NCLEX-RN
NCLEX RN Exam Preview Answers
1. A woman who has lived in the United States for a year after moving from Europe has learned to speak English and is almost finished with her college studies. She now dresses like her peers and says that her family in Europe would hardly recognize her. This situation illustrates which concept?
- A. Integration
- B. Assimilation
- C. Biculturalism
- D. Heritage consistency
Correct answer: B
Rationale: Assimilation is a unidirectional, linear process moving from unacculturated to acculturated, in which a person develops a new cultural identity and becomes like members of the dominant culture. In this scenario, the woman has adapted to the new culture by learning the language, dressing like her peers, and expressing that her family in Europe would hardly recognize her. This aligns with the process of assimilation. Integration and biculturalism, on the other hand, involve bidirectional and bidimensional processes that induce reciprocal change in both cultures while maintaining aspects of the original culture in one's ethnic identity. Since there is no indication in the question that the woman has retained aspects of her original culture, integration and biculturalism are not the correct concepts. Heritage consistency refers to the degree to which one retains their original or traditional culture, which is not addressed in the scenario provided.
2. The nurse receives change-of-shift report on the following four patients. Which patient should the nurse assess first?
- A. A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled
- B. A 46-year-old patient on bed rest who is complaining of sudden onset of shortness of breath
- C. A 77-year-old patient with tuberculosis (TB) who has four antitubercular medications due in 15 minutes
- D. A 35-year-old patient who was admitted the previous day with pneumonia and has a temperature of 100.2 F (37.8 C)
Correct answer: B
Rationale: The correct answer is the 46-year-old patient on bed rest who is complaining of sudden onset of shortness of breath. Patients on bed rest who are immobile are at high risk for deep vein thrombosis (DVT). Sudden onset of shortness of breath in a patient with a DVT suggests a pulmonary embolism, which requires immediate assessment and action such as oxygen administration to maintain adequate oxygenation. The other patients should also be assessed as soon as possible, but they do not present with an immediate life-threatening condition that requires urgent intervention like the patient experiencing sudden shortness of breath.
3. When percussing over the abdomen of an obese patient, the nurse is unable to identify any changes in sound. What would the nurse do next?
- A. Ask the patient to take deep breaths to relax the abdominal musculature.
- B. Consider this finding as normal and proceed with the abdominal assessment.
- C. Increase the amount of strength used when attempting to percuss over the abdomen.
- D. Decrease the amount of strength used when attempting to percuss over the abdomen.
Correct answer: C
Rationale: When percussing an obese patient's abdomen, the thickness of their body wall can affect the sound produced. A stronger percussion stroke is needed for obese or very muscular patients. The force of the blow determines the loudness of the note. Asking the patient to take deep breaths, considering the finding as normal, or decreasing the strength used are not appropriate actions in this scenario.
4. In which situation would the nurse use bimanual palpation technique?
- A. Palpating the thorax of an infant
- B. Palpating the kidneys and uterus
- C. Assessing pulsations and vibrations
- D. Assessing the presence of tenderness and pain
Correct answer: B
Rationale: Bimanual palpation involves using both hands to envelop or capture specific body parts or organs like the kidneys, uterus, or adnexa. This technique is particularly useful for assessing the size, shape, consistency, and mobility of deep organs like the kidneys and uterus. Palpating the thorax of an infant (Choice A) is usually done with a different technique like gentle, single-handed palpation. Assessing pulsations and vibrations (Choice C) and assessing tenderness and pain (Choice D) typically do not require the use of bimanual palpation, making Choices A, C, and D incorrect.
5. The nurse is discussing the term subculture with a student nurse. Which statement by the nurse would best describe subculture?
- A. "Fitting as many people as possible into the majority culture."?
- B. "Identifying small groups of people who do not want to be identified with the larger culture."?
- C. "Singling out groups of people who suffer differential and unequal treatment as a result of cultural variations."?
- D. "Recognizing groups of people within a culture with shared characteristics that are not common to all members of the culture."?
Correct answer: D
Rationale: A subculture refers to a group of people within a larger culture who share distinct beliefs, values, or attitudes that are not universal among all members of the larger culture. Subcultures can emerge based on factors such as ethnicity, religion, education, occupation, age, and gender. The correct answer describes the concept of a subculture accurately. Choices A, B, and C are incorrect because they do not capture the essence of a subculture. Fitting people into the majority culture, identifying small groups who distance themselves from the larger culture, or singling out individuals facing differential treatment do not define subculture. Subcultures represent specific groups with shared characteristics that differentiate them from the broader cultural norms.
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