NCLEX-RN
NCLEX RN Practice Questions With Rationale Questions
Question 1 of 5
Jack is a 2-month-old with a diagnosis of spinal muscular atrophy (SMA) type I. He has been admitted to the hospital for progressive respiratory difficulty. His parents have been informed that if he is not placed on ventilatory support, he will continue to decompensate and die of respiratory failure. Jack's physician discusses the poor prognosis of Jack's condition, and tells the parents that he will not be able to be removed from ventilatory support once it is initiated, due to his progressive neurological disease. After much discussion, the parents have decided to decline ventilatory support, agree to a do not resuscitate (DNR) order, and request hospice care for Jack. Another parent heard them discussing Jack's situation in the waiting room and says she could never do that to her baby. What is the most appropriate response to this parent?
Correct Answer: B
Rationale: In healthcare settings, privacy regulations prevent professionals from discussing patient situations with individuals not involved in that patient's care. Maintaining patient confidentiality is crucial to protect sensitive information. In this scenario, sharing details about Jack's situation with the parent who overheard the conversation would breach confidentiality. It is important to handle such situations delicately, especially in emotional environments like intensive care unit waiting rooms. While empathy and support are essential, it is equally crucial to respect patient privacy and confidentiality.
Therefore, responding with 'I can't discuss another patient's situation' is the most appropriate and professional response in this context.
Question 2 of 5
A victim of a gunshot wound to the abdomen has been admitted to the hospital, accompanied by a police officer. When questioned, the officer states that the patient is a suspect in a homicide, which occurred as part of the same incident. A small child was killed as the result of a stray bullet. The patient is combative, yells that he's in pain and demands medication. What is your most appropriate response?
Correct Answer: C
Rationale: The most appropriate and caring response is to perform a pain assessment and administer the pain medication that has been ordered. Regardless of personal feelings about any given situation, the nurse's responsibility is to provide unbiased, appropriate, and supportive care, as stated in the American Nurses Association (AN
A) Code of Ethics.
Choice A is not appropriate as it disregards the patient's immediate need for pain relief.
Choice B may escalate the situation and is not the priority in this case.
Choice D is not the immediate action needed to address the patient's pain and distress.
Question 3 of 5
Ruth is a 72-year-old patient who has been upset and crying all morning. When asked why she is upset, she turns toward the wall in silence. What collaborative process may be helpful in caring for this patient?
Correct Answer: A
Rationale: Collaborating with the patient care technician is an appropriate approach in this scenario. Patient care technicians and nurses' aides often provide direct care to patients, developing a closer relationship with them. Patients may feel more comfortable sharing their feelings with these caregivers compared to other healthcare professionals. In this situation, Ruth's distress appears more emotional than spiritual, making it more suitable to speak with someone directly involved in her care. Calling the chaplain (
Choice
B) might not directly address Ruth's immediate emotional needs as it could focus more on spiritual support. Involving the social worker (
Choice
C) could help address underlying emotional or social issues, but speaking with the patient care technician is a more direct and immediate step to assess and provide initial support. Calling the patient's husband (
Choice
D) may not address Ruth's immediate emotional distress and may not be appropriate without understanding the root cause of her upset.
Question 4 of 5
A 3-year-old pediatric patient's mother would like to stay at the patient's bedside throughout the night as the patient seems calmer when she is present. What is the most caring and appropriate response?
Correct Answer: C
Rationale: Allowing the mother to stay throughout the night is the most caring and appropriate response in this situation. Pediatric facilities often recognize the crucial role parents play in their child's care and are supportive of unlimited visitation. Allowing the mother to stay can help maintain the child's calmness and enhance the bond between the family and healthcare team. Reinforcing visiting hours (
Choice
A) may not address the specific needs of this situation where the child benefits from the mother's presence. Allowing her to stay for a short period beyond normal hours (
Choice
B) may not fully address the need for her continuous presence. Offering to get bedding for a couch in the waiting room (
Choice
D) may not be necessary if the mother can stay with her child in the patient's room.
Question 5 of 5
Who owns a patient's x-rays?
Correct Answer: C
Rationale: X-rays are typically owned by the facility that conducts the procedure, not the patient or the doctor. The facility that performs the procedure is responsible for maintaining and storing the x-rays as part of the patient's medical records. The patient does not own the x-rays since they are part of their medical record and not a physical possession. The doctor also does not own the x-rays as they are generated as a result of the medical procedure conducted at the facility, making choice C the correct answer.