NCLEX-PN
Nclex Practice Questions 2024
1. Upon arrival at the emergency room, the client presents with severe burns to the left arm, hands, face, and neck. What action should take priority?
- A. Starting an IV
- B. Applying oxygen
- C. Obtaining blood gases
- D. Medicating the client for pain
Correct answer: Applying oxygen
Rationale: In a client with severe burns to the face and neck, airway assessment and supplemental oxygen are crucial. Therefore, applying oxygen is the priority to ensure adequate oxygenation for the client. This intervention takes precedence over other actions to stabilize the client's condition. Starting an IV for fluid resuscitation is the next appropriate step following ensuring oxygenation (Choice A). While pain management is important, it is a secondary priority after ensuring oxygenation and fluid resuscitation, making medicating the client for pain a later intervention (Choice D). Obtaining blood gases (Choice C) is not the immediate priority in this scenario and would typically be ordered by the healthcare provider based on the client's condition and response to initial interventions.
2. After the client discusses her relationship with her father, the nurse says, “Tell me whether I am understanding your relationship with your father. You feel dominated and controlled by him?” This is an example of:
- A. verbalizing the implied.
- B. seeking consensual validation.
- C. encouraging evaluation.
- D. suggesting collaboration.
Correct answer: seeking consensual validation.
Rationale: Seeking consensual validation is the correct answer. Consensual validation is a technique used to check one’s understanding of what the client has said. It involves confirming with the client whether the nurse's interpretation aligns with the client's feelings or thoughts. This process helps build rapport, trust, and a shared understanding between the nurse and the client. Verbalizing the implied (choice A) refers to expressing the underlying or implicit meaning of a client's statement. Encouraging evaluation (choice C) involves prompting the client to assess or judge a situation. Suggesting collaboration (choice D) entails proposing working together with the client on a shared goal, which is not the primary focus in the scenario provided.
3. When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?
- A. Lifetime prevalence and intensity of alcohol use are greater in men than in women.
- B. Caucasians report higher levels of alcohol use than African Americans or Hispanics.
- C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
- D. Heavy use is more common in lower socioeconomic groups due to affordability.
Correct answer: Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
Rationale: The correct answer is that overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age. Recent research indicates that alcohol and illicit drug use tends to rise into the mid-20s and then decline with age. Choices A and B are incorrect because lifetime prevalence and intensity of alcohol use are greater in men than in women, and Caucasians do not report higher levels of alcohol use compared to African Americans or Hispanics. Choice D is incorrect because heavy use is more common in lower socioeconomic groups due to factors like stress, coping mechanisms, and availability, not just affordability.
4. A client reports that he is 'talking to the voices.' The nurse observes this behavior. The nurse’s next action should be:
- A. touching the client to help him return to reality
- B. leaving the client alone until reality returns
- C. asking the client to describe what is happening
- D. telling the client there are no voices
Correct answer: touching the client to help him return to reality
Rationale: When a client reports talking to voices, the nurse should engage in a gentle touch to help the client return to reality. It is important for the nurse to acknowledge the client's experience and attempt to redirect them gently. Touch can provide grounding and connection. Asking the client to describe what is happening can be overwhelming and might exacerbate the situation. Leaving the client alone may not be safe or therapeutic as the client may need support. Telling the client there are no voices denies their reality and is not helpful in managing their experience.
5. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?
- A. A client with Alzheimer’s disease
- B. A client with pneumonia
- C. A client with appendicitis
- D. A client with thrombophlebitis
Correct answer: A client with Alzheimer’s disease
Rationale: The client with Alzheimer’s disease is the most stable among the clients listed and can be appropriately assigned to the nursing assistant. Nursing assistants are capable of providing care such as feeding and assisting with activities of daily living for individuals with Alzheimer's disease. Clients with pneumonia, appendicitis, and thrombophlebitis are less stable and necessitate the expertise of a registered nurse for accurate assessment and interventions. Therefore, the nursing assistant can effectively care for the client with Alzheimer’s disease while ensuring that the other clients receive the necessary level of care from a registered nurse.
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