NCLEX NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The nurse is writing out discharge instructions for the parents of a child diagnosed with celiac disease. The nurse should focus primarily on which aspect of care?
- A. Restricting activity
- B. Following a gluten-free diet
- C. Following a lactose-free diet
- D. Giving medication to manage the condition
Correct answer: Following a gluten-free diet
Rationale: The primary nursing consideration in the care of a child with celiac disease is to instruct the child and parents about proper dietary management. The cornerstone of managing celiac disease is maintaining a strict gluten-free diet to prevent symptoms and long-term complications. While medications may be part of the treatment plan, dietary adjustments, particularly following a gluten-free diet, are crucial for managing the condition effectively. Restricting activity is not the primary focus of care for celiac disease. A lactose-free diet is not typically necessary unless the child also has lactose intolerance, which is distinct from celiac disease.
2. Who is legally able to make decisions for the patient or resident during a patient care conference when the patient is not mentally able to make decisions on their own?
- A. The patient or their healthcare proxy
- B. Only the patient
- C. Only the healthcare proxy
- D. The doctor
Correct answer: Only the healthcare proxy
Rationale: When a patient is unable to make decisions due to mental incapacity, the healthcare proxy, designated by the patient in advance, has the legal authority to make decisions on the patient's behalf. In this situation, the patient lacks the capacity to make decisions independently. The healthcare proxy's role is to represent the patient's wishes and best interests. The doctor's role in a patient care conference is to provide medical expertise, offer recommendations, and assist in the decision-making process, but the final decision-making authority lies with the healthcare proxy, not the doctor.
3. After informing an older client that an IV line needs to be inserted, the client becomes very apprehensive, loudly verbalizing a dislike for all healthcare providers and nurses. How should the nurse respond?
- A. Ask the client to remain quiet so the procedure can be performed safely.
- B. Concentrate on completing the insertion as efficiently as possible.
- C. Calmly reassure the client that the discomfort will be temporary.
- D. Tell the client a joke as a means of distraction from the procedure.
Correct answer: Calmly reassure the client that the discomfort will be temporary.
Rationale: The nurse should respond with a calm demeanor to help reduce the client's apprehension. By calmly reassuring the client that the discomfort from the procedure will be temporary, the nurse acknowledges the client's feelings and provides comfort. This response shows empathy and understanding, which can help build trust. Asking the client to remain quiet may escalate the situation and not address the client's underlying concerns. Concentrating solely on completing the insertion efficiently may overlook the client's emotional needs and may increase their anxiety. Telling a joke may not be appropriate in this serious situation and could be perceived as insensitive, failing to address the client's emotional distress effectively.
4. A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank for 20 minutes. Which of the following is the most important instruction the nurse can give the parent?
- A. This too shall pass.
- B. Take the child immediately to the ER
- C. Contact the Poison Control Center quickly
- D. Give the child syrup of ipecac
Correct answer: Contact the Poison Control Center quickly
Rationale: In situations where a child has ingested a potentially harmful substance, contacting the Poison Control Center quickly is crucial. The Poison Control Center can provide specific guidance tailored to the child's situation, which can include whether immediate medical attention is necessary or if any actions need to be taken at home. Option A, 'This too shall pass,' is not appropriate as it dismisses the seriousness of the situation. Option B, 'Take the child immediately to the ER,' may not always be the best course of action without guidance from experts. Option D, 'Give the child syrup of ipecac,' is outdated advice and not recommended as a first response to poisoning incidents.
5. Which of the following is an example of a living will?
- A. A client's son has been appointed to make his healthcare decisions if he becomes incapacitated
- B. A client has designated which of his children will receive his home and property before he dies
- C. A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
- D. A client designates what type of burial or cremation services he would want after his death
Correct answer: A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
Rationale: A living will is a type of advanced directive that a client develops to stipulate his preferences for healthcare in the event that he is unable to do so. This includes specific instructions about medical treatments in certain situations. Choice C is the correct answer as it reflects a scenario where the client has clearly outlined their preference regarding resuscitation through chest compressions. Choices A, B, and D do not pertain to a living will. Choice A involves a healthcare proxy or agent, choice B involves a will or estate planning, and choice D involves funeral or burial arrangements, which are not part of a living will.
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