NCLEX-PN
Nclex PN Questions and Answers
1. A client with cancer is transported to the radiology department for a bone scan to determine whether the cancer has metastasized to bone. While the client is in the radiology department, the client's wife arrives for a visit and asks what test is being performed on the client. What should the nurse tell the wife?
- A. A bone scan is being performed.
- B. She can read the client's medical record to determine what the health care provider prescribed.
- C. The radiology department is not clear as to which test has been prescribed.
- D. She will have to discuss the prescribed test with the client.
Correct answer: D
Rationale: In healthcare, confidentiality is crucial. Without the client's consent, nurses cannot disclose confidential information to anyone else, even to family members. Therefore, the appropriate response is to inform the client's wife that she will have to discuss the test with the client directly. It is not appropriate to disclose sensitive medical information without the client's permission. Offering the wife to read the medical record is a violation of privacy and confidentiality. Indicating that the radiology department is unclear about the prescribed test is inaccurate and does not uphold confidentiality. Moreover, it is not the responsibility of another department to disclose medical information; it is the duty of the healthcare provider and the client to discuss such matters.
2. The nurse manager of a quality improvement program asks a nurse in the neurological unit to conduct a retrospective audit. Which action should the auditing nurse plan to perform in this type of audit?
- A. Checking the crash cart to ensure that all needed supplies are readily available in case of an emergency
- B. Checking the documentation written by a new nursing graduate on her assigned clients at the end of the shift
- C. Reviewing neurological assessment checklists for all clients on the unit to ensure that these assessments are being conducted as prescribed
- D. Obtaining the assigned medical record from the hospital's medical record room to review documentation made during a client's hospital stay
Correct answer: D
Rationale: Quality improvement, also known as performance improvement, focuses on processes contributing to client safety and care outcomes. Retrospective audits involve reviewing medical records after discharge for compliance with standards. Concurrent audits assess staff compliance during a client's stay. Therefore, obtaining the medical record from the hospital's record room for review is crucial in a retrospective audit. Options A, B, and C are more suited for concurrent audits as they involve real-time assessment during a client's stay.
3. People-related supervisory tasks include all of the following except:
- A. coaching
- B. encouraging
- C. target setting
- D. rewarding
Correct answer: C
Rationale: People-related supervisory tasks involve direct interaction with individuals performing the work. Coaching, encouraging, rewarding, evaluating, and facilitating are all part of these tasks as they focus on supporting and motivating employees. Target setting, on the other hand, is a task-centered responsibility that involves projecting goals or objectives to be accomplished. It focuses more on setting objectives and goals rather than directly interacting with individuals, making it the exception among the given choices.
4. A client being treated for sickle cell disease has an order for pain medication. Morphine was ordered, but the nurse is having difficulty deciphering the dose. The nurse should ____.
- A. ask the attending physician to clarify the order, including the correct medication, dose, route, and frequency
- B. call the charge nurse to inform the attending physician and verify the order, including the correct medication, dose, route, and frequency
- C. call the attending physician to verbally verify the order, including the correct medication, dose, route, and frequency
- D. refrain from administering the medication until the charge nurse can assist in determining the correct dosage
Correct answer: C
Rationale: In this scenario, when a nurse encounters difficulties in deciphering an order, the appropriate action is to contact the attending physician directly to clarify and verify the medication, dose, route, and frequency. It is crucial for the nurse to have a clear understanding of the order before administering any medication to ensure patient safety and proper treatment. Option A is incorrect as it suggests asking the attending physician to clarify without specifying the urgency of the situation. Option B involves an unnecessary additional step by first contacting the charge nurse before reaching out to the attending physician, potentially delaying the clarification process. Option D is incorrect as it advises refraining from administering the medication, which may not be necessary if the correct dosage can be promptly verified by contacting the attending physician.
5. A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefits of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing?
- A. Fidelity
- B. Nonmaleficence
- C. Autonomy
- D. Justice
Correct answer: B
Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the principle of avoiding harm. In healthcare ethics, practitioners aim not only to do good but also to ensure they do no harm. In this scenario, the healthcare team is discussing treatment options with the intention of inflicting the least harm on the client. Choice A, Fidelity, refers to keeping promises made to clients, families, and healthcare professionals. Choice C, Autonomy, pertains to respecting a person's independence and right to make decisions. Choice D, Justice, involves fairness, equity, and the fair allocation of resources, such as healthcare services.
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