NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. How do technological advances relate to HIPAA?
- A. Technology can expose us to HIPAA violations.
- B. Computers facilitate information sharing.
- C. Computer screens should be visible only to authorized personnel.
- D. Technology enhances HIPAA confidentiality.
Correct answer: A
Rationale: Technology can expose us to HIPAA violations. For instance, leaving a computer screen unattended and visible to unauthorized individuals can result in breaches of patient confidentiality, leading to HIPAA violations. While computers can indeed aid in sharing information, this is not directly related to HIPAA compliance. Ensuring that computer screens are only visible to authorized personnel is a good practice, but it does not address the broader risks and challenges posed by technological advancements in maintaining HIPAA compliance. Therefore, the correct answer is that technology can expose us to HIPAA violations.
2. Select the age group that is coupled with an infectious disease that is most common in this age group.
- A. Infants: High bilirubin
- B. Pre-School and School Age Children: Shingles
- C. Young Adults and Teenagers: Sexually transmitted diseases
- D. The Elderly: Malaria
Correct answer: C
Rationale: Young adults and teenagers are at the highest risk for sexually transmitted diseases due to their sexual activity. High bilirubin is a laboratory finding related to jaundice and not an infectious disease. Shingles is more common in the elderly population, not in pre-school and school-age children. Malaria is not most common in the elderly; it is prevalent in regions with specific mosquito vectors. Therefore, the correct answer is that young adults and teenagers are most commonly associated with sexually transmitted diseases.
3. While caring for a client in labor, a nurse attaches an electronic fetal monitor to the client's abdomen to assess the baby's heart rate. The nurse observes that the baby's heart rate slows down during each contraction and does not return to normal limits until after the contraction is complete. What 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 are characterized by the baby's heart rate declining in utero during contractions. The heart rate drops below baseline and stays low until after the contraction ends. Late decelerations are concerning as they indicate uteroplacental insufficiency, which can compromise fetal oxygenation. This pattern is a non-reassuring sign and requires immediate intervention. Variable decelerations are typically abrupt decreases in heart rate, often associated with cord compression. Early decelerations, on the other hand, mirror the contractions and are considered benign, resulting from fetal head compression. Accelerations are reassuring signs of fetal well-being, indicating a responsive and healthy fetal nervous system.
4. A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks gestation. How would the nurse accurately document this information?
- A. G4 T1 P0 A1 L2
- B. G3 T1 P0 A1 L2
- C. G3 T0 P1 A1 L2
- D. G4 T0 P1 A1 L2
Correct answer: D
Rationale: The correct answer is G4 T1 P0 A1 L2. This documentation accurately represents the woman's obstetric history. G4: She is currently pregnant (1), has twins (1), and had a miscarriage (1), totaling four pregnancies. T1: She has had one pregnancy that resulted in the birth of her twins at term. P0: She has not had any preterm births. A1: She had one miscarriage at 12 weeks gestation. L2: She has two living children (the twins). Therefore, the correct documentation reflects all aspects of her obstetric history as provided.
5. A nurse is performing an end-of-shift count of narcotics kept in the locked cabinet. The narcotic log states there should be 26 oxycodone pills left, but there are only 24 in the drawer. What is the first action of the nurse?
- A. Perform the count again
- B. Contact the pharmacy to determine if the narcotic log is incorrect
- C. Check with the last nurse to sign out narcotics from the system
- D. Notify the house supervisor that narcotic medications are missing
Correct answer: A
Rationale: The first action the nurse should take in this situation is to perform the count again. This step is crucial to ensure there was no miscount during the initial check. By verifying the count, the nurse can confirm if there is indeed a discrepancy in the number of oxycodone pills. Contacting the pharmacy, checking with the last nurse, or notifying the house supervisor should only be considered after ensuring the count is accurate. It's important to rule out any human error before escalating the issue to others.
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