NCLEX-PN
Nclex Exam Cram Practice Questions
1. When assessing a client's risk for elimination impairment, which of the following factors is least relevant?
- A. current medications
- B. ambulation abilities
- C. family history
- D. hydration status
Correct answer: C
Rationale: When assessing a client's risk for elimination impairment, family history is the least relevant factor to consider. Current medications can affect elimination functions through side effects, ambulation abilities can impact mobility to access toileting facilities, and hydration status directly influences urinary output and bowel function. Family history, although providing some context, does not have a direct impact on the client's current risk of elimination impairment.
2. A licensed practical nurse (LPN) works on an adult medical/surgical unit and has been pulled to work on the burn unit, which cares for clients of all ages. What should the LPN do?
- A. The LPN should take the assignment, but make it clear they will only care for adult clients.
- B. The LPN should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting.
- C. The LPN should refuse to take the assignment, as caring for the infant and child population is not within their scope of practice.
- D. The LPN should take the assignment, but ask to be paired with a more experienced LPN.
Correct answer: B
Rationale: In this scenario, it is crucial for the LPN to demonstrate flexibility and a willingness to adapt to the new assignment that involves caring for clients of all ages. While the LPN may have expertise in a specific nursing area, it is essential to be able to provide care to diverse client populations. Accepting the assignment reflects a commitment to teamwork and patient care. However, to ensure safe and competent care, the LPN should communicate with the charge nurse about the situation. Requesting a quick orientation will help the LPN familiarize themselves with the burn unit's specific requirements, equipment, and protocols. This proactive approach allows the LPN to address any concerns, ask questions, and seek necessary support, ultimately ensuring the best care for all clients in the burn unit. Choice A is incorrect because limiting care to only adult clients may not be feasible in a unit that cares for clients of all ages. Choice C is incorrect as refusing the assignment outright may not be the best approach without considering alternatives. Choice D is not the most effective option as asking to be paired with a more experienced LPN does not address the need for a quick orientation to the new unit.
3. A 51-year-old client with amyotrophic lateral sclerosis (Lou Gehrig disease) is admitted to the hospital because his condition is deteriorating. The client tells the nurse that he wants a do-not-resuscitate (DNR) order. The nurse should provide the client with which information?
- A. Oral consent is not sufficient, and the client's request will be honored by all healthcare providers.
- B. Consent must be obtained from the family.
- C. The DNR request should be discussed with the healthcare provider, who will write the order.
- D. The healthcare provider makes the final decision about a DNR request.
Correct answer: C
Rationale: When a client requests a DNR order, the nurse should contact the healthcare provider so that the provider may discuss the request with the client. A DNR order should be written, not verbal, following agency and state guidelines. Therefore, the correct answer is that the DNR request should be discussed with the healthcare provider, who will write the order. Option A is incorrect as oral consent is not sufficient for a DNR order. Option B is incorrect because the client, not the family, has the authority to request a DNR order. Option D is incorrect because the healthcare provider discusses the request with the client but does not make the final decision.
4. Why might breast implants interfere with mammography?
- A. They might cause additional discomfort.
- B. They are contraindications to mammography.
- C. They are likely to be dislodged.
- D. They might prevent detection of masses.
Correct answer: D
Rationale: Breast implants can interfere with mammography by potentially preventing the detection of masses. The presence of implants can obscure a clear view of breast tissue, making it difficult to identify abnormalities such as masses that may indicate breast cancer. Choices A, B, and C are incorrect because discomfort, contraindications, and dislodgment are not primary reasons why breast implants interfere with mammography. The main concern is the impedance of detecting abnormalities accurately due to the implants.
5. Which of the following foods might a client with hypercholesterolemia need to decrease intake of?
- A. broiled catfish
- B. hamburgers
- C. wheat bread
- D. fresh apples
Correct answer: B
Rationale: A client with hypercholesterolemia should decrease their intake of foods high in cholesterol. Hamburgers, being red meat, have a high cholesterol content, hence should be decreased in the diet. Broiled catfish, wheat bread, and fresh apples are not high in cholesterol, so there is no need to decrease their intake. Broiled catfish is a lean source of protein, wheat bread is a complex carbohydrate, and fresh apples are a good source of fiber and vitamins. Therefore, hamburgers are the correct choice to decrease intake for a client with hypercholesterolemia.
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