Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW.

1. The primary goal of nursing care during the emergent phase after a burn injury is to
   1. replace lost fluids.
   2. prevent infection.
   3. control pain.
   4. promote wound healing.
2. Which of the following laboratory tests should the nurse monitor when the client is receiving warfarin (Coumadin) therapy?
   1. partial thromboplastin time (PTT)
   2. serum potassium
   3. arterial blood gases
   4. prothrombin time (PT)
3. A client with a moderate level of anxiety is pacing quickly in the hall. As the nurse approaches, he states, "Help me. I can't take it anymore." Which of the following would be the best response initially?
   1. "It would be best if you would lie down until you’re calmer."
   2. "Let's go to a quieter area where we can talk if you want."
   3. "Try doing your relaxation exercises to calm down."
   4. "I'll get some medicine to help you relax."
4. Which of the following should the nurse teach a client with generalized anxiety disorder to help him cope with anxiety?
   1. cognitive and behavioral strategies
   2. issue avoidance and denial of problems
   3. rest and sleep
   4. withdrawal from role expectations and role relationships
5. Which of the following assessment findings should a nurse expect to find in a client with bacterial pneumonia?
   1. increased tactile fremitus
   2. bilateral expiratory wheezing
   3. resonance on percussion
   4. vesicular breath sounds

Match the terms in column 1 with a definition, example, or related statement in column 2.

Column 1	Column 2
1. orlistat (Xenical)	a. a source of commercial caffeine found in weight-loss products
2. glucomannan	b. a combination dietary supplement associated with severe hepatotoxicity
3. kilocalories	c. the most frequently prescribed adrenergic anorexiant
4. phentermine (Adipex)	d. decreases absorption of dietary fat from the intestine
5. guarana	e. a measurement of energy
6. epinephrine	f. produces a feeling of stomach fullness, causing a person to eat less
7. guar gum	g. increases the effects of phentermine and sibutramine
8. alcohol	h. decreases the effects of phentermine and sibutramine
9. sibutramine (Meridia)	i. the most commonly prescribed antiobesity drug
10. LipoKinetix	j. dietary fiber found in weight-loss products

Answers: 1d, 2f, 3e, 4c, 5a, 6g, 7j, 8h, 9i, 10b.

Source: Study Guide to Accompany Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 8th ed., Lippincott Williams & Wilkins, 2007.

A dehydration emergency can trigger these signs and symptoms:

• Increased thirst
• Decreased urination
• Weakness or lightheadedness
• Dry mouth and mucous membranes
• Dry eyes and few tears when crying
• Decreased skin turgor
• Sunken cheeks, eyes, possibly abdomen, fontanelle in infants
• Irritability
• Listlessness, low energy level

When teaching your patient about diverticular disease, be sure to share these key points:

• Teach about the disease process and its treatments.
• Reinforce the importance of dietary fiber and the harmful effects of constipation and straining during defecation.
• Encourage increased intake of food high in indigestible fiber, including fresh fruits and vegetables, whole grain bread, and wheat or bran cereals.
• Warn that a high-fiber diet may temporarily cause flatulance and discomfort.
• Advise the patient to relieve constipation with stool softeners or bulk-forming cathartics.
• Teach about prescribed medications, including their names, indications, dosages, adverse effects, and special considerations.
• Discuss warning signs of complications, such as obstruction, infection, and hemorrhage, and the need to seek immediate medical attention if they occur.
• If the patient is having surgery, explain surgical procedures and refer him to an enterostomal therapist.

Don't miss these substantive, peer-reviewed features from Nursing2007. They'll help you learn about evidence-based practice.

• Getting ahead of acute meningitis & encephalitis
  By Cristina Matthews, RN, CNRN, BSN; Laurie Miller, RN, CNRN, CS, MS; and Mary Mott, RN, CNRN, CS, MS
• Protecting patients from harm: Taking aim at heart failure
  By Donna Chojnowski, RN, CRNP, MSN

1. 1 During the emergent phase of burn care, one of the most significant problems is hypovolemic shock. The development of hypovolemic shock can lead to impaired blood flow through the heart and kidneys, resulting in decreased cardiac output and renal ischemia. Efforts are directed toward replacing lost fluids and preventing hypovolemic shock. Preventing infection and controlling pain are important goals, but preventing circulatory collapse is a higher priority. It’s too early in the stage of burn injury to promote wound healing.
2. 4 Warfarin interferes with clotting. The nurse should monitor the PT and evaluate for warfarin's therapeutic effects. A therapeutic PT range is between 1.5 and 2.5 times the control value; the health care provider should establish the range. It may also be reported as an International Normalized Ratio (INR), a standardized system that provides a common basis for communicating and interpreting PT results. The PTT is monitored in clients who are receiving heparin therapy. Serum potassium levels and arterial blood gas values aren’t affected by warfarin.
3. 2 The nurse should initially lead a client with moderate anxiety to a less stimulating environment and help him discuss his feelings. Doing so helps him gain control over anxiety that could be overwhelming. Telling him that it would be best to lie down until he’s calmer isn’t appropriate because he’s too anxious to benefit from this intervention. Suggesting that he try relaxation exercises could be helpful after the nurse takes him to a less stimulating environment and lets him vent and discuss his feelings. Getting an order for medication to help the client relax is an intervention that the nurse would carry out later after trying to help him decrease anxiety through ventilation and relaxation exercises.
4. 1 A client with generalized anxiety disorder needs to learn cognitive and behavioral strategies to cope with anxiety appropriately. In doing so, his anxiety decreases and becomes more manageable. The client may need assertiveness training, reframing, and relaxation exercises to adaptively deal with anxiety.
5. 1 Increased tactile fremitus can be present in bacterial pneumonia, indicating the presence of pulmonary consolidation. Additional findings would include crackles, bronchial breath sounds, and dullness on percussion. Bilateral expiratory wheezing and resonance on percussion aren’t present in bacterial pneumonia. Vesicular breath sounds are normal and wouldn’t be an expected finding in bacterial pneumonia.

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