthma (4) correct—beta-blocker that blocks beta adrenergic impulses to the bronchial tree that cause bronchodilation resulting in increased bronchoconstriction 4. A husband and wife meet at the mental health clinic to make an appointment for family therapy. Suddenly, the wife begins to sob loudly. As the nurse approaches, the husband says, “I guess we just don’t get along.” Which of the following responses by the nurse is MOST appropriate?