NCLEX-PN
Safe and Effective Care Environment Nclex PN Questions
1. Which of the following foods might a client with hypercholesterolemia need to decrease intake of?
- A. broiled catfish
- B. hamburgers
- C. wheat bread
- D. fresh apples
Correct answer: B
Rationale: A client with hypercholesterolemia should decrease their intake of foods high in cholesterol. Hamburgers, being red meat, have a high cholesterol content, hence should be decreased in the diet. Broiled catfish, wheat bread, and fresh apples are not high in cholesterol, so there is no need to decrease their intake. Broiled catfish is a lean source of protein, wheat bread is a complex carbohydrate, and fresh apples are a good source of fiber and vitamins. Therefore, hamburgers are the correct choice to decrease intake for a client with hypercholesterolemia.
2. What is the appropriate ratio of cardiac compressions to ventilations in an adult client for one-person CPR?
- A. 5:01
- B. 1:05
- C. 15:02
- D. 2:15
Correct answer: C
Rationale: The correct answer is 15:2. For one-person CPR on an adult, the ratio of compressions to ventilations is 15:2. This ratio ensures adequate oxygenation while maintaining effective circulation. Choice A (5:1) and Choice B (1:5) are incorrect ratios and do not align with the recommended guidelines for adult CPR. Choice D (2:15) is also incorrect as it reverses the order of compressions and ventilations.
3. Which isolation procedure will be followed for secretions and blood?
- A. Respiratory Isolation
- B. Standard Precautions
- C. Contact Isolation
- D. Droplet Isolation
Correct answer: B
Rationale: The correct answer is Standard Precautions. Standard precautions are taken in all situations for all clients and involve all body secretions except sweat. They are designed to reduce the rate of transmission of microbes from one host to another or one source to another. Respiratory Isolation (Choice A) is used for diseases transmitted by airborne particles, not secretions and blood. Contact Isolation (Choice C) is for clients known or suspected to be infected with microorganisms that can be transmitted by direct or indirect contact. Droplet Isolation (Choice D) is used for diseases transmitted by large respiratory droplets expelled during coughing, sneezing, talking, or procedures.
4. Priorities designated as intermediate by the nurse are:
- A. the nonemergency, non-life-threatening needs of the client.
- B. those tasks that can be delegated to assistive personnel.
- C. those tasks that can be performed at the end of the shift.
- D. those tasks that can be performed at any time
Correct answer: A
Rationale: Priorities designated as intermediate by the nurse are those that are not urgent but still important, such as the nonemergency, non-life-threatening needs of the client. They do not impact the client's immediate physiological status but require attention. Intermediate priorities may need the skill level of an RN for completion and may have specific time requirements. Choices B, C, and D are incorrect because the priority being intermediate doesn't mean it can be delegated, done at a specific time, or done at any time; it simply indicates a non-urgent but necessary task for the client's well-being.
5. Regardless of their practice area, nurses should be concerned with:
- A. all drug-resistant bacteria.
- B. microorganisms that are critical.
- C. transmission of microorganisms.
- D. overprescription of bacteriostatic drugs.
Correct answer: C
Rationale: All nurses should be concerned with preventing the transmission of microorganisms to themselves and others. A primary way to achieve this is through asepsis. Nursing practice emphasizes providing a safe environment to shield clients, family, and healthcare providers from infections. Choices A, B, and D are incorrect. While drug-resistant bacteria, critical microorganisms, and overprescription of bacteriostatic drugs are important, nurses' primary focus should be on preventing microorganism transmission to ensure safety and well-being.
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