NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. Which of the following abides by the Americans with Disabilities Act of 1990?
- A. A nurse manager cannot cancel an interview with a potential employee because he has left-sided paralysis
- B. A nurse is allowed to have a leave of absence to recover after a back injury
- C. A nurse is mandated to receive 12 weeks off of work after having a baby
- D. A nurse manager must hire a nurse who uses a walker for mobility
Correct answer: A
Rationale: The Americans with Disabilities Act of 1990 prohibits discrimination against individuals with disabilities in employment practices, ensuring equal opportunities for qualified individuals. Therefore, a nurse manager cannot cancel an interview with a potential employee simply because the individual has left-sided paralysis. Doing so would be considered discriminatory under the ADA. Choices B, C, and D do not directly align with ADA requirements. Choice B involves medical leave, which can be covered under a different law; choice C refers to maternity leave, which is protected under other regulations; and choice D involves a hiring decision based on a mobility aid, not the individual's qualifications, which does not fall under ADA guidelines.
2. Who among the following individuals wrote a medical code of ethics?
- A. Hammurabi
- B. Thomas Percival
- C. Hippocrates
- D. All of the above
Correct answer: D
Rationale: All of the above individuals contributed to the development of medical ethics. Hammurabi created the earliest known code around 2500 BC. Hippocrates, known for the principle 'Do no harm,' emphasized ethical practices in medicine. Thomas Percival, a physician interested in sociological medicine, authored a Code of Medical Ethics in 1803, which influenced modern medical ethics. Therefore, the correct answer is 'All of the above.' Choices A, B, and C are incorrect because each of them individually wrote a medical code of ethics, making 'All of the above' the most inclusive and accurate answer.
3. A client is having blood tests and has an elevated lymphocyte level. Based on knowledge of cellular components, what does the nurse know about these cells?
- A. Contain histamine and provide protection during allergic reactions
- B. Are involved in phagocytosis
- C. Provide protection and immunity against foreign substances
- D. Carry hemoglobin and oxygen to body tissues
Correct answer: C
Rationale: Lymphocytes are a type of white blood cells that play a crucial role in supporting the body's immune system. They are responsible for producing substances that protect the body against infections and foreign substances that could potentially harm the client. Lymphocytes consist of two main types: T cells, which are produced in the thymus, and B cells, which are produced in the lymphatic tissue. Choice A is incorrect because histamine is mainly associated with basophils and mast cells, not lymphocytes. Choice B is incorrect as phagocytosis is a function of other white blood cells such as neutrophils and macrophages. Choice D is also incorrect as carrying hemoglobin and oxygen is a function of red blood cells, not lymphocytes.
4. Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted for a bowel obstruction. She recently stated that she has decided that she doesn't want any further aggressive care and is requesting to be placed under hospice care. Her husband and daughter are supportive of her decision. She spoke with her oncologist about it, and he stated that he did not agree and wrote orders on her chart for chemotherapy. What would be the best first response to this situation?
- A. Give the patient a list of other oncologists
- B. Tell the family to report the doctor to the state quality board
- C. Notify the doctor that the patient refuses the chemotherapy
- D. Give the patient hospice information
Correct answer: C
Rationale: The patient has the right to refuse any treatment, and the doctor should be notified that the orders on the chart cannot be performed, with appropriate documentation. In this situation, the best first response is to notify the doctor that the patient refuses the chemotherapy. This step ensures that the patient's wishes are respected and that inappropriate treatments are not administered. It also opens up a dialogue with the oncologist, giving him the opportunity to understand the patient's perspective and potentially support her decision. Providing hospice information is a good follow-up step after addressing the immediate issue of refusing chemotherapy, as it allows the patient to initiate her own hospice evaluation if desired. Giving the patient a list of other oncologists or telling the family to report the doctor to the state quality board are not appropriate initial responses and may not align with the patient's wishes or autonomy.
5. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:
- A. 10 years
- B. Forever
- C. Until the age of majority
- D. 2 years after the patient was last seen in the office
Correct answer: B
Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.
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