NCLEX-RN
NCLEX RN Practice Questions With Rationale Questions
Question 1 of 9
Who typically owns a patient's medical record?
Correct Answer: B
Rationale: The correct answer is 'The physician.' Physicians typically own their patients' medical records as they are the ones responsible for creating, updating, and maintaining these records. However, it is essential to note that patients have the legal right to access and obtain copies of their medical records. Choice A ('The patient') is incorrect as patients do not own their medical records, but they do have rights regarding access to them. Choice C ('The Legal Counsel of the Office') is incorrect as legal counsel typically do not own or have ownership rights over medical records. Choice D ('No one owns a medical record') is incorrect as medical records are owned by healthcare providers who create and maintain them, such as physicians.
Question 2 of 9
Who among the following individuals wrote a medical code of ethics?
Correct Answer: D
Rationale: All of the above individuals contributed to the development of medical ethics. Hammurabi created the earliest known code around 2500 BC. Hippocrates, known for the principle 'Do no harm,' emphasized ethical practices in medicine. Thomas Percival, a physician interested in sociological medicine, authored a Code of Medical Ethics in 1803, which influenced modern medical ethics. Therefore, the correct answer is 'All of the above.' Choices A, B, and C are incorrect because each of them individually wrote a medical code of ethics, making 'All of the above' the most inclusive and accurate answer.
Question 3 of 9
Richard is a 72-year-old with stage 4 lung cancer who has been admitted to the hospital for pneumonia. He is alert and oriented and states he would like to sign a do not resuscitate (DNR) order. His wife enters the room after he has signed it and is very upset that he has made this decision without discussing it with her. She wants to know what she can do to get the DNR reversed. What should your first response be?
Correct Answer: D
Rationale: The correct response in this situation is to offer caring support for both parties. Richard, being alert and oriented, has the right to make his own decisions, including signing a do not resuscitate (DNR) order. It is important to respect his autonomy while also acknowledging his wife's feelings. By offering caring support, the nurse can facilitate a discussion between Richard and his wife, helping them navigate their emotions and decisions. Contacting the unit manager or hospital's attorney would not be appropriate as the initial response. These actions may escalate the situation and are not focused on addressing the emotional needs of the couple. Trying to talk Richard out of his decision would disregard his autonomy and right to make choices about his own care, which goes against ethical principles of patient autonomy and informed decision-making.
Question 4 of 9
Becky is a 17-year-old type I diabetic who has been admitted for her third episode of diabetic ketoacidosis (DKA) since being diagnosed last year. She states that she hates feeling different from her friends and refuses to take her insulin as recommended. What would be the most helpful action for Becky?
Correct Answer: C
Rationale: Contacting the local support group for diabetic teens would be the most helpful action for Becky. By reaching out to see if another diabetic teenager could provide support, Becky would have the opportunity to connect with someone in her peer group who faces similar challenges. This connection can help reduce her sense of isolation and the feeling of being 'different.' Choice A, 'Scolding her for not taking her insulin,' is inappropriate and could further alienate Becky. It does not address the underlying emotional issues driving her behavior. Choice B, 'Recommending that she use an insulin pump,' does not directly address Becky's emotional struggle with feeling different from her friends. While an insulin pump may be a helpful tool, it does not tackle the root cause of her non-compliance. Choice D, 'Telling her parents they must provide more strict oversight,' focuses on imposing stricter control without addressing Becky's emotional needs or offering peer support, which may not be effective in improving her insulin adherence in the long term.
Question 5 of 9
OSHA has very strict standards for hospital employees who may encounter hazardous materials or patients who have been exposed to them. These regulations include all of the following EXCEPT:
Correct Answer: D
Rationale: OSHA regulations for hospital employees dealing with hazardous materials or exposed patients require respiratory protection for potentially exposed employees, training on respiratory protection, and the provision of personal protective equipment. However, not all ED personnel are required to be trained in decontamination procedures. While all ED staff should have a basic understanding of hazmat situations, specific training in decontamination procedures is only necessary for those who will be directly involved in the decontamination process. Therefore, the correct answer is that all ED personnel must be trained in decontamination procedures, as this is not a mandatory requirement under OSHA regulations for hospital employees who may encounter hazardous materials or exposed patients.
Question 6 of 9
A nurse caring for a pediatric client shows little concern when the parents attempt to speak with her about their daughter's illness. When approached by the nurse manager about her behavior, the nurse responds by saying, 'I don't want to get involved. It doesn't matter what I do anyway; my work does not make much of a difference.' This nurse is exhibiting which of the following characteristics?
Correct Answer: B
Rationale: The correct answer is 'Depersonalization.' A nurse who distances themselves from clients to avoid emotional involvement is displaying depersonalization. This behavior is often seen in nurses experiencing burnout due to stress. Depersonalization can stem from low morale, moral distress, and may serve as a defense mechanism to cope with stress and emotional exhaustion. It is a way to shield oneself from feeling overwhelmed by the burdens of caring for others. Choice A, 'Objectivity,' is incorrect because objectivity involves maintaining a neutral and unbiased perspective, which is not the case here. Choice C, 'Procrastination,' is incorrect as it refers to delaying tasks, not emotional distancing. Choice D, 'Disruption,' is irrelevant to the scenario described and does not align with the nurse's behavior of detachment and lack of concern.
Question 7 of 9
In a clinic in a primarily African American community, a higher incidence of uncontrolled hypertension is noted in patients. To correct this health disparity, what should the nurse do first?
Correct Answer: C
Rationale: To address the higher incidence of uncontrolled hypertension in the primarily African American community, the nurse should first assess the perceptions of community members about the care at the clinic. Understanding the community's perspective can provide valuable insights into the reasons behind the health disparity. Initiating a regular home-visit program or scheduling teaching sessions about low-salt diets are important interventions but should come after gathering information on community perceptions. Obtaining low-cost antihypertensive drugs is not the initial priority; understanding community perspectives is crucial for developing effective interventions.
Question 8 of 9
Which of the following is a function of risk management?
Correct Answer: A
Rationale: The function of risk management in healthcare is to assess and address potential risks that could lead to errors and their effects on the healthcare environment. This involves identifying, evaluating, and prioritizing risks to minimize their impact and prevent adverse outcomes. Choice A is correct because it aligns with the core purpose of risk management in healthcare. Choices B, C, and D are incorrect as they do not directly relate to the primary focus of risk management, which is the proactive management of risks to ensure patient safety and quality care.
Question 9 of 9
When teaching a client with coronary artery disease about nutrition, what should the nurse emphasize?
Correct Answer: C
Rationale: The correct answer is to emphasize avoiding very heavy meals. Eating large, heavy meals can divert blood away from the heart for digestion, potentially endangering clients with coronary artery disease. This practice may lead to an increased risk of plaque accumulation in the arteries, potentially obstructing the delivery of blood and oxygen to vital organs. Choices A, B, and D are incorrect. While eating three balanced meals a day, adding complex carbohydrates, and limiting sodium intake are generally good dietary practices, they are not the primary focus when teaching a client with coronary artery disease about nutrition. The emphasis should be on avoiding heavy meals that can strain the cardiovascular system.