NCLEX-RN Exam Questions - Part 101

1. A male client has experienced low back pain for several years. He is the primary support of his wife and six children. Although he would qualify for disability, he plans to continue his employment as long as possible. His back pain has increased recently, and he is unable to control it with non-steroidal anti-inflammatory agents. He refuses surgery and cannot take narcotics and remain alert enough to concentrate at work. His physician has suggested application of a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following is an appropriate rationale for using a TENS unit for relief of pain?

A) TENS units have an ultrasonic effect that relaxes muscles, decreases joint stiffness, and increases range of motion.
B) TENS units produce endogenous opioids that affect the central nervous system with analgesic potency comparable to morphine.
C) TENS units work on the gate-control theory of pain; biostimulation therapy of large fibers block painful stimuli.
D) TENS units prevent muscle spasms, decrease the potential for further injury, and minimize pressure on joints.



2. A male client had a right below-the-knee amputation 4 days ago. His incision is healing well. He has gotten out of bed several times and sat at the side of the bed.Each time after returning to bed, he has experienced pain as if it were located in his right foot. Which nursing measure indicates the nurse has a thorough understanding of phantom pain and its management?

A) Phantom pain is entirely in the client - s mind. The client should be instructed that the pain is psychological and should not be treated.
B) The basis for phantom pain may occur because the nerves still carry pain sensation to the brain even though the limb has been amputated. The pain is real, intense, and should be treated.
C) The cause of phantom pain is unknown. The nurse should provide the client with support, promote sleep, and handle the injured limb smoothly and gently.
D) Phantom pain is caused by trauma, spasms, and edema at the incisional site. It will decrease when postoperative edema decreases. It should be treated with nonnarcotic medication whenever possible.



3. A 28-year-old woman was admitted to the hospital for a thyroidectomy. Postoperatively she is taken to the postanesthesia care unit for several hours. In preparing for the clients return to her room, which nursing measure best demonstrates the nurses thorough understanding of possible postthyroidectomy complications?

A) Dressings are placed at the bedside for dressing changes, which are to be done every 2 hours to best detect postoperative bleeding.
B) Narcotics are readily available and administered when the client returns to her room to prevent excruciating pain.
C) A tracheostomy set, O2, and suction are available at the bedside.
D) The nurse should instruct the client as soon as possible on alternative means of communication.



4. A male client is diagnosed with hypoparathyroidism. He has been on dialysis for several years. He is experiencing symptoms such as numbness of the lips, muscle weakness, carpopedal spasms, and wheezing. Given the clients symptoms, nursing assessment would focus on:

A) Detection of tetany
B) Detection of hypocalcemia to prevent seizures
C) Evidence of depression
D) Detection of premature cataract formation



5. A male client has been an insulin-dependent diabetic for approximately 30 years. He frequently indulges in highsugar foods and forgets to take his insulin. He has not experienced acute diabetic emergencies over the years but is now beginning to demonstrate symptoms of diabetic peripheral neuropathy. This distresses him because dancing is one of his favorite pastimes. He decides to question his wifes home health nurse about diabetic peripheral neuropathy. The nurse points out his noncompliance to his diabetic diet and insulin regimen. The client answers the nurse, 'It has been my experience that the diabetic diet is very difficult to follow.As far as the insulin, isn - t a fellow allowed to forget now and then?' The client - s actions and response best demonstrate:

A) Depression
B) Anger
C) Denial
D) Bargaining