NCLEX NGN RN / NGN NCLEX ACTUAL EXAM MAY 2023 EXAM| 300 QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES| 100% CORRECT

NCLEX NGN RN / NGN NCLEX ACTUAL EXAM MAY 2023 EXAM| 300 QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES| 100% CORRECT QUESTION The client with schizophrenia says to the nurse, " I was walking down the street and really enjoyed the weather, but carrots are probably my favorite vegetable. did the ocean always look blue?" the nurse recognizes the statement as an example of which of the following? 1 associative looseness 2 concrete thinking 3 tangentiality 4 word salad Answer: 1 QUESTION The nurse is caring for a client with severe anorexia nervosa. which of the following findings are consistent with this diagnosis? select all that apply 1 BMI of 16kg/m2 2 Fine downy hair on the face and back 3 has not menstruated in 3 months 4 potassium of 3.1 mEq/L 5 refuses to engage in exercise 6 unable to tolerate Heat Answer: ANS 1234 Anorexia nervosa is an eating disorder common among adolescents and young adults ages 18 to 24. subtypes of the disorder include the restricting type in which there are no bulimic features and the binging purging type in which restriction is still primary cause of weight loss but bulimic features such as self-induced vomiting are present. clinical manifestations of anorexia nervosa include: fear of weight gain: clients May engage in extensive dieting, intense exercise, and or purging behaviors (eg self-induced vomiting, misuse of laxatives or diuretics) resulting in excessive weight loss (BMI 18.5 kg/m3) option 1 Lanugo: find terminal hair can be seen extreme c cases (option 2) Amenorrhea: clients may stop menstruating due to decreased body fat and the resulting low estrogen levels (option3) fluid and electrolyte imbalance: malnutrition, dehydration, and excessive vomiting can cause hypokalemia and metabolic alkalosis leading to complications such as cardiac dysrhythmias (option 4) decrease metabolic rate: severe weight loss results in hypertension bradycardia decreased body temperature and cold intolerance manifestations of anorexia nervosa will resolve after the weight loss is corrected although the recovery process will take several months Option 5 clients with anorexia nervosa often engage in lengthy invigorous exercise to lose weight Option 6 anorexia nervosa manifests as cold not heat intolerance due to the clients decrease metabolic rate QUESTION The mental health nurse is planning care for a client nearly admitted with dissociative identity disorder. Which interventions will the nurse include? Select all that apply 1 develop a trusting relationship with each of the alternate identities 2 encourage the client to journal about feelings and dissociation triggers 3 explain to the client in detail the events of missing memories and lost time 4 listen for expressions of self harm from the alternate identities 5 teach grounding taking such as deep breathing to hinder dissociation Answer: ANS 1245 Dissociative identity disorder is a condition in which two or more identities alternately control the client's behavior. The alternate identities likely develop as a response to abuse or traumatic events and serve to protect the client from stressful memories. the client may not be able to be aware of the alternate identities and may be confused by lost time and gaps in memory. switching between identities occurs as a reaction to stress and individual triggers. The goal of treatment is to integrate the identities into one personality while maintaining safety. the client should Journal about feelings and dissociation triggers and use a groundbreaking technique (eg deep breathing, rubbing stone, counting coins) to counter dissociative episodes (options 2 and 5). Identities may be volatile and should be monitored for indications of harm to solve for others (option 4). the nurse should attempt to form trusting, therapeutic relationships with each identity to explore feelings and facilitate identity integration (option 1) Option 3 this is Association and memory gaps are protective mechanisms. forcing the client to hear or attempt to recall memories may result in distress and regress. allow clients to recall memories at their own pace. QUESTION The nurse provides teaching to an adolescent client prescribed extended release methylphenidate for attention deficit hyperactivity disorder. Which client statement indicates the teaching has been effective? 1 if I miss a dose I should take an extra dose at the next meal 2 I mean initially gain some weight when starting this medication 3 I should drink caffeine containing beverages if I get tired while studying 4 I will take this medication in the morning before school Answer: 4 ANS D Attention deficit hyperactivity disorder causes problems with executive function which can affect all aspects of life including school performance, social relationships and Career Success. Methylphenidate Is a central nervous system stimulant used to treat ADHD and narcolepsy. It improves focus and attention by increasing levels of certain neurotransmitters (e.g. dopamine, norepinephrine) in the brain. adverse effects include irritability, decreased appetite, hypertension, tachycardia, sleep disturbances and jitteriness. extended release Methylphenidate Should be taken in the morning to minimize the risk of sleep disturbances. some dosage forms are taken 30 to 45 minutes before meals because food can affect absorption While others are taken with food. client should follow the prescription instructions for their specific medication and may also consult with the pharmacist (option 4) Option 1 Methylphenidate is a controlled substance with the potential for tolerance psychological dependence and psychosis if taken it excess (Eg taking extra after a missed dose). client should not take extra doses unless instructed by a healthcare provider Option 2 Methylphenidate can cause appetite suppression and weight loss not weight gain growth patterns and nutritional status should be closely monitored Option 3 caffeine containing beverages should be avoided while taking this medication because caffeine is also a CNS stimulant and may increase the incidence of adverse effects (eg hypertension, irritability, tachycardia, insomnia). QUESTION A behavioral health clinic nurse assesses 23 year old client who started taking paroxetine 3 weeks ago. which statement made by the client is most im