NCLEX NCLEX-PN
NCLEX-PN Quizlet 2023
1. A pregnant Asian client who is experiencing morning sickness wants to take ginger to relieve the nausea. Which of the following responses by the nurse is appropriate?
- A. “I will call your physician to see if we can start some ginger.”
- B. “We don’t use home remedies in this clinic.”
- C. “Herbs are not as effective as regular medicines.”
- D. “Just eat some dry crackers instead.”
Correct answer: “I will call your physician to see if we can start some ginger.”
Rationale: The correct response is appropriate as it demonstrates cultural sensitivity. Ginger is commonly used to alleviate nausea, particularly in Asian cultures. Contacting the physician to discuss the use of ginger ensures the client's safety and respects their preferences. Choices B and C are incorrect as they disregard the client's request and fail to acknowledge their cultural beliefs. Choice D is incorrect because it does not address the client's desire to use ginger for relief.
2. While making rounds at 3 am, the nurse discovers a small fire in a client’s room. What should the nurse do first?
- A. Remove the client from the room immediately.
- B. Leave the client’s room to obtain a fire extinguisher.
- C. Instruct a nurse tech to pull the fire alarm.
- D. Evacuate all clients from the unit.
Correct answer: Remove the client from the room immediately.
Rationale: During a fire emergency, the priority is the safety of the individual in the room where the fire is located. Removing the client from the room immediately is the first step in the RACE acronym for fire safety: Rescue/Remove, Alarm, Contain, and Extinguish. This action ensures the client's safety before addressing the fire itself. Choice B is incorrect as leaving the client’s room to obtain a fire extinguisher can delay the immediate removal of the client from the danger. Choice C is incorrect as pulling the fire alarm should be done after ensuring the client's safety. Choice D is incorrect as evacuating all clients from the unit should come after ensuring the safety of the individual in immediate danger.
3. After applying oxygen using bi-nasal prongs to a client who is having chest pain, the nurse should implement which intervention?
- A. Have the client take slow deep breaths in through their mouth and out through their nose.
- B. Post signs indicating that oxygen is in use on the client’s door and in their room
- C. Apply Vaseline petroleum to both nares and 2 by 2 gauze around the oxygen tubing at the client’s ears
- D. Encourage the client to hyperextend the neck, take a few deep breaths and cough.
Correct answer: Post signs indicating that oxygen is in use on the client’s door and in their room
Rationale: After applying oxygen using bi-nasal prongs to a client with chest pain, it is essential for the nurse to post signs indicating that oxygen is in use on the client’s door and in their room. This safety precaution alerts healthcare providers and visitors that the client is receiving oxygen therapy, reducing the risk of accidents or misunderstandings. Choice A is incorrect because instructing the client to take slow deep breaths is not the appropriate intervention after applying oxygen. Choice C suggests applying Vaseline and gauze, which is unnecessary and not a standard practice. Choice D advising the client to hyperextend the neck, take deep breaths, and cough is not indicated after applying oxygen therapy and could potentially be harmful.
4. A client who has undergone a total hip replacement is told that she will need to go to an extended care rehabilitation facility for therapy before going home. Which member of the healthcare team should the nurse ask to plan the discharge and transition from the hospital to the rehabilitation facility?
- A. Physical therapist
- B. Occupational therapist
- C. Clergy
- D. Social worker
Correct answer: Social worker
Rationale: In this scenario, the appropriate member of the healthcare team to plan the discharge and transition from the hospital to the rehabilitation facility is the social worker. Social workers are trained to provide counseling services, emotional support, arrange placements in care facilities, and locate financial resources for clients. While clergy provide spiritual support and guidance, physical therapists assist in physical treatments, and occupational therapists help with activities of daily living, the social worker is best suited to address the client's needs related to discharge planning and transition. Therefore, the correct answer is the social worker.
5. During an interview, what action should a nurse conducting an interview with a client take to collect subjective data?
- A. Takes minimal notes to avoid impeding observation of the client’s nonverbal behaviors
- B. Takes a great deal of notes to allow the client to continue at his or her own pace as the nurse records what he or she is saying
- C. Takes notes because this allows the nurse to break eye contact with the client, which may increase the client’s level of comfort
- D. Takes notes to allow the nurse to shift attention away from the client, which may make the nurse more comfortable
Correct answer: Takes minimal notes to avoid impeding observation of the client’s nonverbal behaviors
Rationale: During an interview, a nurse should minimize note-taking to focus on the client and not impede the conversation. Taking minimal notes allows the nurse to effectively observe the client's nonverbal behaviors, which provide valuable subjective data. Option B, taking many notes, is incorrect as it can distract the nurse from the client's cues and hinder interaction. Option C, taking notes to break eye contact, is incorrect as it may decrease the client's comfort level and disrupt communication. Option D, taking notes to shift attention away from the client, is incorrect as it diminishes the client's importance and may make them uncomfortable during sensitive discussions. Therefore, the correct approach is for the nurse to take minimal notes, ensuring effective observation of the client’s nonverbal behaviors while collecting subjective data.
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