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. A nurse with five years of experience working in a hospital unit is promoted as a mentor and preceptor to a new nursing staff. This is an example of:
- A. Collegiality
- B. Competence
- C. Advocacy
- D. Integration
Correct answer: A
Rationale: Collegiality is the action of forming relationships and supporting others through work experiences. In this scenario, the nurse being promoted as a mentor and preceptor exemplifies collegiality by fostering an encouraging educational relationship with the new nursing staff. The nurse demonstrates appropriate nursing care, teaches skills, and supports the professional growth of others. Choice B, 'Competence,' refers to having the necessary skills and knowledge, but in this context, the focus is on the supportive and educational role of the nurse. Choice C, 'Advocacy,' involves speaking up for patients' rights and needs, which is not directly demonstrated in the scenario. Choice D, 'Integration,' does not directly relate to the situation described, where the emphasis is on mentoring and guiding new staff.
3. A healthcare professional is preparing to insert an indwelling catheter in a female client. Which of the following positions of the client is most appropriate for this procedure?
- A. Lithotomy position
- B. Prone position
- C. Dorsal recumbent position
- D. High Fowler's position
Correct answer: C
Rationale: When preparing to insert an indwelling catheter for a female client, the most appropriate position is the dorsal recumbent position. In this position, the client lies on their back with knees bent. This position allows for easy access to the urethral area for catheter insertion. The lithotomy position, with legs elevated and spread apart, is more invasive and typically used for gynecological exams. The prone position, lying face down, is not suitable for catheter insertion. High Fowler's position, sitting upright at a 90-degree angle, is not ideal for catheter insertion as it does not provide proper access to the perineal area.
4. The chain of infection includes the ________________.
- A. germ, agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host
- B. active natural, active artificial, passive natural, and passive artificial
- C. opportunism, weakness, immunity, and colonization
- D. intrinsic, extrinsic, internal, and external transmission
Correct answer: A
Rationale: The chain, or cycle, of infection includes the germ (microorganism), agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host. This sequence describes how infections are passed from one person to another. Choice B is incorrect because it refers to types of immunity, not components of the chain of infection. Choice C is also incorrect as it lists terms unrelated to the chain of infection. Choice D is incorrect as it describes transmission types, not components of the chain of infection. Understanding the chain of infection is crucial in preventing the spread of infections by breaking one or more links in the chain, such as interrupting the mode of transmission through proper hand hygiene.
5. Richard is a 72-year-old with stage 4 lung cancer who has been admitted to the hospital for pneumonia. He is alert and oriented and states he would like to sign a do not resuscitate (DNR) order. His wife enters the room after he has signed it and is very upset that he has made this decision without discussing it with her. She wants to know what she can do to get the DNR reversed. What should your first response be?
- A. Contact the unit manager to talk with her
- B. Contact the hospital's attorney to discuss with her
- C. Try to talk Richard out of his decision
- D. Offer caring support for both parties
Correct answer: D
Rationale: The correct response in this situation is to offer caring support for both parties. Richard, being alert and oriented, has the right to make his own decisions, including signing a do not resuscitate (DNR) order. It is important to respect his autonomy while also acknowledging his wife's feelings. By offering caring support, the nurse can facilitate a discussion between Richard and his wife, helping them navigate their emotions and decisions. Contacting the unit manager or hospital's attorney would not be appropriate as the initial response. These actions may escalate the situation and are not focused on addressing the emotional needs of the couple. Trying to talk Richard out of his decision would disregard his autonomy and right to make choices about his own care, which goes against ethical principles of patient autonomy and informed decision-making.
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