NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. What is the purpose of performing quality control?
- A. Create a paper trail to show that the laboratory is compliant with OSHA standards for quality control.
- B. Improve the odds that the results reported for any given test are as accurate and reliable as possible.
- C. Be required by law to be part of a quality assurance program.
- D. All of the above
Correct answer: B
Rationale: The primary purpose of performing quality control is to enhance the accuracy and reliability of test results. Quality controls are crucial for ensuring the reliability of each analyte tested. While quality control is not mandated by specific laws, accrediting bodies often require it to maintain accreditation. Creating a paper trail and legal requirements are not the primary objectives of quality control, making choices A and C incorrect. Therefore, the correct answer is to improve the accuracy and reliability of reported test results.
2. A client in labor has an electronic fetal monitor attached to the abdomen, and the nurse notes that the baby's heart rate slows down during each contraction, returning to normal limits only after the contraction is complete. Which type of fetal heart rate change does this pattern describe?
- A. Variable decelerations
- B. Late decelerations
- C. Early decelerations
- D. Accelerations
Correct answer: B
Rationale: Late decelerations refer to a pattern where the baby's heart rate decreases during contractions and does not return to normal until after the contraction ends. This is considered a non-reassuring sign as it indicates potential fetal distress. Late decelerations are associated with uteroplacental insufficiency, and immediate medical attention is required. Variable decelerations (Choice A) are abrupt, unpredictable decreases in the fetal heart rate, usually associated with cord compression. Early decelerations (Choice C) are usually benign and mirror the contraction pattern. Accelerations (Choice D) are reassuring signs of fetal well-being, characterized by an increase in the fetal heart rate.
3. Because of budget cuts in the hospital, the nursing manager informs the staff that they must either rotate to other units more often or take their turns staying home from work. Which principle is this nurse manager demonstrating?
- A. Justice
- B. Paternalism
- C. Veracity
- D. Fraternity
Correct answer: D
Rationale: Veracity involves truth-telling, even in challenging situations. In this scenario, the nurse manager is being transparent about the need for staff to rotate units or take turns staying home due to budget cuts. This allows the staff to make informed decisions about their work schedules and potential impact on their pay and work areas. Option A, Justice, does not apply as the focus is on communication and transparency, not fairness. Option B, Paternalism, does not fit as it involves decisions made for others' well-being without their input, which is not the case here. Option D, Fraternity, pertains to unity among individuals, which is not the principle demonstrated by the nurse manager in this situation.
4. A client asks a nurse, 'Do you think I should move back home after this procedure?' and the nurse responds by saying, 'Do you think you should move back home?' What type of therapeutic communication is the nurse representing?
- A. Observation
- B. Reflection
- C. Summarizing
- D. Validating
Correct answer: B
Rationale: The nurse is demonstrating the therapeutic communication technique of reflection. In this scenario, the nurse is redirecting the question back to the client, encouraging them to explore their thoughts and feelings about the situation. Reflection involves restating a statement or question in a way that prompts the client to consider their own answers, fostering self-awareness and insight. Observation involves stating facts, summarizing involves condensing information, and validating involves confirming the client's feelings or experiences, none of which are demonstrated in this interaction.
5. Which of the following is an example of whistle-blowing?
- A. A nurse contacts administration about a colleague who takes supplies to use for a mission trip
- B. A client sues a nurse because she failed to call the physician about his wound infection
- C. A nursing assistant calls for help when a client falls out of bed
- D. A client developed a sacral pressure ulcer when he was not turned in bed for over four hours
Correct answer: A
Rationale: Whistle-blowing involves notifying administration or a supervisor about unethical or illegal activities. In this scenario, the nurse reporting a colleague taking supplies for personal use is an example of whistle-blowing as it involves reporting behavior that is dishonest and potentially harmful. Choices B, C, and D do not represent whistle-blowing. Choice B involves a legal action by a client against a nurse, choice C is a situation where immediate care is provided, and choice D is a case of neglect that should have been prevented.
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