NCLEX-PN
Nclex PN Questions and Answers
1. What is the best definition of ethics in nursing?
- A. advocating for the client
- B. knowing your scope of practice
- C. being able to differentiate right from wrong
- D. being willing to report violations
Correct answer: C
Rationale: Ethics in nursing refers to the moral principles that govern a nurse's behavior and decision-making. It involves being able to differentiate right from wrong, making choices that are morally sound, and upholding integrity in patient care. While advocating for the client (choice A) is an important aspect of nursing care, it does not fully encompass the broad concept of ethics. Knowing your scope of practice (choice B) is essential for safe and competent care but is not a comprehensive definition of ethics. Being willing to report violations (choice D) is part of ethical practice, but it is not the core definition of ethics in nursing.
2. The nurse is caring for a client awaiting test results on a biopsy. The client is unconscious, and the physician informs the client's spouse that the biopsy came back positive for cancer. The spouse asks the nurse if they will not share this news with the client because they would prefer the client be unaware of the diagnosis. Which of the following responses is most appropriate?
- A. "I will have a psychiatrist confirm whether the news will cause negative effects, and if so, I will comply with your request."?
- B. "For ethical reasons, I am unable to withhold this information from the client."?
- C. "You do not have the option to sign paperwork stating you are accepting the risk of not sharing this with the client."?
- D. "You must have a durable power of attorney for healthcare advanced directive in place before I can consider this request."?
Correct answer: B
Rationale: The correct response is, "For ethical reasons, I am unable to withhold this information from the client."? The ethical principle of veracity requires that the nurse is truthful with the client and does not withhold information even if it is requested by the family. Choice A is incorrect because seeking a psychiatrist's confirmation is not necessary to uphold the ethical principle of truth-telling. Choice C is incorrect as implying that signing paperwork overrides the nurse's ethical obligation to be honest with the client is inappropriate. Choice D is also incorrect as a durable power of attorney is not relevant in this situation where the spouse is asking the nurse to withhold information.
3. Which action exemplifies the use of evidence-based practice in the delivery of client care?
- A. Advising a client to agree to the treatment recommended by their healthcare provider
- B. Taking a rectal temperature from a client for whom bleeding precautions have been instituted
- C. Donning sterile gloves to change an abdominal wound dressing
- D. Encouraging a client to take an herbal substance to treat their insomnia
Correct answer: C
Rationale: Evidence-based practice is an approach to client care where the nurse integrates the client’s preferences, clinical expertise, and the best research evidence to deliver quality care. Donning sterile gloves to change an abdominal wound dressing exemplifies evidence-based practice as it prevents the entrance of harmful bacteria into the wound, following best practice guidelines. The other options do not align with evidence-based practice. Advising a client to agree to a treatment does not involve integrating research evidence. Taking herbal substances may not be supported by strong research evidence and can pose risks. Additionally, rectal temperature-taking in a client with bleeding precautions can increase the risk of injury to the rectal mucosa, not aligning with best practices in care delivery.
4. 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.
5. The client is going for surgery and mentions their religious objection to blood transfusions. Which of the following responses would be most appropriate?
- A. "I can ask pastoral care to send someone to speak with you about this concern since it would not be safe to refuse a blood transfusion."?
- B. "I understand, and you have the right to refuse blood transfusions."?
- C. "While I understand, if there is excessive bleeding during surgery, we may need to transfuse blood to stabilize you."?
- D. "I have received a blood transfusion before, and I do not think you understand the risks versus the benefits of refusing this."?
Correct answer: B
Rationale: The most appropriate response is, '"I understand, and you have the right to refuse blood transfusions."? This answer shows respect for the client's autonomy and religious beliefs. It is crucial for healthcare providers to acknowledge and support a patient's decision-making regarding their care, even if it conflicts with medical advice. Option A is not ideal as it might seem dismissive of the client's beliefs. Option C introduces a potential negative outcome of refusing a blood transfusion, which could induce fear or coercion. Option D is inappropriate because it implies judgment and does not uphold the client's autonomy.
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