NCLEX-RN
NCLEX RN Practice Questions With Rationale
1. Which of the following is an example of effective time management?
- A. Always agreeing to others' requests for help
- B. Arranging long meetings to discuss important data
- C. Using multiple forms of technology to communicate or educate others
- D. Working in a secluded area to minimize interruptions
Correct answer: D
Rationale: Effective time management involves strategies that help individuals focus and complete tasks efficiently. Working in a secluded area to minimize interruptions is an example of effective time management as it allows for concentration and productivity without distractions. Choices A, B, and C are not examples of effective time management. Always agreeing to others' requests for help can lead to overcommitment and time mismanagement. Arranging long meetings can be counterproductive as they consume time that could be used for actual work. Using multiple forms of technology, though helpful, can lead to information overload and inefficiency if not managed properly. Therefore, the most effective choice for optimal time management in this scenario is working in a secluded area to minimize interruptions.
2. A client is admitted to a nursing unit with a remittent fever. Which statement best describes this pattern of fever?
- A. A fever that spikes and then lowers without returning to normal
- B. A fever that lasts 2 days followed by normal temperature for 2 days, followed by fever again
- C. A fever that lasts 2 days followed by normal temperature for 12 hours, followed by fever again
- D. A persistent fever that has lasted over 24 hours
Correct answer: A
Rationale: A remittent fever is characterized by temperature fluctuations where the fever spikes and then lowers but does not return to normal temperature. Option A best describes this pattern of fever. Option B describes a pattern of fever known as a biphasic fever, where the fever alternates between days of fever and normal temperature. Option C describes a pattern of fever that is more indicative of an intermittent fever, where the fever lasts for a specific duration followed by an interval of normal temperature. Option D does not accurately describe a remittent fever, as it suggests a persistent fever that has lasted over 24 hours, which is not specific to the remittent pattern.
3. A writer is admitted for the second time accompanied by his wife. He is demanding, arrogant, talks fast, and is hyperactive. Initially, the nurse should plan this for a manic client:
- A. Set realistic limits to the client's behavior
- B. Repeat verbal instructions as often as needed
- C. Allow the client to express feelings to relieve tension
- D. Assign a staff member to be with the client at all times to help maintain control
Correct answer: A
Rationale: For a manic client who is demanding, arrogant, talks fast, and is hyperactive, setting realistic limits to the client's behavior is essential to ensure safety as manic clients may engage in injurious activities. A quiet environment and consistent, firm limits help to maintain control. While repeating verbal instructions may be necessary due to distractibility, it is not the priority compared to setting limits for safety. Allowing the client to express feelings is important, but only non-destructive methods of expression should be permitted. Assigning a staff member to be with the client at all times is not a realistic approach as it may not always be feasible or necessary for managing manic behavior effectively.
4. Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted for a bowel obstruction. She recently stated that she has decided that she doesn't want any further aggressive care and is requesting to be placed under hospice care. Her husband and daughter are supportive of her decision. She spoke with her oncologist about it, and he stated that he did not agree and wrote orders on her chart for chemotherapy. What would be the best first response to this situation?
- A. Give the patient a list of other oncologists
- B. Tell the family to report the doctor to the state quality board
- C. Notify the doctor that the patient refuses the chemotherapy
- D. Give the patient hospice information
Correct answer: C
Rationale: The patient has the right to refuse any treatment, and the doctor should be notified that the orders on the chart cannot be performed, with appropriate documentation. In this situation, the best first response is to notify the doctor that the patient refuses the chemotherapy. This step ensures that the patient's wishes are respected and that inappropriate treatments are not administered. It also opens up a dialogue with the oncologist, giving him the opportunity to understand the patient's perspective and potentially support her decision. Providing hospice information is a good follow-up step after addressing the immediate issue of refusing chemotherapy, as it allows the patient to initiate her own hospice evaluation if desired. Giving the patient a list of other oncologists or telling the family to report the doctor to the state quality board are not appropriate initial responses and may not align with the patient's wishes or autonomy.
5. A client is receiving education on cholesterol. Which of the following statements from the client indicates the need for further teaching?
- A. I would like my HDL levels to be over 50.
- B. It is better for me to have high HDL levels and low LDL levels.
- C. It is better for me to have high LDL levels and low HDL levels.
- D. My goal is to get my total cholesterol below 200.
Correct answer: C
Rationale: The correct answer is, 'It is better for me to have high LDL levels and low HDL levels.' This statement indicates a need for further teaching because high LDL levels contribute to atherosclerosis, while high HDL levels can protect against heart disease. The client should understand the importance of lowering LDL levels and increasing HDL levels to maintain good heart health. Choice A is correct as desiring HDL levels over 50 is a positive goal. Choice B is correct as it reflects the ideal scenario of high HDL and low LDL levels. Choice D is correct as a total cholesterol below 200 is a common goal for heart health. Therefore, Choice C is incorrect as it suggests an opposite and unhealthy relationship between LDL and HDL levels.
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