Exam 4 NCLEX-style practice questions Unit 9 (Substance-related and eating
disorders), Unit 10 (Violence, sexual assault, abuse, and special populations),
and Units 11/12 (Death, dying, and grieving).
Unit 9: Substance Related & Eating Disorders
Source Focus: Substance disorders, Anorexia, Bulimia, Binge-eating,
Alcohol/Opioid withdrawal.
1. A nurse is caring for a client admitted with alcohol withdrawal. Which
assessment finding indicates the client is experiencing late-stage withdrawal
(delirium tremens)?
A. Fine tremors of the hands
B. Nausea and vomiting
C. Agitation and fluctuating consciousness/hallucinations
D. Anxiety and insomnia
Answer: C. Rationale: While tremors and anxiety are early signs, delirium
tremens is a medical emergency characterized by severe agitation,
hallucinations, and fluctuating levels of consciousness.
2. A client is admitted to the ED with an opioid overdose. Which intervention
is the priority?
A. Administer methadone.
B. Assess for suicidal ideation.
C. Administer naloxone (Narcan).
D. Begin the CIWA assessment protocol.
Answer: C. Rationale: The syllabus identifies opioid withdrawal and substance
use as key topics. In an overdose, the priority is reversing respiratory
depression using naloxone.
3. A nurse is assessing a client with anorexia nervosa. Which physical
symptom is the nurse most likely to observe?
A. Erosion of dental enamel
B. Lanugo (fine downy hair)
C. Warm, flushed skin
D. Tachycardia
Answer: B. Rationale: Lanugo is a classic physiological response to starvation
and loss of body fat seen in anorexia nervosa. Enamel erosion is associated
with bulimia.
, 4. A client with bulimia nervosa is being treated in an outpatient setting.
Which laboratory result is of most concern to the nurse?
A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Hemoglobin 13 g/dL
D. Glucose 85 mg/dL
Answer: A. Rationale: Bulimia involves purging behaviors (vomiting/laxatives)
which lead to electrolyte imbalances, specifically hypokalemia, putting the
client at risk for cardiac arrhythmias.
5. Which statement by a client with alcohol use disorder indicates the
defense mechanism of denial?
A. "I know I drink too much, but I can't stop."
B. "I only drink on weekends to relax, I don't have a problem."
C. "My wife is the reason I drink; she nags me constantly."
D. "I lost my job because I was hungover."
Answer: B. Rationale: Denial involves refusing to acknowledge the existence
or severity of a problem. Blaming the wife (C) is projection.
6. A nurse is planning care for a client with binge-eating disorder. Which
nursing diagnosis is most appropriate?
A. Imbalanced nutrition: less than body requirements
B. Risk for fluid volume deficit
C. Imbalanced nutrition: more than body requirements
D. Ineffective airway clearance
Answer: C. Rationale: Binge-eating disorder involves consuming large
quantities of food without the compensatory purging behaviors seen in
bulimia, leading to obesity and excess nutrition.
7. A client is prescribed disulfiram (Antabuse) for alcohol use disorder. What
is the priority teaching point?
A. "Take this medication only when you feel the urge to drink."
B. "Avoid all products containing alcohol, including mouthwash and cough
syrup."
C. "This medication will decrease your cravings for alcohol."
D. "You may experience euphoria if you drink alcohol while taking this."
disorders), Unit 10 (Violence, sexual assault, abuse, and special populations),
and Units 11/12 (Death, dying, and grieving).
Unit 9: Substance Related & Eating Disorders
Source Focus: Substance disorders, Anorexia, Bulimia, Binge-eating,
Alcohol/Opioid withdrawal.
1. A nurse is caring for a client admitted with alcohol withdrawal. Which
assessment finding indicates the client is experiencing late-stage withdrawal
(delirium tremens)?
A. Fine tremors of the hands
B. Nausea and vomiting
C. Agitation and fluctuating consciousness/hallucinations
D. Anxiety and insomnia
Answer: C. Rationale: While tremors and anxiety are early signs, delirium
tremens is a medical emergency characterized by severe agitation,
hallucinations, and fluctuating levels of consciousness.
2. A client is admitted to the ED with an opioid overdose. Which intervention
is the priority?
A. Administer methadone.
B. Assess for suicidal ideation.
C. Administer naloxone (Narcan).
D. Begin the CIWA assessment protocol.
Answer: C. Rationale: The syllabus identifies opioid withdrawal and substance
use as key topics. In an overdose, the priority is reversing respiratory
depression using naloxone.
3. A nurse is assessing a client with anorexia nervosa. Which physical
symptom is the nurse most likely to observe?
A. Erosion of dental enamel
B. Lanugo (fine downy hair)
C. Warm, flushed skin
D. Tachycardia
Answer: B. Rationale: Lanugo is a classic physiological response to starvation
and loss of body fat seen in anorexia nervosa. Enamel erosion is associated
with bulimia.
, 4. A client with bulimia nervosa is being treated in an outpatient setting.
Which laboratory result is of most concern to the nurse?
A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Hemoglobin 13 g/dL
D. Glucose 85 mg/dL
Answer: A. Rationale: Bulimia involves purging behaviors (vomiting/laxatives)
which lead to electrolyte imbalances, specifically hypokalemia, putting the
client at risk for cardiac arrhythmias.
5. Which statement by a client with alcohol use disorder indicates the
defense mechanism of denial?
A. "I know I drink too much, but I can't stop."
B. "I only drink on weekends to relax, I don't have a problem."
C. "My wife is the reason I drink; she nags me constantly."
D. "I lost my job because I was hungover."
Answer: B. Rationale: Denial involves refusing to acknowledge the existence
or severity of a problem. Blaming the wife (C) is projection.
6. A nurse is planning care for a client with binge-eating disorder. Which
nursing diagnosis is most appropriate?
A. Imbalanced nutrition: less than body requirements
B. Risk for fluid volume deficit
C. Imbalanced nutrition: more than body requirements
D. Ineffective airway clearance
Answer: C. Rationale: Binge-eating disorder involves consuming large
quantities of food without the compensatory purging behaviors seen in
bulimia, leading to obesity and excess nutrition.
7. A client is prescribed disulfiram (Antabuse) for alcohol use disorder. What
is the priority teaching point?
A. "Take this medication only when you feel the urge to drink."
B. "Avoid all products containing alcohol, including mouthwash and cough
syrup."
C. "This medication will decrease your cravings for alcohol."
D. "You may experience euphoria if you drink alcohol while taking this."
