NCLEX-PN
NCLEX PN Test Bank
1. A nurse who works in a medical care unit is told that she must float to the intensive care unit because of a short-staffing problem on that unit. The nurse reports to the unit and is assigned to three clients. The nurse is angry with the assignment because she believes that the assignment is more difficult than the assignment delegated to other nurses on the unit and because the intensive care unit nurses are each assigned only one client. The nurse should most appropriately take which action?
- A. Refuse to do the assignment
- B. Tell the nurse manager to call the nursing supervisor
- C. Return to the medical care unit and discuss the assignment with the nurse manager on that unit
- D. Ask the nurse manager of the intensive care unit to discuss the assignment
Correct answer: D
Rationale: In this scenario, the nurse feeling that the assignment is more difficult than what other nurses received should approach the nurse manager of the intensive care unit to discuss the assignment. By doing so, the nurse can seek clarification on the rationale for the assignment or confirm if it is genuinely more challenging. Refusing the assignment is not appropriate as it could impact patient care. Returning to the medical care unit would be considered client abandonment and does not directly address the conflict at hand. Instructing the nurse manager to involve the nursing supervisor is an aggressive approach that does not directly resolve the issue.
2. A nurse is planning task assignments for the day. Which task should the nurse assign to the nursing assistant?
- A. Suctioning a client who requires periodic suctioning
- B. Assessing a client who has undergone an arteriogram and requires close monitoring
- C. Performing colostomy irrigation on a client with an ostomy
- D. Assisting a client who needs frequent ambulation with a walker
Correct answer: D
Rationale: When delegating tasks, a nurse must consider the staff member's education and competency level. Noninvasive tasks like helping a client ambulate with a walker are usually suitable for nursing assistants. Suctioning a client and colostomy irrigation are invasive procedures that require a licensed nurse's skills. Assessing a client post-arteriogram for any complications or changes in condition also necessitates the expertise of a licensed nurse. Therefore, the most appropriate task to assign to a nursing assistant is assisting a client who needs frequent ambulation with a walker.
3. Which situation is an example of the use of evidence-based practice in the delivery of client care?
- A. Encouraging a client who has had a stroke to consume thickened liquids and soft foods
- B. Picking up a dislodged radiation implant with long-handled forceps and placing it in a lead container to minimize radiation exposure
- C. Pouring 1 to 2 mL of sterile solution that will be used for wound cleansing into a plastic-lined waste receptacle before pouring the solution into a sterile basin
- D. Blowing on a fingerstick site to dry it after cleaning the site with an alcohol swab
Correct answer: C
Rationale: Evidence-based practice is an approach that integrates client preferences, clinical expertise, and the best research evidence to deliver quality care. Pouring sterile solution into a plastic-lined waste receptacle before using it for wound cleansing reflects evidence-based practice by preventing the entrance of harmful bacteria into the wound. Option A is incorrect because encouraging a stroke client to consume thickened liquids and soft foods is appropriate, not thin liquids and foods that pose a choking risk. Option B is incorrect as picking up a radiation implant with long-handled forceps to minimize radiation exposure is a safety measure, not evidence-based practice. Option D is incorrect because blowing on a fingerstick site after cleaning can recontaminate the site, which goes against best practices in infection control.
4. A licensed practical nurse tells the certified nursing assistant (CNA) staff that they will need to comply with the mandatory overtime policy that the long-term care facility has implemented. Later that day, the nurse overhears a CNA complaining about the policy and telling other CNAs that she will not work the overtime if she has made other plans after her regular shift. What is the best approach for the nurse to use in dealing with the conflict?
- A. Providing a positive reward system for the CNA to encourage working the mandatory overtime
- B. Ignoring the complaints
- C. Avoiding assigning the CNA mandatory overtime
- D. Meeting with the CNA regarding her behavior concerning the overtime policy
Correct answer: D
Rationale: In this situation, the best approach for the nurse is to meet with the CNA regarding her behavior concerning the overtime policy. Initiating a discussion is crucial to address resistance by a staff member. A face-to-face meeting allows for the verbalization of feelings, identification of problems, and the opportunity to develop strategies to solve the issue. Ignoring the complaints and avoiding assigning mandatory overtime do not tackle the root of the problem. Providing a positive reward system might offer a temporary fix but does not directly address the resistance and conflict.
5. A nurse working the 7 a.m. to 3 p.m. shift is reviewing the records of the assigned clients. Which client should the nurse assess first?
- A. A client scheduled for hemodialysis at 10 a.m.
- B. A client scheduled for contrast computed tomography (CT) at noon.
- C. A client scheduled for a nuclear scanning procedure at 10 a.m.
- D. A client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m.
Correct answer: A
Rationale: The correct answer is the client scheduled for hemodialysis at 10 a.m. This client needs immediate assessment before the procedure, which may take up to 5 hours. The nurse should ensure the client is physically and emotionally prepared, check for fluid overload by assessing weight and lung sounds, review vital signs, and laboratory test results. The other clients described in the options have needs that are not as urgent. The client scheduled for a nuclear scanning procedure at 10 a.m. may require information reinforcement and increased fluid intake before the procedure. The client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m. may need pain medication administered 30 minutes prior to the therapy. The client scheduled for a contrast CT at noon may need procedure information reinforcement and a special contrast preparation just before the procedure.
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