NCLEX NCLEX-PN
2024 PN NCLEX Questions
1. People who live in poverty are most likely to obtain health care from:
- A. their primary care physician (family doctor)
- B. a neighborhood clinic
- C. specialists
- D. Emergency Departments or urgent care centers
Correct answer: D
Rationale: Individuals living in poverty often face barriers to accessing regular healthcare services, leading them to utilize Emergency Departments or urgent care centers as their primary source of healthcare. These facilities provide immediate care without the need for appointments or insurance, making them more accessible to those in poverty. While primary care physicians and neighborhood clinics are essential for preventive care, individuals in poverty may have difficulty accessing these services due to financial constraints or lack of insurance. Specialists typically require referrals and may not be easily accessible to individuals without stable healthcare coverage. Therefore, Emergency Departments or urgent care centers are the most likely healthcare option for people living in poverty.
2. A nurse notes that an elderly client suddenly does not keep appointments and is not wearing appropriate clothing. Which statement by the client raises the suspicion of financial abuse?
- A. “I am having difficulty paying for this new antibiotic the physician prescribed.”
- B. “I am a little short on cash since my daughter moved in to help me.”
- C. “I have not felt like shopping since the weather has gotten worse.”
- D. “People do not realize how difficult it is to make ends meet on a fixed income.”
Correct answer: “I am a little short on cash since my daughter moved in to help me.”
Rationale: The correct answer is B: “I am a little short on cash since my daughter moved in to help me.” This statement raises suspicion of financial abuse as it suggests a recent change in financial circumstances after the daughter moved in. Financial abuse in elderly clients can be indicated by sudden unexplained financial deficits or changes, such as difficulty paying for necessities despite previously being able to do so. Choices A, C, and D do not directly imply a recent financial change due to external factors, making them less indicative of potential financial abuse. Option B is the most concerning statement that warrants further investigation into possible financial exploitation.
3. With a breech presentation, the nurse must be particularly alert for which of the following?
- A. quickening
- B. ophthalmia neonatorum
- C. pica
- D. prolapsed umbilical cord
Correct answer: prolapsed umbilical cord
Rationale: With a breech presentation, the nurse must be particularly alert for a prolapsed umbilical cord. Prolapsed umbilical cord is a critical emergency situation where the umbilical cord descends into the vagina before the fetal presenting part, leading to compression between the presenting part and the maternal pelvis. This compression can compromise or completely cut off fetoplacental perfusion, endangering the fetus. Immediate delivery should be attempted to save the fetus. Quickening refers to fetal movements felt by the mother, ophthalmia neonatorum is an eye infection in newborns, and pica is a condition characterized by cravings for non-nutritive substances, none of which are directly related to the risks associated with a breech presentation and prolapsed umbilical cord.
4. A person who had a left CVA and right lower extremity hemiparesis is being instructed by a nurse to use a quad cane. Which of the following is the most appropriate gait sequence?
- A. Place the cane in the patient’s left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
- B. Place the cane in the patient’s left upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.
- C. Place the cane in the patient’s right upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
- D. Place the cane in the patient’s right upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.
Correct answer: Place the cane in the patient’s left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
Rationale: The correct gait sequence for a person with left CVA and right lower extremity hemiparesis using a quad cane is to place the cane in the patient’s strong upper extremity, which is the left upper extremity in this case. The correct sequence should be right lower extremity followed by left upper extremity, as this pattern mimics a normal gait pattern. Therefore, Choice A is the correct answer. Choices B, C, and D are incorrect because they do not follow the proper gait sequence for this specific patient's condition. The cane should be placed in the strong upper extremity, and the affected lower extremity should move first to provide stability and support, which is essential in this situation.
5. Which of the following situations requires nurse intervention?
- A. A certified nursing assistant states, 'The patient in 307 is not wearing gloves while shaving her legs.'
- B. A nursing assistant at the nursing station states, 'The patient in 307 has a respiratory rate of 16.'
- C. A nursing student in the cafeteria states, 'Dr. Jones told the patient in room 307 that she was going to die.'
- D. A certified nursing assistant states, 'Dr. Jones hasn’t made rounds this morning.'
Correct answer: A nursing student in the cafeteria states, 'Dr. Jones told the patient in room 307 that she was going to die.'
Rationale: The correct answer is C. Patient confidentiality must be maintained at all times to respect the patient's privacy and dignity. Disclosing sensitive information like a patient's prognosis in a public setting violates confidentiality and can cause distress. The nurse should intervene in this situation and educate the nursing student about the importance of not discussing confidential patient information in public. Choices A, B, and D do not involve breaching patient confidentiality and do not require immediate nurse intervention. Choice A focuses on infection control measures, choice B relates to clinical assessment, and choice D is about the doctor's rounds, which are not urgent matters requiring immediate intervention.
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