NCLEX-RN
NCLEX RN Actual Exam Test Bank
1. Which of the following is an anthropometric measurement?
- A. Blood pressure
- B. Temperature
- C. Pulse Rate
- D. Weight
Correct answer: D
Rationale: Anthropometric measurements relate to the size, weight, and proportions of the human body. Weight is a key anthropometric measurement as it directly reflects body mass, making it the correct choice. Blood pressure, temperature, and pulse rate are physiological measurements that do not specifically pertain to body size or proportion, hence making them incorrect choices in the context of anthropometric measurements.
2. When considering the structural organization of the human body, what is the basic unit of life?
- A. Chemicals
- B. Atoms
- C. Molecules
- D. Cells
Correct answer: D
Rationale: The basic unit of life is the cell. Cells are considered the fundamental unit of life because they are capable of carrying out all the processes necessary for life, such as growth, reproduction, responding to stimuli, and more. While chemicals, atoms, and molecules are essential components of cells and living organisms, they are not considered the basic unit of life. Chemicals are general substances, atoms are the smallest units of matter, and molecules are combinations of atoms. Therefore, the correct answer is cells, as they are the building blocks of all living organisms.
3. You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to an LPN/LVN?
- A. Complete admission assessment.
- B. Set up oxygen and suction equipment.
- C. Place a padded tongue blade at the bedside.
- D. Pad the side rails before the patient arrives.
Correct answer: B
Rationale: The correct answer is to delegate the task of setting up oxygen and suction equipment to the LPN/LVN. This task falls within their scope of practice and can be safely performed by them. Completing the admission assessment (Choice A) typically requires a higher level of assessment and critical thinking, making it more appropriate for a registered nurse. Placing a padded tongue blade at the bedside (Choice C) involves potential airway management, which is a more complex task and should be done by a higher-level provider. Padding the side rails before the patient arrives (Choice D) is a task related to patient safety and should be done by the healthcare team as a whole, not solely delegated to an LPN/LVN.
4. You are ready to wash your patient's face. You would start by washing what area of the face?
- A. The forehead
- B. The eyes
- C. The ears
- D. The cheeks
Correct answer: B
Rationale: When washing a patient's face, it is essential to start by cleaning the eyes. The eye area is considered the priority because moving from an area that can potentially be infected to areas of the face and body that are least able to become infected with a washcloth helps prevent the spread of germs. Washing the forehead, ears, or cheeks before the eyes may risk transferring bacteria to a more sensitive area like the eyes, which could lead to infections or other complications. Therefore, starting with the eyes ensures proper hygiene and reduces the risk of introducing harmful microorganisms to the patient's face.
5. The nurse suspects that a client is withholding health-related information out of fear of discovery and possible legal problems. The nurse formulates nursing diagnoses for the client carefully, being concerned about a diagnostic error resulting from which of the following?
- A. Incomplete data
- B. Generalizing from experience
- C. Identifying with the client
- D. Lack of clinical experience
Correct answer: A
Rationale: In this scenario, the nurse is cautious about potential diagnostic errors due to incomplete data. When a client withholds information, it can lead to incomplete data, which may result in inaccurate nursing diagnoses and care planning. Therefore, the nurse's primary concern is collecting accurate data to make informed clinical decisions. Choices B, C, and D are not relevant to the situation described. Generalizing from experience, identifying with the client, and lack of clinical experience do not directly address the issue of incomplete data impacting the diagnostic process.
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