2023 RN test 3 NCLEX questions and Answers with complete solutions

2023 RN test 3 NCLEX questions and Answers with complete solutions 1. A college student visits the school's health center reporting extreme fatigue and slight restlessness. The student states, "Exams are right around the corner, and all I feel like doing is sleeping." There are no abnormal physical assessment findings. How does the nurse best help the student frame their desire to sleep? a. Asking the student if they are worried about failing exams b. Telling them they must strive to sleep 7 to 9 hours nightly c. Evaluating their use of recreational drugs d. Explaining that some people use sleep as a coping mechanism - ANS- a. Fatigue and mild anxiety are often handled without conscious thought through the use of coping mechanisms, such as sleeping. These coping mechanisms are protective behaviors used to decrease stress and anxiety. 1. A group of nursing students in a leadership course are studying the ANA position regarding assisted suicide. The professor asks the students for the best response to a note written by a ventilator-dependent patient "help me end my suffering, I don't want to live anymore." Which nursing response is consistent with the ANA's position? a. "I will do everything possible to keep you comfortable but will not administer medication to cause your death." b. "Being removed from the ventilator is a form of active euthanasia, which is not supported by the nurses' code of ethics." c. After exhausting every intervention to keep a dying patient comfortable, the nurse says, "Let's talk about when and how you want to die." d. "I'm personally opposed to assisted suicide, but I'll find you a colleague who can help you." - ANS- a. The ANA Code of Ethics states that the nurse "should provide interventions to relieve pain and other symptoms in the dying patient consistent with palliative care practice standards and may not act with the sole intent to end life" (2015, p. 3). Removing mechanical ventilation or other life support at the patient's request or request of the surrogate when treatment is futile is not performed with the sole intent to end life but to promote dignity and comfort. Nurses should be prepared to respond to the request: "Nurse, please help me die...." 1. A home health care nurse has been caring for a patient with advanced AIDS who is working through the stages of death and dying. The nurse documents the patient has entered the acceptance phase of death when the patient makes which statement? a. "I've made peace with everyone, and I'm actually ready to move on." b. "God cannot possibly be good if He allows people to get this horrible disease." c. "I just want to get better. A friend of mine had success with a plant-based diet." d. "The test results must be mixed up with someone else's; I feel better now." - ANS- a. According to Kübler-Ross, when the patient reaches the stage of acceptance, they feel tranquil. This patient has accepted the reality of death and is prepared for the transition to death. 1. A hospice nurse who cared for a dying patient and their family documents that the family is experiencing a period of mourning. Which behaviors would the nurse expect to see at this stage? Select all that apply. a. The family arranges for a funeral for their loved one. b. The family arranges for a memorial scholarship for their loved one. c. The coroner pronounces the patient's death. d. The family arranges for hospice for their loved one. e. The patient is diagnosed with terminal cancer. f. The patient's daughter writes a poem expressing her sorrow. - ANS- a, b, f. Mourning refers to the actions and expressions of grief, including the symbols and ceremonies (e.g., a funeral or final celebration of life) that make up the outward expressions of grief. It is a period of grief and acceptance, as the person learns to deal with their loss. A diagnosis of cancer and the coroner's pronouncing the patient's death are not behaviors of the family during a period of mourning. Arranging for hospice care precedes a patient's death. 1. A nurse at a health fair calculates the body mass index (BMI) of a person who weighs 68 kg and is 165 cm (1.65 m) tall. How will the nurse document the BMI? a. 25 kg/m2 b. 46 kg/m2 c. 68 kg/m2 d. 165 kg/m2 - ANS- Example: Weight = 68 kg, height = 165 cm (1.65 m), Calculation: 68 ÷ (1.65)2 = 24.98 1. A nurse at the university health clinic has assessed a student reporting an inability to concentrate and a pounding heart. The student states, "my boyfriend just dumped me out of the blue. They were supposed to be my date at my sister's wedding this weekend. How can I go now?" Which response would the nurse make? a. "Can you tell me what part of this is most problematic right now?" b. "What alternatives can you think of at this late date?" c. "You might start by evaluating your relationship." "It may be best to not think about this person until after the wedding." - ANS- a. Although identifying the problem may be difficult, a solution to a crisis situation is impossible until the problem is identified. 1. A nurse caring for an older adult living in a long-term care facility uses reminiscence to help the patient adapt to the changes of aging. The nurse uses which question to encourage reminiscence? a. "Tell me about how you celebrated Christmas when you were young." b. "Tell me how you plan to spend your time this weekend." c. "Did you enjoy the choral group that performed here yesterday? d. "Why don't you want to talk about your feelings?" - ANS- a. Use of life review or reminiscence encourages reflection; the older adult can restructure life experiences and better adapt to life circumstances. Asking about a recent event, upcoming plans, or feelings would be unlikely to encourage reminiscence. 