NCLEX NCLEX-PN
NCLEX PN Test Bank
1. A health care provider repeatedly asks a nurse to write his verbal prescriptions in his clients’ charts after he makes his rounds. The nurse is uncomfortable with writing the prescriptions and explains this to the health care provider, but the health care provider tells the nurse that she will be reported if she does not write the prescriptions. How should the nurse manage this conflict?
- A. Stating to the health care provider, 'I don’t really care whether you report me. I am not writing your prescriptions.'
- B. Fulfilling the health care provider’s request
- C. Discussing the situation with the nurse manager
- D. Reporting the health care provider to the chief of medicine at the hospital
Correct answer: Discussing the situation with the nurse manager
Rationale: When a conflict arises, it is most appropriate to try resolving the conflict directly. In this situation, the nurse has tried to explain why she is uncomfortable with the health care provider’s request but has been unable to resolve the conflict. The nurse would then most appropriately use organizational channels of communication and discuss the issue with the nurse manager, who would then proceed to resolve the conflict. The nurse manager may attempt to discuss the situation with the health care provider or seek assistance from the nursing supervisor. Fulfilling the health care provider’s request and writing the prescriptions in the clients’ charts ignores the issue. Reporting the health care provider to the chief of medicine is inappropriate because the nurse should use the appropriate organizational channels of communication to resolve the conflict. Stating 'I don’t really care whether you report me. I am not writing your prescriptions.' is an inappropriate statement and will result in further conflict between the nurse and health care provider.
2. The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
- A. That can be assessed
- B. That is in situ
- C. With increasing lymph node involvement
- D. With distant metastasis
Correct answer: That is in situ
Rationale: The correct answer is B: 'That is in situ.' Cancer in situ means that the cancer is still localized to the primary site. Cancer is graded in terms of tumor, grade, node involvement, and metastasis. Answer A is incorrect because Tis indicates a tumor that is in situ and can be assessed. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrect because a tumor that is in situ is not metastasized.
3. The client is preparing to learn about the effects of isoniazid (INH). Which information is essential for the client to understand?
- A. Isoniazid should be taken with meals to reduce gastrointestinal upset.
- B. Prolonged use of isoniazid may result in dark, concentrated urine.
- C. Taking aluminum hydroxide (Maalox) with isoniazid can enhance the drug's effects.
- D. Consuming alcohol daily can increase the risk of drug-induced hepatitis.
Correct answer: Consuming alcohol daily can increase the risk of drug-induced hepatitis.
Rationale: It is crucial for the client to understand that consuming alcohol while on isoniazid can increase the risk of drug-induced hepatitis. Hepatic damage can lead to dark, concentrated urine. To minimize gastrointestinal upset, it is recommended to take isoniazid with meals rather than on an empty stomach. Additionally, the client should avoid taking aluminum-containing antacids like aluminum hydroxide with isoniazid, as it can reduce the drug's effectiveness. Choice A is incorrect because isoniazid should not be taken on an empty stomach to help reduce GI upset. Choice B is incorrect, as prolonged use of isoniazid does not typically cause dark, concentrated urine. Choice C is incorrect as taking aluminum hydroxide with isoniazid does not enhance the drug's effects; in fact, it may decrease its effectiveness.
4. Nurse Ann tells nurse Christine that one of her client’s status is declining but that she will do her best to juggle her other two clients. Which action is most appropriate?
- A. Nurse Christine should offer to give medications to Nurse Ann’s other two clients.
- B. Nurse Christine should inform their supervisor that assignments may need to be changed.
- C. Nurse Christine should ask other nurses who might be able to help Nurse Ann.
- D. Nurse Ann should try not to burden other nurses and continue caring for her assigned clients.
Correct answer: Nurse Christine should inform their supervisor that assignments may need to be changed.
Rationale: In this situation, when Nurse Ann informs Nurse Christine that a client's status is declining and she needs to attend to them, the most appropriate action for Nurse Christine is to inform their supervisor that assignments may need to be changed. By informing the supervisor, necessary adjustments can be made to ensure proper care for all clients. Offering to give medications to Nurse Ann’s other two clients (choice A) may not address the underlying issue of a declining client and could lead to a delay in care. Asking other nurses for help (choice C) might not be the most efficient solution, as the supervisor is responsible for reassigning tasks. Nurse Ann continuing to care for all her assigned clients (choice D) may compromise the quality of care provided to the declining client and may spread her too thin, impacting all clients negatively.
5. What is the next step for a 64-year-old male diagnosed with COPD and CHF who shows a 10 lbs increase in total body weight over the last few days?
- A. Contact the patient’s physician immediately.
- B. Check the intake and output on the patient’s flow sheet.
- C. Encourage the patient to ambulate to reduce lower extremity edema.
- D. Check the patient’s vitals every 2 hours.
Correct answer: Check the intake and output on the patient’s flow sheet.
Rationale: In a patient with COPD and CHF experiencing a sudden increase in total body weight, the priority is to check the intake and output on the patient’s flow sheet to evaluate fluid balance. This assessment helps determine if the weight gain is due to fluid retention, which can exacerbate CHF. Contacting the physician may be necessary based on the intake and output findings. While encouraging ambulation is beneficial for circulation, it may not address the root cause of fluid retention. Checking vitals every 2 hours is important for monitoring stability but may not pinpoint the reason behind the weight gain.
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