NCLEX NCLEX-PN
2024 Nclex Questions
1. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- A. conversion.
- B. regression
- C. introjection.
- D. rationalization
Correct answer: regression
Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.
2. A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate’s action can result in what type of charge?
- A. Fraud
- B. Tort
- C. Malpractice
- D. Negligence
Correct answer: Fraud
Rationale: The correct answer is 'Fraud.' Identifying oneself as a nurse without a license defrauds the public and can lead to prosecution. A tort is a wrongful act in breach of a legal duty imposed by law; malpractice is the failure to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care. In this scenario, the key issue is the misrepresentation of licensure status, which constitutes fraud. Therefore, choices B, C, and D are incorrect.
3. The LPN is teaching a first-time mother about breastfeeding her newborn. Which statement, if made by the mother, would reflect that the teaching had been successful?
- A. “My baby should be having at least 4-6 wet diapers a day until 1 month.”
- B. “It’s nice that breastfed babies eat a bit less than formula-fed babies.”
- C. “My baby should be nursing 8-12 times a day during this period.”
- D. “I’m a little nervous about my milk coming in tomorrow. I’ve heard it’s uncomfortable.”
Correct answer: “My baby should be nursing 8-12 times a day during this period.”
Rationale: The correct answer is, '“My baby should be nursing 8-12 times a day during this period.”' This statement indicates successful teaching because newborns should nurse 8-12 times during the newborn period to ensure they receive adequate nutrition and establish a good milk supply. This frequency helps in meeting the baby's demands for growth and development. Choice A is incorrect because while it mentions the appropriate number of wet diapers a day once the mother's milk comes in, it does not reflect successful teaching about breastfeeding frequency. Choice B is incorrect because it discusses feeding amounts in comparison to formula-fed babies, which is not a direct indicator of successful breastfeeding teaching. Choice D is incorrect because it focuses on the mother's concerns about milk coming in, not on understanding the feeding frequency needed for the newborn.
4. The healthcare provider sustains a needle puncture that requires HIV prophylaxis. Which of the following medication regimens should be used?
- A. an antibiotic such as Metronidazole and a protease inhibitor (Saquinavir)
- B. two non-nucleoside reverse transcriptase inhibitors
- C. one protease inhibitor such as Nelfinavir
- D. two protease inhibitors
Correct answer: two non-nucleoside reverse transcriptase inhibitors
Rationale: In the scenario of a needle puncture requiring HIV prophylaxis, the CDC recommends initiating treatment with two non-nucleoside reverse transcriptase inhibitors, unless there is drug resistance. This regimen is preferred over other options such as a single protease inhibitor or two protease inhibitors due to its effectiveness and safety profile in this specific context. Non-nucleoside reverse transcriptase inhibitors are commonly used in post-exposure prophylaxis due to their activity against HIV and lower risk of resistance development compared to other antiretroviral drug classes.
5. A new mother asks the nurse, 'I was told that my infant received my antibodies during pregnancy. Does that mean that my infant is protected against infections?' Which statement should the nurse make in response to the mother?
- A. The immune system of an infant is immature, and the infant is at risk for infection.
- B. The transfer of your antibodies protects your infant until the infant is 12 months old.
- C. Yes, your infant is protected from all infections.
- D. If you breastfeed, your infant is protected from infection.
Correct answer: The immune system of an infant is immature, and the infant is at risk for infection.
Rationale: The transplacental transfer of maternal antibodies supplements the infant’s weak response to infection until approximately 3 to 4 months of age. While the infant starts producing immunoglobulin (Ig) soon after birth, it only reaches about 60% of the adult IgG level, 75% of the adult IgM level, and 20% of the adult IgA level by 1 year of age. Breast milk provides additional IgA protection. Although the immune system matures during infancy, full protection against infections is not achieved until early childhood, putting the infant at risk for infections. Choice B is incorrect because maternal antibody protection typically lasts around 3 to 4 months, not until the infant is 12 months old. Choice C is incorrect as infants are not shielded from all infections due to their immature immune system. Choice D is incorrect because while breastfeeding offers extra protection, it does not guarantee complete immunity against infections.
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