NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The chain of infection includes the ________________.
- A. germ, agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host
- B. active natural, active artificial, passive natural, and passive artificial
- C. opportunism, weakness, immunity, and colonization
- D. intrinsic, extrinsic, internal, and external transmission
Correct answer: A
Rationale: The chain, or cycle, of infection includes the germ (microorganism), agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host. This sequence describes how infections are passed from one person to another. Choice B is incorrect because it refers to types of immunity, not components of the chain of infection. Choice C is also incorrect as it lists terms unrelated to the chain of infection. Choice D is incorrect as it describes transmission types, not components of the chain of infection. Understanding the chain of infection is crucial in preventing the spread of infections by breaking one or more links in the chain, such as interrupting the mode of transmission through proper hand hygiene.
2. The nurse teaches a patient about the transmission of pulmonary tuberculosis (TB). Which statement, if made by the patient, indicates that teaching was effective?
- A. I will avoid being outdoors whenever possible.
- B. My husband will be sleeping in the guest bedroom.
- C. I will take the bus instead of driving to visit my friends.
- D. I will keep the windows closed at home to contain the germs.
Correct answer: B
Rationale: To prevent the transmission of pulmonary tuberculosis, it is important for the infected individual to minimize exposure to close contacts and household members. Sleeping alone in a separate room, like the guest bedroom, is an effective measure. The other choices are not ideal: Choice A is incorrect because spending time outdoors is encouraged for ventilation; Choice C is incorrect as using public transportation increases the risk of transmission; Choice D is incorrect because keeping windows closed limits ventilation, which is necessary to reduce the concentration of infectious particles in the air.
3. Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the staff nurse?
- A. Standard four-drug therapy for TB
- B. Need for annual repeat TB skin testing
- C. Use and side effects of isoniazid (INH)
- D. Bacille Calmette-Gurin (BCG) vaccine
Correct answer: C
Rationale: The nurse is considered to have a latent TB infection and should be treated with INH daily for 6 to 9 months. The four-drug therapy would be appropriate if the nurse had active TB. TB skin testing is not done for individuals who have already had a positive skin test. BCG vaccine is not used in the United States for TB and would not be helpful for this individual, who already has a TB infection.
4. A client needs to give informed consent for electroconvulsive therapy treatments. Which of the following actions should the nurse take?
- A. Explain the adverse effects the client might experience from the treatment
- B. Verify the client gave consent voluntarily for the treatment
- C. Describe the benefits of the treatment to the client
- D. Outline possible alternatives to the treatment for the client
Correct answer: B
Rationale: When obtaining informed consent for a procedure like electroconvulsive therapy, the nurse's primary responsibility is to ensure that the client has given consent voluntarily and is capable of making such a decision. While it is essential to provide information on the treatment's benefits, risks, and alternatives, the priority is to verify the client's voluntary consent. Explaining the adverse effects and describing the benefits are important steps in the informed consent process, but the critical step is to confirm the client's voluntary agreement. Outlining possible alternatives to the treatment is also important but comes after ensuring the client's voluntary consent.
5. A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?
- A. Call security to hold the client until he signs the order
- B. Notify the physician to convince the client to stay
- C. Speak with the client's spouse to persuade him to stay
- D. Allow the client to leave and document the refusal in his chart
Correct answer: D
Rationale: The nurse cannot force the client to stay in the hospital to receive treatment or to sign an AMA order. It is essential to respect the client's autonomy and decision-making capacity. While involving security or pressuring the client through the physician or spouse may seem like options, they are not appropriate in this situation. The nurse should allow the client to leave if they are competent to make that decision, document the refusal in the client's chart to ensure all actions are appropriately documented, and follow institutional policies for patients leaving against medical advice.
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