NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. What preparation is necessary for a colposcopy procedure?
- A. NPO for 8-12 hours before the procedure.
- B. D/C all hypertension medications for two days prior to the procedure.
- C. Take three Dulcolax tablets and two containers of Miralax the day before to clear out the lower GI system.
- D. None of the above prep is necessary for this type of procedure.
Correct answer: D
Rationale: A colposcopy procedure is performed to examine the vagina and cervix. The only preparation required is washing the external genitals with soap and water on the morning of the procedure. Choices A, B, and C suggest unnecessary preparations that are not relevant to a colposcopy. NPO for 8-12 hours, discontinuing hypertension medications, and using laxatives are not part of the standard preparation for a colposcopy.
2. Mrs. M has had diabetes for seven years. She has worked hard to control her blood glucose levels and watch her dietary intake. Her physician orders a hemoglobin A1C test. Which of the following best describes the action of this test?
- A. The test determines if the client is anemic and needs iron supplements
- B. The test determines if there is excess glucose building up in the urine
- C. The test determines the amount of hemoglobin reaching the liver to support gluconeogenesis
- D. The test determines the amount of hemoglobin that is coated with glucose
Correct answer: D
Rationale: A hemoglobin A1C test, also known as a glycated hemoglobin test, determines the amount of hemoglobin that is coated with glucose. Excess glucose in the bloodstream may cause it to attach to hemoglobin on red blood cells. Because the life of these cells is between 2 and 3 months, the hemoglobin A1C is an accurate measurement of a client's glucose during that time. Choices A, B, and C are incorrect. Choice A relates to anemia and iron supplements, which are not assessed by a hemoglobin A1C test. Choice B mentions excess glucose in the urine, which is typically assessed through a urine glucose test, not the hemoglobin A1C test. Choice C is incorrect as the test is not related to the amount of hemoglobin reaching the liver to support gluconeogenesis; instead, it specifically measures the amount of hemoglobin that is glycated or coated with glucose.
3. Which example best describes the concept of beneficence?
- A. A nurse provides pain medication for a client in the recovery room who is experiencing pain
- B. A client has an advanced directive in place stating that he does not want intubation if he needs CPR
- C. At the request of the client, a nurse does not inform the family about his cancer diagnosis
- D. A nurse withholds narcotic medication for a client in pain, knowing that he is currently disoriented
Correct answer: A
Rationale: Beneficence is the ethical principle of doing good and acting in the best interest of the client. Providing pain relief to a client in the recovery room who is experiencing pain aligns with beneficence as it promotes the client's well-being and comfort. Choice B is related to autonomy, where the client's wishes regarding treatment are respected. Choice C involves confidentiality and the client's right to privacy. Choice D represents nonmaleficence, as withholding pain medication from a client in pain could cause harm and goes against the principle of doing no harm.
4. Is it true that Hepatitis C virus (HCV) can be spread through hugging, sneezing, coughing, sharing eating utensils, and other forms of casual contact?
- A. True
- B. False
- C.
- D.
Correct answer: B
Rationale: False. HCV is not spread through casual contact such as hugging, sneezing, or sharing eating utensils. The correct modes of transmission for HCV include direct contact with human blood through blood transfusions, improperly sterilized needles and syringes, needle sharing, or occasionally through sexual contact. Therefore, the statement is false, making 'False' the correct answer. Choices A, C, and D are incorrect as they do not accurately reflect the mode of transmission of HCV.
5. A client in the emergency room enters the care area to start an IV. He finds a man sitting on the table, hunched over, and attempting to take deep breaths. He states, 'my chest hurts so much!' His wife is sitting on a chair in the corner, crying. Which of the following is the first action of the client?
- A. Bring the IV kit and quickly start an IV
- B. Assess his breathing and provide oxygen, if necessary
- C. Administer medication to control chest pain
- D. Talk with his wife and find out why she is crying
Correct answer: B
Rationale: In the above scenario, the first action of the nurse should be to assess the client's airway and breathing. It is crucial to address respiratory status first, as the client appears to be experiencing difficulty breathing. Providing oxygen if necessary can help support oxygenation and alleviate potential respiratory distress. Administering medication for chest pain or starting an IV can come after ensuring adequate oxygenation. Talking with the client's wife, though important for emotional support, is not the priority when the client's respiratory status needs to be assessed and managed promptly.
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