NCLEX-RN : Patient-Specific Care

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

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Example Question #3 : Alcohol And Drug Abuse

Which of the following drugs is considered a central nervous system (CNS) depressant?

Possible Answers:

Cyclobenzaprine

Marijuana

All of these

Atenolol

Correct answer:

All of these

Explanation:

All of the drugs listed are considered to be CNS depressants. While generally classified as a psychedelic, marijuana has multiple central depressant effects such as sedation and muscle relaxation. Also, alcohol is another commonly used depressant. 

Example Question #1 : Alcohol And Drug Abuse

Alcohol abuse-induced thiamine deficiency can cause which of the following?

Possible Answers:

Wolf-Hirschhorn syndrome

Agnosia

Wernicke-Korsakoff syndrome

Lewy body dementia

Correct answer:

Wernicke-Korsakoff syndrome

Explanation:

Wernicke-Korsakoff syndrome is caused by a severe deficiency in thiamine, often seen in severe alcohol dependency. It is characterized by visual disturbances, ataxia, and altered consciousness. Wolf-Hirschhorn syndrome is a genetic disorder causing developmental disability and may involve seizures. Lewy body dementia is associated with Parkinson's disease. Agnosia is a neurological disorder causing impaired ability to process sensory information.

Example Question #62 : Care

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) criteria for substance abuse includes all of the following except __________.

Possible Answers:

recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home

recurrent substance use in situations in which it is physically hazardous

continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance

All of these are part of the DSM V criteria for substance abuse

Correct answer:

All of these are part of the DSM V criteria for substance abuse

Explanation:

All of the items listed are part of the DSM V criteria for substance abuse. In addition, the individual's symptoms must not qualify for substance dependence and recurrent substance-related legal problems are other DSM V criteria for substance abuse.

Example Question #3 : Alcohol And Drug Abuse

A 42 year old man presents to the ER for alcohol toxicity. While taking the history, the nurse discovers that he drinks on average one fifth of vodka per night, and often must drink an additional 6-12oz to get "a good buzz." When he doesn't drink, he experiences tremors and feels unwell until he is able to drink again. When asked if he would like to quit drinking he states that he has tried unsuccessfully several times over his life. He knows that he needs to get control over his drinking because it is seriously impairing his relationship with his husband and their 13 year old daughter. 

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V), this patient can be considered to have which of the following conditions?

Possible Answers:

None of these

Substance dependency

Substance abuse

Substance addiction

Correct answer:

Substance dependency

Explanation:

The symptoms described by this patient put his alcohol use in the category of substance dependency, according to the DSM V, a more severe form of abuse than substance addiction. The criteria for this condition are:

  1. Tolerance 
  2. Withdrawal
  3. Unintentional excesses in consumption
  4. Persistent desire or unsuccessful efforts to reduce or control substance use
  5. A great deal of time is spent to get, use, or recover from the substance
  6. Interference with social life
  7. The substance use is continued despite knowledge problems caused by use

Example Question #1 : Alcohol And Drug Abuse

Prolonged alcohol abuse can result in a severe deficiency in what vitamin?

Possible Answers:

Niacin (B3)

Thiamine (B1)

Folate

Vitamin C

Correct answer:

Thiamine (B1)

Explanation:

Prolonged alcohol abuse can result in a severe deficiency in thiamine, or vitamin B1 by reducing dietary thiamine intake, impairing gastrointestinal absorption of thiamine, and causing impaired thiamine utilization in cells. Note that individuals who partake in prolonged alcohol abuse may have various other dietary deficiencies.

Example Question #1 : Alcohol And Drug Abuse

Which of the following symptoms is most worrisome in a patient undergoing alcohol withdrawal?

Possible Answers:

Agitation

Tachycardia

Bradycardia

Delirium tremens

Correct answer:

Delirium tremens

Explanation:

Delirium tremens (DT) is a rapid onset of confusion seen during alcohol withdrawal. The symptoms of DT include altered mental status, autonomic instability, and even seizures. DT is also characterized by hallucinations such as the sensation of something "crawling" on the patient. DT is the most severe consequence of withdrawal and can be fatal if untreated.

Example Question #41 : Patient Specific Care

Identify the disorder that presents the following signs and symptoms: numbness, paralysis, loss of vision, or other neurological symptoms after a traumatic or stressful event, without any identifiable medical cause.

Possible Answers:

Conversion disorder

Bipolar disorder

Schizophrenia

Stiff person syndrome

Correct answer:

Conversion disorder

Explanation:

Conversion disorder is typified by numbness, paralysis, loss of vision, or other neurological symptoms after a traumatic or stressful event, without any identifiable medical cause. Schizophrenia, bipolar disorder, and stiff person syndrome all have medically identifiable causes. 

Example Question #42 : Patient Specific Care

What is the best approach towards dealing with a delirious patient?

Possible Answers:

Frequent reorientation to time, place, and name.

Frequent sedation with antipsychotics

Frequent sedation with benzodiazepenes

Frequent 4-point restraints

Correct answer:

Frequent reorientation to time, place, and name.

Explanation:

Delirium is an organic dysfunction of the brain usually seen in sick patients post-op. These patients need frequent reorientation to name, time, and place until the delirium resolves. Agitation, confusion, and difficult to control behavior is typically controlled with antipsychotics, however, they are not first line treatment. Restraints should be avoided at all costs.

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