NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The nurse teaches a patient about the transmission of pulmonary tuberculosis (TB). Which statement, if made by the patient, indicates that teaching was effective?
- A. I will avoid being outdoors whenever possible.
- B. My husband will be sleeping in the guest bedroom.
- C. I will take the bus instead of driving to visit my friends.
- D. I will keep the windows closed at home to contain the germs.
Correct answer: B
Rationale: To prevent the transmission of pulmonary tuberculosis, it is important for the infected individual to minimize exposure to close contacts and household members. Sleeping alone in a separate room, like the guest bedroom, is an effective measure. The other choices are not ideal: Choice A is incorrect because spending time outdoors is encouraged for ventilation; Choice C is incorrect as using public transportation increases the risk of transmission; Choice D is incorrect because keeping windows closed limits ventilation, which is necessary to reduce the concentration of infectious particles in the air.
2. Who typically owns a patient's medical record?
- A. The patient
- B. The physician
- C. The Legal Counsel of the Office
- D. No one owns a medical record
Correct answer: B
Rationale: The correct answer is 'The physician.' Physicians typically own their patients' medical records as they are the ones responsible for creating, updating, and maintaining these records. However, it is essential to note that patients have the legal right to access and obtain copies of their medical records. Choice A ('The patient') is incorrect as patients do not own their medical records, but they do have rights regarding access to them. Choice C ('The Legal Counsel of the Office') is incorrect as legal counsel typically do not own or have ownership rights over medical records. Choice D ('No one owns a medical record') is incorrect as medical records are owned by healthcare providers who create and maintain them, such as physicians.
3. After a lengthy explanation of a medical procedure, the patient asks many questions. The physician answers all of the questions to the best of their ability. The patient then gives consent for treatment. The costly equipment and supplies are put into place, and the patient is prepared. Two minutes before the procedure is to start, the patient begins panicking and changes their mind. Which of the following situations would be the best way to avoid litigation?
- A. Document that the patient originally gave consent and proceed if the benefits of the procedure outweigh the patient's wishes.
- B. Have the patient sign a form stating that they are refusing consent. If they refuse to sign, do not proceed with the procedure.
- C. Repeat the explanation of the procedure until the patient understands that having the procedure done is the best form of treatment. Do not proceed with the procedure.
- D. Do not proceed. Document the patient's refusal, have the patient sign a refusal to consent to treatment. If the patient refuses to sign the form, have a witness available to sign.
Correct answer: D
Rationale: In this scenario, the best course of action to avoid litigation is to respect the patient's right to refuse treatment, especially when changing their mind before the procedure starts. By not proceeding with the treatment, documenting the patient's refusal, and having the patient sign a refusal to consent form, you are following proper ethical and legal procedures. If the patient refuses to sign the form, having a witness available to sign further strengthens the documentation of the patient's decision. This approach ensures that the patient's autonomy and right to make informed decisions about their healthcare are respected. Choices A, B, and C do not prioritize the patient's right to refuse treatment and could potentially lead to legal issues if treatment is carried out against the patient's wishes.
4. The clinic nurse teaches a patient with a 42 pack-year history of cigarette smoking about lung disease. Which information will be most important for the nurse to include?
- A. Options for smoking cessation
- B. Reasons for annual sputum cytology testing
- C. Erlotinib (Tarceva) therapy to prevent tumor risk
- D. Computed tomography (CT) screening for lung cancer
Correct answer: A
Rationale: The most critical information for the nurse to provide to a patient with a significant smoking history is options for smoking cessation. Smoking is the primary cause of lung cancer, making smoking cessation essential in reducing the risk of developing the disease. Annual sputum cytology testing is not a standard screening test for lung cancer; instead, CT scanning is being explored for this purpose. Erlotinib therapy is used in lung cancer treatment but not for preventing tumor risk in individuals without cancer. CT screening for lung cancer is still under investigation and is not primarily aimed at prevention but rather early detection in high-risk individuals.
5. The BRAT diet is often prescribed for patients with gastroenteritis. This acronym stands for:
- A. Bananas, Rice, Applesauce, and Toast
- B. Bread, Rice, Apricots, and Tapioca
- C. Bananas, Rolls, Apricots, and Toast
- D. Bananas, Rolls, Applesauce, and Tapioca
Correct answer: A
Rationale: The BRAT diet, which stands for Bananas, Rice, Applesauce, and Toast, is commonly recommended for patients with gastroenteritis. These easily digestible foods help firm up stools due to their low fiber content and provide essential nutrients lost during vomiting and diarrhea. Choice B is incorrect because it includes apricots, which are not part of the traditional BRAT diet. Choice C is incorrect as it includes rolls, which are not typically included in the BRAT diet. Choice D is incorrect as it includes tapioca, which is not part of the traditional BRAT diet. Therefore, the correct answer is Bananas, Rice, Applesauce, and Toast.
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