NCLEX-RN
NCLEX RN Predictor Exam
1. When caring for a single client during one shift, it is appropriate for the nurse to reuse only which of the following personal protective equipment?
- A. Goggles
- B. Gown
- C. Surgical mask
- D. Clean gloves
Correct answer: A
Rationale: Goggles may be reused unless they are overly contaminated by material that has splashed in the nurse's face and cannot be effectively rinsed off. Gowns are at high risk for contamination and should be used only once and then discarded or washed. Surgical masks and gloves should never be washed or reused. Goggles provide eye protection from splashes and should be cleaned and disinfected after each use to ensure proper protection.
2. You are taking care of 7 patients today. One of your residents wants water; another needs help walking to the bathroom; another just stated that they have chest pain; and another is crying because his daughter did not visit him today. Which patient care task is the lowest in terms of priority?
- A. The water
- B. Help to the bathroom
- C. The chest pain
- D. The crying person
Correct answer: D
Rationale: The lowest priority patient care task in this scenario is addressing the emotional need of the patient who is crying because his daughter did not visit him today. While emotional support is important, the other needs - providing water, assisting to the bathroom, and addressing chest pain - are physical needs that must take priority as they directly impact the patient's well-being and health. It is crucial to acknowledge and address emotional needs but in this situation, the physical needs of the patients should be addressed first.
3. During a client interview, which of the following leading questions should the nurse avoid asking?
- A. What medication do you take at home?
- B. You are really excited about the plastic surgery, aren't you?
- C. Were you aware I've had this same type of surgery?
- D. What would you like to talk about?
Correct answer: B
Rationale: The nurse should avoid asking leading questions during a client interview as they can influence the client's response. Option B is a leading question as it suggests an expected response from the client, potentially biasing the information provided. This can lead to inaccurate data collection and subsequent errors in diagnostic reasoning. Choices A, C, and D are open-ended questions that encourage the client to provide unbiased information and allow for a more comprehensive assessment.
4. A physician has ordered that a client must be placed in a high Fowler's position. How does the nurse position this client?
- A. The client is placed face-down
- B. The client lies on his back with his head lower than his feet
- C. The client lies on his back with the knees drawn up toward the chest
- D. The client is sitting with the backrest at a 90-degree angle
Correct answer: D
Rationale: A high Fowler's position is a modification of the semi-Fowler's position, in which the client is seated with arms resting at the sides or in the lap. The high Fowler's position requires that the client's head and upper chest are elevated, and the backrest is at a 90-degree angle. This position supports breathing and appropriate chest wall movement, making it easier for the client to breathe. Choices A, B, and C are incorrect because a high Fowler's position involves the client being in a sitting position with the backrest at a 90-degree angle, not being face-down, lying with the head lower than the feet, or lying on the back with knees drawn up towards the chest.
5. A client with expressive aphasia is pointing wildly at the bath water but unable to speak. Which response from the nurse is most appropriate?
- A. Is something wrong with the bath water?
- B. Just calm down, we'll finish your bath soon.
- C. Are you trying to tell me something?
- D. Shall I turn on the television?
Correct answer: A
Rationale: A client with expressive aphasia faces difficulty expressing themselves verbally but can understand others. In this scenario, the client's gestures indicate a communication attempt. The nurse's best response is to directly address the potential issue the client is indicating, which is the bath water. Option A acknowledges the client's non-verbal communication and seeks to address their concern. Choices B, C, and D do not directly address the client's attempt to communicate about the bath water, which is the focal point of the interaction.
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