NCLEX RN Practice Questions With Rationale - Nurselytic

Correct Answer: C

Rationale: An assisted living facility is an example of a tertiary care provider. Tertiary care providers offer specialized services such as rehabilitation, long-term care, and management of complex medical conditions. These services are typically provided after primary and secondary care interventions.
Choice A, primary care, focuses on preventive care and routine medical treatment for common illnesses, which is not the level of care provided by assisted living facilities.
Choice B, secondary care, involves specialized medical services provided by medical specialists and hospitals for conditions that require a higher level of expertise than primary care, but it is not the level of care provided by assisted living facilities.
Choice D, None of the above, is incorrect as assisted living facilities fall under the category of tertiary care providers.

Correct Answer: C

Rationale: The patient has the right to refuse any treatment, and the doctor should be notified that the orders on the chart cannot be performed, with appropriate documentation. In this situation, the best first response is to notify the doctor that the patient refuses the chemotherapy. This step ensures that the patient's wishes are respected and that inappropriate treatments are not administered. It also opens up a dialogue with the oncologist, giving him the opportunity to understand the patient's perspective and potentially support her decision. Providing hospice information is a good follow-up step after addressing the immediate issue of refusing chemotherapy, as it allows the patient to initiate her own hospice evaluation if desired. Giving the patient a list of other oncologists or telling the family to report the doctor to the state quality board are not appropriate initial responses and may not align with the patient's wishes or autonomy.

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.

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.

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.