NCLEX-PN
Reduction of Risk Potential NCLEX Questions
Extract:
Question 1 of 5
A client asks the nurse to call the police and states: "I need to report that I am being abused by a nurse." The nurse should first
Correct Answer: C
Rationale: Obtain more details of the client's claim of abuse. The advocacy role of the professional nurse, as well as the legal duty of the reasonable prudent nurse, requires the investigation of claims of abuse to ensure appropriate action and protection for the client.
Question 2 of 5
A patient has experienced a severe third degree burn to the trunk in the last 36 hours. Which phase of burn management is the patient in?
Correct Answer: A
Rationale: The shock phase is considered the first 24-48 hours in burn wound management.
Question 3 of 5
The client with a left-sided weakness is to be discharged to home, where the client has an electrical bed. In preparation for discharge, the nurse assesses the client's ability to get out of bed independently- Which client actions indicate that further instruction is needed? Select all that apply.
Correct Answer: C,D
Rationale: C: Rolling onto the weaker left side is incorrect; the client should roll onto the stronger right side to maximize strength and stability. D: Using the weak elbow instead of the stronger elbow and hand to push off increases the risk of injury and instability.
Question 4 of 5
A client states, 'People think I'm no good, you know what I mean?' Which of these responses would be most therapeutic?
Correct Answer: C
Rationale: I'm not sure what you mean. Tell me a bit more about that.' This therapeutic communication technique elicits more information, especially when delivered in an open, non-judgmental fashion.
Question 5 of 5
A power outage occurs at a hospital, and a backup generator supplying power to a telemetry unit fails. After obtaining a flashlight, what is the nurse's next best action?
Correct Answer: C
Rationale: Obtaining oxygen tanks is the priority, as room oxygen sources fail during a power outage, and clients on oxygen are at immediate risk.