NCLEX-RN
Safe and Effective Care Environment NCLEX RN Questions
1. What is the most effective step in hand washing?
- A. Using friction to remove potential pathogens.
- B. Using hospital-grade soap.
- C. Moisturizing the hands after washing to prevent cracking.
- D. Washing hands with soap for at least 15 seconds.
Correct answer: A
Rationale: The most effective step in hand washing is using friction to remove potential pathogens. While using soap, moisturizing hands, and washing for a sufficient duration are important aspects of hand hygiene, the mechanical action of rubbing hands together with friction is crucial in dislodging and removing dirt, debris, and potential pathogens. Hospital-grade soap may be beneficial, but the physical act of friction is key to effective hand washing. Moisturizing after washing is important for skin health but not the most effective step in the hand washing process. Simply washing hands for a specific duration, such as 15 seconds, without proper friction may not effectively remove contaminants. Therefore, using friction for thorough cleaning is the most crucial step in hand washing.
2. Which of these is a correctly stated outcome goal written by the nurse?
- A. The client will walk 2 miles daily by March 19
- B. The client will understand how to give insulin by discharge
- C. The client will regain their former state of health by April 1
- D. The client achieve desired mobility by May 7
Correct answer: A
Rationale: Outcome goals should be SMART, i.e., Specific, Measurable, Appropriate, Realistic, and Timely. Option A is the only outcome that has a specific behavior (walks daily), with measurable performance criteria (2 miles), and a time estimate for goal attainment (by March 19). Option B lacks specificity in terms of what 'understand how to give insulin' entails, and the timeline is vague ('by discharge'). Option C is not measurable or specific about what 'regain their former state of health' means. Option D does not provide a specific behavior or measurable criteria for 'desired mobility,' and the timeline is the only element that is time-bound.
3. The nurse is preparing to assess a patient’s abdomen by palpation. How should the nurse proceed?
- A. Avoid palpating reportedly “tender†areas as this may cause pain.
- B. Palpate tender areas quickly to minimize patient discomfort.
- C. Initiate the assessment with deep palpation while encouraging the patient to relax and take deep breaths.
- D. Begin the assessment with light palpation to detect surface characteristics and to acclimate the patient to touch.
Correct answer: D
Rationale: The correct approach is to begin the assessment with light palpation to detect surface characteristics and to acclimate the patient to touch. This allows the nurse to first assess surface features before proceeding to deeper palpation. Starting with light palpation also helps the patient become more comfortable with being touched, creating a smoother examination experience. Palpating tender areas quickly, as suggested in choice B, can increase patient discomfort. Deep palpation, as in choice C, is typically performed after light palpation to avoid discomfort and ensure proper assessment. Avoiding palpation of tender areas first, as in choice A, helps prevent causing unnecessary pain and should be done towards the end of the assessment.
4. To properly read a meniscus,
- A. hold the measuring device at eye level and read the bottom of the curve of the liquid level
- B. hold the measuring device at eye level and read the top of the curve of the liquid level where the liquid adheres to the walls of the container.
- C. hold the measuring device at table level and, looking down into the measuring device, read the bottom of the curve of the liquid level.
- D. hold the measuring device at table level and, looking down into the measuring device, read the top of the curve of the liquid level.
Correct answer: A
Rationale: To properly read a meniscus, it is essential to hold the measuring device at eye level to avoid parallax error. Reading the bottom of the curve of the liquid level is correct because the meniscus is the concave or convex curve at the liquid's surface. Choice B is incorrect because reading the top of the curve where the liquid adheres to the walls of the container can lead to inaccurate measurements. Choices C and D are incorrect as they suggest holding the device at table level, which can introduce parallax error and result in an incorrect reading.
5. Which of the following medical terms means 'surgical fixation of the stomach'?
- A. Abdominorrhaphy
- B. Gastroplasty
- C. Gastropexy
- D. Abdominorrhexis
Correct answer: C
Rationale: The correct answer is 'Gastropexy,' which means 'surgical fixation of the stomach.' This procedure involves surgically fixing the stomach in place. 'Abdominorrhaphy' refers to suturing or repairing the abdomen, not related to fixing the stomach. 'Gastroplasty' is a surgical reconstruction of the abdomen, not specifically related to fixing the stomach. 'Abdominorrhexis' refers to the rupture or tearing of the abdomen, not a surgical fixation procedure.
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