NCLEX-RN
NCLEX RN Exam Prep
1. In which of the following ways can a healthcare provider promote the sense of taste for an older adult?
- A. Mixing foods together on the dinner tray
- B. Avoiding cologne, air fresheners, or room deodorizers
- C. Encouraging the client to chew food thoroughly
- D. Discouraging the use of salt or seasonings with prepared food
Correct answer: C
Rationale: As individuals age, their sense of taste may diminish, impacting the enjoyment of eating. One effective way for a healthcare provider to promote the sense of taste for an older adult is by encouraging them to chew food thoroughly. Thorough chewing increases the contact of food with the taste buds, enhancing the chances of experiencing the flavors. Mixing foods together on the dinner tray may not necessarily enhance taste perception. Avoiding strong scents like cologne, air fresheners, or room deodorizers is more related to olfactory senses rather than taste. Discouraging the use of salt or seasonings can further diminish the taste experience for older adults who may already have reduced taste sensitivity.
2. The supervising RN asks you to bring the unit's collected lab specimens to the lab 'stat'. You should ______________.
- A. not decline this task because nurses do not handle 'stats'.
- B. run this errand as promptly as possible
- C. run this errand immediately and without delay
- D. Complete this task before the end of your shift or after your lunch.
Correct answer: C
Rationale: In healthcare settings, 'stat' is commonly used to indicate that something should be done immediately and without any delay. It is a critical term used to prioritize urgent tasks. Nurses are responsible for various tasks, including handling urgent requests such as transporting lab specimens promptly. Option A is incorrect as nurses can handle urgent tasks like 'stats'. Option B is not as specific as option C, which clearly emphasizes the need for immediate action. Option D is incorrect as it suggests delaying the task until later, which goes against the urgency implied by the term 'stat'.
3. The nurse informs the physical therapy department that the client is too weak to use a walker and needs to be transported by wheelchair. Which step of the nursing process is the nurse engaged in at this time?
- A. Assessment
- B. Planning
- C. Implementation
- D. Evaluation
Correct answer: C
Rationale: The nurse is responsible for coordinating the plan of care with other disciplines to ensure the client's safety. This action represents the implementation phase of the nursing process. During the implementation phase, the nurse puts the care plan into action, which includes coordinating with other healthcare team members like the physical therapy department. Assessment involves data gathering, planning involves goal setting, and evaluation involves determining the attainment of client goals.
4. Which of the following may represent an upper airway obstruction?
- A. Retractions
- B. Elongated expiratory phase
- C. Stridor
- D. Expiratory wheezing
Correct answer: C
Rationale: Stridor is the sound produced by turbulent airflow through a partially obstructed upper airway. It is a classic sign of upper airway obstruction. While an elongated expiratory phase may indicate lower airway obstruction, stridor specifically points to an upper airway issue. Retractions are also often seen in upper airway obstruction due to the increased effort of breathing. Expiratory wheezing, on the other hand, is more indicative of lower airway conditions such as asthma or chronic obstructive pulmonary disease (COPD).
5. The client is a chronic carrier of infection. To prevent the spread of the infection to other clients or healthcare providers, the nurse emphasizes interventions that do which of the following? (Berman & Snyder, 2012, p. 713)
- A. Eliminate the reservoir
- B. Block the portal of exit from the reservoir
- C. Block the portal of entry into the host
- D. Decrease the susceptibility of the host
Correct answer: B
Rationale: To prevent the spread of infection from a chronic carrier, the nurse should focus on blocking the portal of exit from the reservoir, which is the carrier person. By preventing the movement of the organism from the reservoir, the infection can be contained. Eliminating the reservoir is not feasible in this case as the carrier is a chronic carrier. Blocking the portal of entry into the host or decreasing the susceptibility of the host would only impact individual prevention and not the spread from the carrier to others.
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