NCLEX-RN Updated 2022, Complete Questions & Answers with rationale

NCLEX-RN for 2022 has been revised with new Comprehensive Questions & Explanations available for review.

Question No.1:

A despondent customer visits the mental health facility for follow-up after a suicide attempt a week ago. She has been taking phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor, consistently for 7 days. She expresses her disappointment as she doesn’t feel any improvement yet. The nurse educates her that the medication needs to reach a therapeutic level before complete symptom relief is achieved. Relief of symptoms is typically expected within:
A. 10 days
B. 2-4 weeks
C. 2 months
D. 3 months
Answer: B
Explanation:
(A) Incorrect, as it can take up to 1 month for the therapeutic effects of the medication to manifest.
(B) Correct, as MAO inhibitors have a slow onset of action, requiring 2-4 weeks before symptom improvement is noticed.
(C) Incorrect, as it can take up to 1 month for the therapeutic effects of the medication to manifest.
(D) Incorrect, as the therapeutic effects of the medication are observed within 1 month of treatment initiation.

Question No.2:

Cystic fibrosis is inherited as an autosomal recessive trait. This implies:
A. Mothers transmit the gene to their sons
B. Fathers pass on the gene to their daughters
C. Both parents must have the disease for a child to inherit it
D. Both parents must be carriers for a child to inherit the disease
Answer: D
Explanation:
(A) Cystic fibrosis is not linked to the X chromosome.
(B) The Y chromosome’s only distinct characteristic is the hairy ears trait.
(C) Both parents don’t need to have the disease but need to be carriers.
(D) In a recessive trait, both genes (one from each parent) are essential for an affected offspring.

Question No.3:

A 24-year-old client arrives at the emergency department claiming to be “God.” The nurse recognizes this as a:
A. Delusion
B. Illusion
C. Hallucination
D. Conversion
Answer: A
Explanation:
(A) Delusion is a false belief.
(B) Illusion is a distorted perception of a real external sensory experience.
(C) Hallucination involves a false sensory perception of any of the senses.
(D) Conversion is the manifestation of inner conflicts through sensory or motor symptoms.

Question No.4:

During acute manic episodes, lithium may take 1-2 weeks to be effective, but full symptom resolution may take up to 4 weeks or a few months. In severe cases, an antipsychotic agent may be prescribed initially to manage acute behavioral excitement and psychotic symptoms. In addition to lithium, which medication might the physician prescribe?
A. Diazepam (Valium)
B. Haloperidol (Haldol)
C. Sertraline (Zoloft)
D. Alprazolam (Xanax)
Answer: B
Explanation:
(A) Diazepam is an anti-anxiety drug and does not target psychotic symptoms.
(B) Haloperidol is an antipsychotic medication and may be used until lithium becomes effective.
(C) Sertraline is an antidepressant primarily used for reducing depression symptoms.
(D) Alprazolam is an anti-anxiety medication and doesn’t address psychotic symptoms.

Question No.5:

A violent client is restrained for several hours. Which intervention is most appropriate while the client is restrained?
A. Provide fluids upon client’s request.
B. Assess skin integrity and extremity circulation before and after applying restraints.
C. Monitor vital signs every 4 hours.
D. Release restraints every 2 hours for client exercise.
Answer: D
Explanation:
(A) Nourishment should be offered at regular intervals irrespective of the client’s requests.
(B) Checking skin integrity and extremity circulation should be continuous while the client is in restraints, not just before and after their application.
(C) Vital signs should be assessed at least every 2 hours, with closer monitoring (possibly every 1-2 hours) for an agitated client in restraints.
(D) Restraints should be loosened every 2 hours for exercising, one limb at a time, to maintain muscle tone, skin integrity, and circulation.

Question No.6:

An 8-year-old girl has been diagnosed with tinea capitis, and the physician has prescribed oral griseofulvin. What instruction should the nurse emphasize to the mother and/or child?
A. Administer oral griseofulvin on an empty stomach for optimal results.
B. Discontinue drug therapy if food tastes unusual.
C. Cease treatment when symptomatic relief is experienced by the child.
D. Watch for headaches, dizziness, and loss of appetite.
Answer: D
Explanation:
(A) Administering the drug with or after meals can reduce gastrointestinal distress. Absorption rate is higher when given with a fatty meal (e.g., ice cream or milk).
(B) Taste alterations may occur due to griseofulvin but do not necessitate discontinuation.