NCLEX NCLEX-PN
NCLEX PN Exam Cram
1. Which of the following is not typically considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct answer: Continuous Insulin
Rationale: Continuous Insulin is not typically considered one of the main mechanisms for treating Type II Diabetes. While medications, nutrition, and increased activity play crucial roles in managing Type II Diabetes, continuous insulin therapy is more common in Type I Diabetes or in specific cases of Type II Diabetes where other treatments are ineffective. Therefore, the correct answer is Continuous Insulin. Choices A, B, and C are mainstays in the treatment of Type II Diabetes, making them incorrect answers.
2. What is the role of an incident report in risk management?
- A. To provide liability protection.
- B. To provide data for analysis by a risk manager to determine how future problems can be avoided.
- C. To discipline staff for errors.
- D. All of the above.
Correct answer: To provide data for analysis by a risk manager to determine how future problems can be avoided.
Rationale: The correct answer is B. Incident reports play a crucial role in risk management by providing data for analysis to prevent future problems. They are not primarily for liability protection (A) or disciplining staff (C). Therefore, choice B is the most appropriate answer. Choosing option D is incorrect because incident reports do not solely exist for all the mentioned purposes, but primarily to provide data for analysis and preventive actions.
3. How does the family carry out its health care functions?
- A. The family provides very little preventive health care to its members at home.
- B. The family provides preventive health care to its members at home.
- C. The family pays for most health services.
- D. The family decides when and where to hospitalize its members.
Correct answer: The family provides preventive health care to its members at home.
Rationale: Families play a crucial role in providing preventive health care to their members at home. This includes activities such as promoting healthy lifestyles, ensuring vaccinations, scheduling regular check-ups, and intervening early when health issues arise. Therefore, the correct answer is that the family provides preventive health care to its members at home. Choices A, C, and D are incorrect because families are expected to actively engage in preventive health care practices rather than providing very little preventive care, solely paying for health services, or making hospitalization decisions. The focus is on the proactive role of families in maintaining the health of their members.
4. The newborn nursery is filled to capacity. Which newborn should the nurse assess first?
- A. A three-hour-old just waking up after a period of sleep
- B. A two-day-old crying loudly
- C. A three-day-old two hours after circumcision
- D. A one-hour-old sucking his fist
Correct answer: A three-hour-old just waking up after a period of sleep
Rationale: The most critical time for assessment in a newborn is during the second period of reactivity, which occurs approximately 3-5 hours after delivery. During this phase, newborns are more likely to gag on mucus and aspirate, making it crucial for the nurse to assess their respiratory status first. Choice A indicates a newborn in this critical phase, requiring immediate assessment for potential airway compromise or respiratory distress. Choices B, C, and D do not present an immediate need for assessment related to airway compromise or respiratory distress.
5. A nurse is determining the fetal heart rate (FHR) and places the fetoscope on the mother’s abdomen to count the FHR. The nurse simultaneously palpates the mother’s radial pulse and notes that it is synchronized with the sounds heard through the fetoscope. Which action should the nurse take?
- A. Count the FHR for 60 seconds, ensuring that it is synchronized consistently with the mother's radial pulse.
- B. Move the fetoscope to another area on the mother's abdomen to locate the fetal heart.
- C. Ask the mother to lie still while both the FHR and the radial pulse rate are counted.
- D. Count the FHR for 30 seconds and then count the radial pulse rate of the mother for 30 seconds.
Correct answer: Move the fetoscope to another area on the mother's abdomen to locate the fetal heart.
Rationale: When auscultating the fetal heart rate, the nurse would place the fetoscope on the maternal abdomen, over the fetal back. The nurse would then palpate the mother’s radial pulse. If her pulse is synchronized with the sounds from the fetoscope, the nurse would move the fetoscope to another area on the mother’s abdomen to locate the FHR. The nurse needs to be sure that the FHR is what is actually being heard. Other sounds that may be heard are the funic sound (blood flowing through the umbilical cord) and the uterine sound (blood flowing through the uterine vessels). The funic sound is synchronized with the FHR; the uterine sound is synchronized with the mother’s pulse. Therefore, moving the fetoscope to a different area will help in accurately locating and counting the fetal heart rate. Choice A is incorrect because counting for 60 seconds without changing the position may not address the issue of accurately locating the FHR. Choice C is incorrect as it does not address the need to reposition the fetoscope to locate the fetal heart. Choice D is incorrect because counting the FHR and the radial pulse rate separately may not help in differentiating the two sounds.
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