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NCSBN NCLEX Preparation Guide 2023 | Questions and answers|

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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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