Saunders NCLEX RN Practice Questions - Nurselytic

Correct Answer: A

Rationale: The correct answer is A: Psychological abuse. This behavior involves verbal threats and emotional manipulation, causing fear and distress to the client. It violates the client's rights and dignity. Abandonment (
B) refers to deserting a client in need. Material exploitation (
C) involves misuse of a client's property or resources. Physical abuse (
D) involves causing harm through physical force.

Correct Answer: A

Rationale: The correct answer is A because documenting the client's own words provides direct evidence of their condition and thought process at the time of the incident. This helps in understanding the client's perspective and decision-making, which is crucial for providing appropriate care and preventing future falls.


Choice B is incorrect because while it may be important to document how the fall happened and when the physician was notified, it does not directly capture the client's own words and thoughts.


Choice C is incorrect as it focuses on the conditions of the room rather than the client's own account of the situation.


Choice D is also incorrect as it pertains to the client's medical history and medications, which are important but not directly relevant to documenting the client's immediate situation and actions.

Correct Answer: A

Rationale: The correct answer is A because whistle-blowing involves reporting unethical or illegal behavior within an organization to higher authorities. In this scenario, the nurse is reporting a colleague's misuse of supplies for personal gain, which is unethical.
Choice B involves a client suing a nurse for malpractice, not whistle-blowing.
Choice C is a standard response to a client falling and does not involve reporting unethical behavior.
Choice D describes a case of neglect, not whistle-blowing.

Correct Answer: C

Rationale: The correct answer is C because using eye contact and maintaining an open stance while the client is talking demonstrates active listening. Eye contact shows attentiveness and respect, while an open stance conveys empathy and receptiveness. This non-verbal communication encourages the client to feel heard and understood, fostering a therapeutic relationship.


Choice A is incorrect because using humor may not always align with the client's feelings or be perceived as appropriate.
Choice B is incorrect as restating what the client said is a form of paraphrasing, not active listening.
Choice D is incorrect because providing personal information can shift the focus away from the client's needs and may breach professional boundaries.

Correct Answer: C

Rationale: The correct answer is C. Assisting with performing incentive spirometry can be delegated to unlicensed assistive personnel (UAP) as it involves a non-invasive procedure that does not require specialized training or licensure. UAP can help patients with using the incentive spirometer to improve lung function under the supervision of a licensed healthcare provider.

Choices A, B, and D involve tasks that require specific skills and knowledge to prevent complications, hence should be performed by licensed healthcare professionals.