1. A nurse caring for older adults in a provider's office researches aging theories to help determine why some people age more rapidly than others. Which statements describe the immunity theory of the aging process? Select all that apply. a. Immunosenescence likely promotes the increase in infections in the older adult. b. Free radicals have adverse effects on adjacent molecules. c. Decreases in size and function of the thymus result in more infections. d. Nutrition likely plays an important role in maintaining the immune response. e. Lifespan depends to a great extent on genetic factors. f. Organisms wear out from increased metabolic functioning. - ANS- a, c, d. The immunity theory of aging focuses on the functions of the immune system and states that the immune response declines steadily after younger adulthood as the thymus loses size and function, resulting in more infections. Vitamin supplements (such as vitamin E) may improve immune function. The cross-linkage theory proposed that a chemical reaction produces damage to the DNA and cell death. The free radical theory states that free radicals—molecules with separated high-energy electrons—formed during cellular metabolism can have adverse effects on adjacent molecules. The genetic theory of aging holds that lifespan depends to a great extent on genetic factors. According to the wear-and-tear theory, organisms wear out from increased metabolic functioning, and cells become exhausted from continual energy depletion from adapting to stressors. 1. A nurse in a long-term care facility is caring for patient with a spinal cord injury affecting their sensory and motor reflexes below the waist. Based on the patient's condition, what would be a priority intervention for this patient? a. Taking care with hot beverages to prevent burns b. Providing adequate pain relief measures to reduce stress c. Monitoring for depression related to social isolation d. Offering meals high in carbohydrates to promote healing - ANS- a. A patient with a damaged neurologic reflex arc has a diminished pain reflex response. This diminished sensation and motor response places the patient at risk for burns. All patients should be provided adequate pain relief, but this is not a priority. Monitoring for depression would be an intervention for this patient but is not related to the damaged neurologic reflex arc. A patient who is immobile should eat a well-balanced diet. 1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea, and anxiety. When the health care provider finds no identifiable cause for the symptoms, which actions would the nurse recommend? Select all that apply. a. Keeping a diary identifying sources of stress b. Sleeping 4 hours per night c. Considering previous strengths and coping d. Asking whom the patient relies on for support e. Asking if the patient's partner is abusive f. Assessing for prior psychiatric conditions - ANS- a, c, d. The sympathetic nervous system reacts to stress with the fight-or-flight response. This response causes increased the heart rate, muscle strength, cardiac output, blood glucose levels, and mental alertness. Increased peristalsis is brought on by the parasympathetic nervous system under normal conditions and at rest. 1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea, and anxiety. With no identifiable cause for the pain, which actions to reduce stress would the nurse recommend? Select all that apply. a. Keeping a diary identifying sources of stress b. Sleeping 4 hours per night c. Considering previous strengths and coping mechanisms d. Asking whom the patient relies on for support e. Asking if their partner is abusive f. Assessing for prior psychiatric conditions - ANS- a, c, d. Keeping a diary of sources of stress can help identify the problem, which is the first step in stress management. The nurse can help the patient identify supports and their strengths. The nurse should recommend sleeping 7 to 9 hours nightly. The nurse would not infer there is a problem of abuse or a psychiatric condition as a cause of their symptoms. Abuse is assessed for routinely, often at the start of the interview, but not in the context of this situation. 1. A nurse in a rehabilitation facility is evaluating patients with chronic pain to develop an interprofessional plan of care. Which patients would the nurse identify who could benefit from a multimodal approach to pain management? Select all that apply. a. Patient receiving chemotherapy for bladder cancer b. Adolescent who had an appendectomy c. Patient who is experiencing a ruptured aneurysm d. Patient with fibromyalgia requesting pain medication e. Patient having back pain related to an accident that occurred last year f. Patient experiencing pain from second-degree burns - ANS- a, d, e. Chronic pain is pain that may be limited, intermittent, or persistent but that lasts beyond the normal healing period. Examples are cancer pain, fibromyalgia pain, and back pain. Acute pain is generally rapid in onset and varies in intensity from mild to severe, as occurs with an emergency appendectomy, a ruptured aneurysm, and pain from burns. 1. A nurse in the emergency department receives a patient rescued from a building fire. The firefighter giving the handoff report tells the nurse the building collapsed immediately after they removed the patient from the building. The nurse notes the patient is experiencing the alarm phase of the fight-or-flight response. What assessment findings support the nurse's observation? Select all that apply. a. Rapid breathing b. Hypotension c. Restlessness d. Withdrawn demeanor e. Tachycardia - ANS- a, c, e. The sympathetic nervous system initiates the fight-or-flight response, preparing the body to fight a stressor or run from it. This phase of the alarm reaction, called the shock phase, is characterized by an increase in energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness. During the second