NCLEX-PN
Nclex PN Questions and Answers
1. A nurse witnesses a client sign the consent form for surgery with the surgeon. As the surgeon leaves, the client starts to speak and then stops. The nurse asks if the client has further questions, and he says, "I don't want to bother the surgeon."? The nurse should ____.
- A. acknowledge the client's wish not to bother the surgeon and tell the client to let you know if they change their mind
- B. acknowledge the client's wish not to bother the surgeon and answer all of their questions, as appropriate
- C. go get the surgeon to answer all of the client's questions
- D. answer any questions as appropriate as well as have the surgeon come back to answer any questions if needed
Correct answer: D
Rationale: In this scenario, the nurse should prioritize the client's understanding and comfort. While acknowledging the client's wish not to bother the surgeon is important, it is equally crucial to ensure that the client's questions are answered appropriately and thoroughly. Choice A is correct as it respects the client's initial sentiment and offers the client the opportunity to ask questions later if needed. Choice B is incorrect as it suggests answering all questions immediately, without considering the client's feelings. Choice C is incorrect as it bypasses the nurse's role in addressing the client's concerns. Choice D, the correct answer, balances respecting the client's wish and ensuring that all questions are appropriately addressed, even if it involves the surgeon returning.
2. A client being treated for sickle cell disease has an order for pain medication. Morphine was ordered, but the nurse is having difficulty deciphering the dose. The nurse should ____.
- A. ask the attending physician to clarify the order, including the correct medication, dose, route, and frequency
- B. call the charge nurse to inform the attending physician and verify the order, including the correct medication, dose, route, and frequency
- C. call the attending physician to verbally verify the order, including the correct medication, dose, route, and frequency
- D. refrain from administering the medication until the charge nurse can assist in determining the correct dosage
Correct answer: C
Rationale: In this scenario, when a nurse encounters difficulties in deciphering an order, the appropriate action is to contact the attending physician directly to clarify and verify the medication, dose, route, and frequency. It is crucial for the nurse to have a clear understanding of the order before administering any medication to ensure patient safety and proper treatment. Option A is incorrect as it suggests asking the attending physician to clarify without specifying the urgency of the situation. Option B involves an unnecessary additional step by first contacting the charge nurse before reaching out to the attending physician, potentially delaying the clarification process. Option D is incorrect as it advises refraining from administering the medication, which may not be necessary if the correct dosage can be promptly verified by contacting the attending physician.
3. A client scheduled for a left mastectomy and axillary lymph node dissection is wearing a wedding band on her left ring finger. The nurse should take which action?
- A. Tape the wedding band in place
- B. Ask the client to sign a release freeing the hospital of responsibility if the wedding band is lost during surgery
- C. Explain to the client why the wedding band must be removed
- D. Ask the client whether she would like to remove the wedding band or wear it to surgery
Correct answer: C
Rationale: In most situations, a wedding band may be taped in place and worn during a surgical procedure. However, if there is a possibility that the client will experience swelling of the hand or fingers, the wedding band should be removed. On admission to a healthcare facility, the client is usually asked to sign a form that releases the agency from responsibility if a client's valuables are lost. After a mastectomy with axillary lymph node dissection, the client is at risk for lymphedema, which can result in swelling of the arm and hand on the affected side. Therefore, the appropriate nursing action is to ask the client to remove the wedding band and explain why. This ensures the client's safety and prevents potential complications. Option A is incorrect because taping the wedding band may not be sufficient if swelling occurs. Option B is incorrect as it does not address the immediate need to remove the wedding band. Option D is incorrect because it fails to provide the client with the necessary information about the potential risks of wearing the wedding band during surgery.
4. Which of the following is not an advanced directive?
- A. informed consent
- B. living will
- C. durable power of attorney for health care
- D. health care proxy
Correct answer: A
Rationale: Informed consent is the process of obtaining permission from a patient before conducting a healthcare intervention. It is not considered an advanced directive. A living will is a legal document that outlines a person's preferences for medical treatment if they are unable to communicate. A durable power of attorney for health care designates a person to make medical decisions on behalf of the patient. A health care proxy, which is another term for a durable power of attorney for health care, also involves appointing someone to make healthcare decisions for an individual if they become unable to do so. Therefore, the correct answer is 'informed consent,' as it is not an advanced directive but rather a different aspect of patient care.
5. During a hospital program about in vitro fertilization, a television crew arrives to film for a series on hospital services. What action should the nurse conducting the program take?
- A. Ask the television crew to interview the individuals attending the program individually.
- B. Allow the television crew to videotape the program as long as they do not publicize that the program is about in vitro fertilization.
- C. Explain to the television crew that videotaping is not allowed.
- D. Allow the television crew to videotape the program.
Correct answer: C
Rationale: Privacy is a client's right to be free from unwanted intrusion into their private affairs. Videotaping constitutes an invasion of a client's privacy, and written permission is required from the client for actions such as photographing or videotaping. Therefore, the nurse must explain to the television crew that videotaping is not allowed to protect the attendees' privacy. Option A is incorrect as it still involves recording the individuals, breaching their privacy. Option B is incorrect because allowing videotaping without consent violates privacy rights. Option D is incorrect as it disregards the need for consent and privacy protection.
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