NCLEX NCLEX-PN
2024 PN NCLEX Questions
1. When reviewing a client's medical notes to confirm pregnancy, a nurse should look for which finding to determine that pregnancy is confirmed?
- A. Amenorrhea
- B. Thinning of the cervix
- C. Palpable fetal movement
- D. Positive result on a home urine test for pregnancy
Correct answer: Palpable fetal movement
Rationale: To confirm pregnancy, the presence of palpable fetal movement is a positive indicator. Palpable fetal movement is a certain sign of pregnancy, known as a fetal movement felt by the examiner. Amenorrhea is a presumptive sign of pregnancy as it is reported by the woman but is not confirmatory. Thinning of the cervix (Hegar sign) is a probable sign of pregnancy, which is not confirmatory. A positive result on a home urine test for pregnancy is also a probable indicator. However, a positive pregnancy test result can sometimes yield false-positive results due to various factors like medication, recent pregnancy, or errors in reading.
2. What effect can medication bound to protein have?
- A. reduced drug availability
- B. limited distribution of the drug to receptor sites
- C. less availability to produce desired medicinal effects
- D. decreased metabolism of the drug by the liver
Correct answer: less availability to produce desired medicinal effects
Rationale: Medication bound to protein leads to less availability to produce desired medicinal effects because only unbound drugs can interact with active receptor sites. If a drug is bound to protein, it cannot bind with a receptor site, reducing its effectiveness. Choice A is incorrect because binding to protein reduces drug availability. Choice B is incorrect because distribution to receptor sites is ineffective if the drug is bound to protein. Choice D is incorrect because metabolism does not occur until the drug is removed from the protein molecule by the liver, allowing the protein to return to circulation.
3. A client is having an abortion in a women’s clinic, and the nurse caring for the client does not think the reasoning is appropriate. The nurse asks, “Are you sure you want to do this? It can’t be undone. Have you read about your other options? Adoption is always a good choice.” The client states she understands all options and is comfortable with her choice. The nurse nods and leaves the room to discuss the procedure with the physician. Which client right did the nurse violate with her actions?
- A. the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion
- B. the client’s right to be left alone without unsolicited attention, as the nurse inserted herself in the client’s healthcare scenario and offered uninvited advice
- C. the client’s right to confidentiality, as the nurse is talking to the physician about the client and the abortion
- D. the client’s right to respectful care, as the nurse clearly made it known that she did not approve of the abortion
Correct answer: the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion
Rationale: A client has the right to make decisions about their healthcare without interference from healthcare team members. In this scenario, the nurse violated the client's right to make personal health decisions without interference by trying to influence the client's decision-making and healthcare choice in the direction of not having an abortion. It is essential for healthcare providers to respect patients' autonomy and decisions, regardless of personal beliefs. Choices B, C, and D are incorrect because the primary violation in this situation is related to the client's right to make their own healthcare decisions without interference.
4. A nurse is assisting with data collection regarding skin and peripheral vascular findings on a client in later adulthood. Which observation would the nurse expect to note as an age-related finding?
- A. Thin, ridged toenails
- B. Thick skin on the lower legs
- C. Loss of hair on the lower legs
- D. Bounding dorsalis pedis pulse
Correct answer: Loss of hair on the lower legs
Rationale: In later adulthood, age-related findings include trophic changes associated with arterial insufficiency, such as thin, shiny skin; thin, ridged toenails; and loss of hair on the lower legs. These changes occur normally with aging. Thick skin on the lower legs would not be an expected age-related finding as it typically indicates chronic venous insufficiency. A bounding dorsalis pedis pulse is not typical in later adulthood and may indicate arterial insufficiency, which is not an age-related finding.
5. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?
- A. a radiologist
- B. a gynecologist
- C. a physiatrist
- D. an oncologist
Correct answer: a gynecologist
Rationale: A 65-year-old female experiencing postmenopausal bleeding should be encouraged to see a gynecologist. Gynecologists specialize in treating and managing diseases of the female reproductive organs, making them the most appropriate physician for this issue. Postmenopausal bleeding can indicate various gynecological conditions such as endometrial atrophy, endometrial hyperplasia, or endometrial cancer, highlighting the importance of consulting a gynecologist for proper diagnosis and management. Radiologists evaluate X-rays, physiatrists manage rehabilitation teams, and oncologists treat clients with cancer. Therefore, in this case, the symptoms point towards a gynecological problem, emphasizing the necessity of seeking care from a gynecologist.
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