NCLEX-PN
Nclex PN Questions and Answers
1. While documenting on a paper form, the nurse realizes they have made a mistake writing the progress note. What should the nurse do?
- A. Use a black marker to fully cover up the mistake.
- B. Do not make any changes to the progress note but explain later in the note that a mistake was made and note what should have been written.
- C. Use whiteout to cover over the mistake and write over it.
- D. Inform the client about the mistake and offer to provide a corrected copy.
Correct answer: B
Rationale: In the scenario described, it is essential for the nurse not to alter the original progress note. Option B is the correct course of action as it maintains the integrity of the documentation while acknowledging the error for transparency and accuracy. Using a black marker (Option A) or whiteout (Option C) can be seen as an attempt to conceal the mistake, which is not in line with professional standards. Option D is incorrect because the mistake should be addressed within the documentation itself, not by informing the client directly about it.
2. What should be included in the assessment of a client with a cast?
- A. capillary refill, warm toes, no discomfort.
- B. posterior tibial pulses, warm toes.
- C. moist skin essential, pain threshold.
- D. discomfort of the metacarpals.
Correct answer: A
Rationale: When assessing a client with a cast, it is crucial to check for capillary refill to ensure adequate circulation. Warm toes indicate good circulation, while the absence of discomfort suggests the cast is not causing any pain or undue pressure on the client. Therefore, choices B, C, and D are incorrect as they do not address the essential components of assessing a client with a cast.
3. Which of the following indicates a hazard for a client on oxygen therapy?
- A. A 'No Smoking' sign is on the door.
- B. The client is wearing a synthetic gown.
- C. Electrical equipment is grounded.
- D. Matches are removed.
Correct answer: B
Rationale: The correct answer is that the client is wearing a synthetic gown. A synthetic gown might generate sparks of static electricity, which can be a fire hazard, especially in the presence of oxygen. Clients on oxygen therapy should wear cotton gowns to minimize the risk of fire. The other options are not hazards for a client on oxygen therapy: having a 'No Smoking' sign on the door promotes safety by preventing smoking, ensuring electrical equipment is grounded reduces the risk of electrical hazards, and removing matches decreases the risk of fire hazards.
4. Several passengers aboard an airliner suddenly become weak and suffer breathing difficulty. The diagnosis is likely to be:
- A. Outbreak of Asian flu.
- B. Chemical exposure.
- C. Bacterial pneumonia.
- D. Allergic reaction.
Correct answer: B
Rationale: The most likely cause of groups of individuals suddenly experiencing similar signs of illness all at once is a chemical exposure. In this scenario, considering the sudden onset of symptoms in multiple passengers on an airliner, the symptoms are more indicative of a chemical exposure rather than Asian flu, bacterial pneumonia, or an allergic reaction. Asian flu, bacterial pneumonia, and allergic reactions do not typically manifest in a way that would affect a group of individuals simultaneously. Therefore, the correct diagnosis in this case is likely to be a chemical exposure.
5. When a client's postoperative pain seems to be getting worse due to grief over the recent death of their spouse, what should the nurse consider?
- A. calling the physician for an increased dosage of pain medication
- B. calling the physician for a sedative
- C. referring the client for a psychiatric consult
- D. developing interventions for grief and loss
Correct answer: D
Rationale: The correct answer is developing interventions for grief and loss. In this scenario, the client's pain is not solely sensory but also affective due to grieving over the death of their spouse. It is essential to address the emotional component of pain by providing support and interventions for grief and loss. Referring the client for a psychiatric consult may not be necessary as grieving is a normal response to such a significant loss. Calling the physician for an increased dosage of pain medication or a sedative solely focuses on the sensory aspect of pain and does not address the underlying emotional distress.
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