NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. If a healthcare professional prevents intentional harm from occurring to a patient, which ethical principle is being supported?
- A. Beneficence
- B. Nonmaleficence
- C. Justice
- D. Fidelity
Correct answer: B
Rationale: The correct answer is Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the obligation to avoid causing harm intentionally. In this scenario, by preventing intentional harm to a patient, the healthcare professional is upholding the principle of nonmaleficence. Beneficence, although important, focuses on doing good and promoting well-being rather than solely preventing harm. Justice relates to fairness and equality in resource distribution, while fidelity involves being faithful and keeping promises, which are not directly applicable to the situation of preventing intentional harm to a patient.
2. Which of the following is the most appropriate example of anticipatory guidance for a 16-year-old who has been hospitalized for an ankle fracture?
- A. Changes associated with puberty
- B. Driving and staying safe
- C. The health hazards of smoking
- D. Social media influences
Correct answer: B
Rationale: Anticipatory guidance is an educational process that provides information important to a client's situation. When considering a 16-year-old who has been hospitalized for an ankle fracture, the most suitable anticipatory guidance would be regarding driving and staying safe. This guidance is crucial as it is age-appropriate and relevant to preventing future injuries. Choices A, C, and D are less pertinent in this scenario. Changes associated with puberty, health hazards of smoking, and social media influences may not directly address the immediate safety concerns of a 16-year-old with an ankle fracture.
3. What would a healthcare professional expect to observe while assessing the growth of children during their school-age years?
- A. Decreasing amounts of body fat and muscle mass
- B. Little change in body appearance from year to year
- C. Progressive height increase of 4 inches each year
- D. Yearly weight gain of about 5.5 pounds per year
Correct answer: D
Rationale: During school-age years, children typically gain about 5.5 pounds per year and increase in height by about 2 inches annually. This steady growth pattern is expected between ages 2 to 10 years. Choice A is incorrect as children at this stage are expected to gain weight and grow in height. Choice B is incorrect as there should be noticeable changes in body appearance due to growth. Choice C is incorrect as a progressive height increase of 4 inches each year is not typical during the school-age years.
4. During an adolescent examination, the nurse asks a 13-year-old female to bend forward at the waist with arms hanging freely. Which of the following assessments is the nurse most likely conducting?
- A. Spinal flexibility
- B. Leg length disparity
- C. Hypostatic blood pressure
- D. Scoliosis
Correct answer: D
Rationale: The correct answer is scoliosis. During the assessment for scoliosis, the nurse asks the adolescent to bend forward at the waist with arms hanging freely to observe for any lateral deviation of the spine, uneven rib levels, or asymmetry. This assessment is a routine part of an adolescent examination, especially in females, as scoliosis is more common in this population. Choices A, B, and C are incorrect. Spinal flexibility is usually assessed through different maneuvers, leg length disparity is evaluated by measuring the length of the legs, and hypostatic blood pressure refers to a decrease in blood pressure due to immobility.
5. The healthcare professional needs to validate which of the following statements pertaining to an assigned client?
- A. The client has a hard, raised, red lesion on his right hand.
- B. A weight of 185 lbs. is recorded in the chart.
- C. The client reported an infected toe.
- D. The client's blood pressure is 124/70.
Correct answer: C
Rationale: Validation is the process of confirming that data are actual and factual. Data that can be measured can be accepted as factual, as in options 1, 3, and 4. The weight, blood pressure, and physical appearance of a lesion can be objectively verified. However, option C, the client reporting an infected toe, requires the nurse to directly assess the client's toe to confirm the statement. This choice involves subjective data that needs to be validated through direct observation, making it the correct answer. Options A, B, and D provide data that can be measured objectively and verified without the need for further assessment.
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