NCLEX-RN Certification Exam Questions with AI Explanations

QUESTION: 121

A 42-year-old client with bipolar disorder has been hospitalized on the inpatient psychiatric unit. She is dancing around, talking incessantly, and singing. Much of the time the client is anorexic and eats very little from her tray before she is up and about again. The nurse's intervention would be to:

Confront the client with the fact that she will have to eat more from her tray to sustain her
Try to get the client to focus on her eating by offering a detailed discussion on the importance of nutrition
Let her have snacks and drinks anytime that she wants them because she will not eat at regular meal times
Not expect the client to sit down for complete meals; monitor intake, offering snacks and juice frequently

Answer(s): D

Explanation:

(A) The manic client's mood may easily change from euphoric to irritable. The nurse should avoid confrontation and let the client know what she can do, rather than what she cannot. (B) Although helpful to refocus or redirect the manic client to discuss only one topic at a time, distractibility is very high and it's best to avoid long discussions. (C) Manic clients have a tendency to manipulate persons in their environment. Staff should monitor intake, including at mealtime and snacks, and be consistent in their approach to meeting nutritional needs. (D) Manic clients may not sit and eat complete meals, but they can carry foods and liquids from regular meals with them. Staff can monitor and give high-caloric and high-energy snacks and liquids.

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QUESTION: 121

A 42-year-old client with bipolar disorder has been hospitalized on the inpatient psychiatric unit. She is dancing around, talking incessantly, and singing. Much of the time the client is anorexic and eats very little from her tray before she is up and about again. The nurse's intervention would be to:

Confront the client with the fact that she will have to eat more from her tray to sustain her
Try to get the client to focus on her eating by offering a detailed discussion on the importance of nutrition
Let her have snacks and drinks anytime that she wants them because she will not eat at regular meal times
Not expect the client to sit down for complete meals; monitor intake, offering snacks and juice frequently

Answer(s): D

Explanation:

(A) The manic client's mood may easily change from euphoric to irritable. The nurse should avoid confrontation and let the client know what she can do, rather than what she cannot. (B) Although helpful to refocus or redirect the manic client to discuss only one topic at a time, distractibility is very high and it's best to avoid long discussions. (C) Manic clients have a tendency to manipulate persons in their environment. Staff should monitor intake, including at mealtime and snacks, and be consistent in their approach to meeting nutritional needs. (D) Manic clients may not sit and eat complete meals, but they can carry foods and liquids from regular meals with them. Staff can monitor and give high-caloric and high-energy snacks and liquids.

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QUESTION: 122

The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:

"My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy."
"At ovulation, my basal body temperature should rise about 0.5F."
"I should douche immediately after intercourse."
"My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle."

Answer(s): B

Explanation:

(A) At ovulation, the cervical mucus is increased, stretchable, and watery clear. (B) Under the influence of progesterone, the basal body temperature increases slightly after ovulation. (C) To enhance fertility, measures should be taken that promote retention of sperm rather than removal. (D) Ovulation, the optimal time for conception, occurs 14+2 days before the next menses; therefore, the date of ovulation is directly related to the length of the menstrual cycle.

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QUESTION: 122

The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:

"My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy."
"At ovulation, my basal body temperature should rise about 0.5F."
"I should douche immediately after intercourse."
"My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle."

Answer(s): B

Explanation:

(A) At ovulation, the cervical mucus is increased, stretchable, and watery clear. (B) Under the influence of progesterone, the basal body temperature increases slightly after ovulation. (C) To enhance fertility, measures should be taken that promote retention of sperm rather than removal. (D) Ovulation, the optimal time for conception, occurs 14+2 days before the next menses; therefore, the date of ovulation is directly related to the length of the menstrual cycle.

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QUESTION: 123

A 56-year-old psychiatric inpatient has had recurring episodes of depression and chronic low self-esteem. She feels that her family does not want her around, experiences a sense of helplessness, and has a negative view of herself. To assist the client in focusing on her strengths and positive traits, a strategy used by the nurse would be to:

Tell the client to attend all structured activities on the unit
Encourage or direct client to attend activities that offer simple methods to attain success
Increase the client's self-esteem by asking that she make all decisions regarding attendance in group activities
Not allow any dependent behaviors by the client because she must learn independence and will have to ask for any assistance from staff

Answer(s): B

Explanation:

(A) The nurse should encourage activities gradually, as client's energy level and tolerance for shared activities improve. (B) Activities that focus on strengths and accomplishments, with uncomplicated tasks, minimize failure and increase self-worth. (C) Asking a client to set a goal to make all decisions about attending group activities is unrealistic, and such decisions are not always under the client's control; this sets up the client for further failure and possibly decreased self-worth. (D) Encouragement toward independence does promote increased feelings of selfworth; however, clients may need assistance with decision making and problem solving for various situations and on an individual basis.

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QUESTION: 121

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QUESTION: 121

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QUESTION: 122

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QUESTION: 122

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QUESTION: 123

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