Page 2590 - Saunders Comprehensive Review For NCLEX-RN

877. Answer: 1

Rationale: The clinical picture of dementia ranges from mild cognitive deficits to
severe, life-threatening alterations in neurological functioning. For the client to use
confabulation or the fabrication of events or experiences to fill in memory gaps is not
unusual. Often, lack of inhibitions on the part of the client may constitute the first
indication of something being “wrong” to the client’s significant others (e.g., the
client may undress in front of others, or the formerly well-mannered client may
exhibit slovenly table manners). As the dementia progresses, the client will have
difficulty sleeping and episodes of wandering or sundowning.
Test-Taking Strategy: Focus on the client’s diagnosis and note the subject, a
manifestation of dementia. Think about the characteristics of dementia to direct you
to the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Mental Health
Health Problem: Mental Health: Neurocognitive impairment
Priority Concepts: Cognition; Coping
Reference: Ignatavicius, Workman, Rebar (2018), pp. 860-861.

878. Answer: 3

Rationale: Clients with anorexia nervosa have the desire to please others. Their
need to be correct or perfect interferes with rational decision-making processes.
These clients are moralistic. Rules and rituals help these clients manage their anxiety.
Test-Taking Strategy: Focus on the subject, managing anxiety. Eliminate options 2
and 4 because of the closed-ended word “always.” Option 1 is not characteristic of a
client with anorexia.
Level of Cognitive Ability: Analyzing
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Mental Health
Health Problem: Mental Health: Eating disorders
Priority Concepts: Anxiety; Coping
Reference: Lewis et al. (2017), pp. 871-872.

879. Answer: 3

Rationale: Iron is needed to allow for transfer of adequate iron to the fetus and to
permit expansion of the maternal red blood cell mass. During pregnancy, the relative
excess of plasma causes a decrease in the hemoglobin concentration and hematocrit,
known as physiological anemia of pregnancy. This is a normal adaptation during
pregnancy. Iron is best absorbed if taken on an empty stomach. Taking it with a fluid
high in ascorbic acid such as tomato juice enhances absorption. Iron supplements
usually cause constipation. Meats are an excellent source of iron. The client needs to
take the iron supplements regardless of food intake.

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