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Saunders NCLEX RN Practice Questions
1. The nurse is performing discharge teaching for Mrs. S after cardiac angioplasty. Her husband is present for the teaching. While explaining the prescription for antiplatelet medication to use at home, Mrs. S's husband states, 'I don't think I can afford to refill that medication.' What is the most appropriate response of the nurse?
- A. Don't worry, your insurance will cover it.
- B. I'll ask the physician if he can prescribe a medication that is more affordable.
- C. You should apply for Medicare to see if they can help you.
- D. This medication is essential for her care and should be given priority over all others that she is taking.
Correct answer: I'll ask the physician if he can prescribe a medication that is more affordable.
Rationale: The most appropriate response for the nurse in this situation is to offer assistance in exploring more affordable medication options. It is important to address the patient's concerns about medication costs to ensure adherence to the treatment plan. By suggesting to ask the physician if a more affordable alternative is available, the nurse shows understanding and a commitment to helping the patient access necessary medications. Choice A is incorrect because assuming insurance coverage without verifying can lead to false expectations. Choice C is incorrect as Medicare eligibility and assistance may not be applicable in this scenario. Choice D is incorrect as it does not address the financial concern raised by the husband and emphasizes the importance of the medication without offering a practical solution to affordability.
2. Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted for a bowel obstruction. She recently stated that she has decided that she doesn't want any further aggressive care and is requesting to be placed under hospice care. Her husband and daughter are supportive of her decision. She spoke with her oncologist about it, and he stated that he did not agree and wrote orders on her chart for chemotherapy. What would be the best first response to this situation?
- A. Give the patient a list of other oncologists
- B. Tell the family to report the doctor to the state quality board
- C. Notify the doctor that the patient refuses the chemotherapy
- D. Give the patient hospice information
Correct answer: C: Notify the doctor that the patient refuses the chemotherapy
Rationale: The patient has the right to refuse any treatment, and the doctor should be notified that the orders on the chart cannot be performed, with appropriate documentation. In this situation, the best first response is to notify the doctor that the patient refuses the chemotherapy. This step ensures that the patient's wishes are respected and that inappropriate treatments are not administered. It also opens up a dialogue with the oncologist, giving him the opportunity to understand the patient's perspective and potentially support her decision. Providing hospice information is a good follow-up step after addressing the immediate issue of refusing chemotherapy, as it allows the patient to initiate her own hospice evaluation if desired. Giving the patient a list of other oncologists or telling the family to report the doctor to the state quality board are not appropriate initial responses and may not align with the patient's wishes or autonomy.
3. You see a patient lying on the floor of the bathroom. You are NOT assigned to this patient. What is the first thing that you should do?
- A. Get the nurse who is caring for the patient.
- B. Tell the nurse that the patient has had another seizure.
- C. Observe the patient for any injuries and call out for help.
- D. Nothing. This patient is not one of your assignments.
Correct answer: Observe the patient for any injuries and call out for help.
Rationale: The correct course of action in this situation is to observe the patient for any injuries and call out for help. It is crucial to act immediately in an emergency, regardless of whether the patient is under your care. Checking for injuries and seeking assistance can help ensure the patient receives prompt and appropriate care. Choosing to inform the nurse of a seizure without evidence or taking no action because the patient is not your assignment are not optimal responses. In a healthcare setting, patient safety and well-being should always be the top priority.
4. After receiving written and verbal instructions from a clinic nurse about a newly prescribed medication, a client asks the nurse what to do if questions arise about the medication after getting home. How should the nurse respond?
- A. Provide the client with a list of reliable internet sites that offer information on medications.
- B. Advise the client to obtain a current edition of a drug reference book from a local bookstore or library.
- C. Reassure the client that information about the medication is included in the written instructions.
- D. Encourage the client to call the clinic nurse or healthcare provider if any questions arise.
Correct answer: Encourage the client to call the clinic nurse or healthcare provider if any questions arise.
Rationale: To ensure safe medication use, the nurse should encourage the client to call the clinic nurse or healthcare provider if any questions arise. This direct communication allows for personalized assistance and clarification tailored to the client's specific concerns. Providing Internet sites (Choice A) may lead to unreliable information, and a drug reference book (Choice B) may not address individualized questions. While the written instructions may contain information (Choice C), they may not cover all potential queries the client might have, making direct contact with the healthcare provider the most appropriate option.
5. The client is 5 feet from the bathroom door when he states, 'I feel faint.' Before the nurse can get the client to a chair, the client starts to fall. What is the priority action for the nurse to take?
- A. Check the client's carotid pulse
- B. Encourage the client to get to the toilet
- C. In a loud voice, call for help
- D. Gently lower the client to the floor
Correct answer: Gently lower the client to the floor
Rationale: The priority action for the nurse is to gently lower the client to the floor (Option D). This action is crucial to prevent injury to both the client and the nurse. Lowering the client to the floor should be done when the client is unable to support his own weight, ensuring a safe position to prevent falls. Checking the client's carotid pulse (Option A) is important, but it should be performed after ensuring the client's safety. Encouraging the client to get to the toilet (Option B) is impractical as the client is already falling. Calling for help in a loud voice (Option C) may cause chaos and alarm other clients, making it a less suitable immediate action in this scenario.
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