NCLEX-PN
2024 PN NCLEX Questions Questions
Extract:
Question 1 of 5
Mr. H. is upset about being in the hospital for another day because he states it costs too much. The rights he is likely to demand include all of the following except:
Correct Answer: D
Rationale: Confidentiality is the maintenance of privacy of information, which is not directly related to the issue Mr. H. is facing. The question indicates that Mr. H. is concerned about the cost of staying in the hospital, which pertains more to financial aspects and the right to examine and question the bill. The right to a reasonable response to requests and the right to refuse treatment are also crucial patient rights that Mr. H. may demand in his current situation.
Therefore, the correct answer is the right to confidentiality, as it is not specifically relevant to the scenario presented.
Question 2 of 5
A nurse is determining the fetal heart rate (FHR) and places the fetoscope on the mother's abdomen to count the FHR. The nurse simultaneously palpates the mother's radial pulse and notes that it is synchronized with the sounds heard through the fetoscope. Which action should the nurse take?
Correct Answer: B
Rationale: When auscultating the fetal heart rate, the nurse would place the fetoscope on the maternal abdomen, over the fetal back. The nurse would then palpate the mother's radial pulse. If her pulse is synchronized with the sounds from the fetoscope, the nurse would move the fetoscope to another area on the mother's abdomen to locate the FHR. The nurse needs to be sure that the FHR is what is actually being heard. Other sounds that may be heard are the funic sound (blood flowing through the umbilical cord) and the uterine sound (blood flowing through the uterine vessels). The funic sound is synchronized with the FHR; the uterine sound is synchronized with the mother's pulse.
Therefore, moving the fetoscope to a different area will help in accurately locating and counting the fetal heart rate.
Choice A is incorrect because counting for 60 seconds without changing the position may not address the issue of accurately locating the FHR.
Choice C is incorrect as it does not address the need to reposition the fetoscope to locate the fetal heart.
Choice D is incorrect because counting the FHR and the radial pulse rate separately may not help in differentiating the two sounds.
Question 3 of 5
A nurse, assigned to care for a hospitalized child who is 8 years old, assists with planning care, taking into account Erik Erikson's theory of psychosocial development. According to Erikson's theory, which task represents the primary developmental task of this child?
Correct Answer: B
Rationale: According to Erikson's theory of psychosocial development, the primary task for an 8-year-old child aligns with the stage of industry versus inferiority. This stage focuses on mastering useful skills and tools of the culture, emphasizing competence in various areas. Option A, 'Developing a sense of control over self and body functions,' is more characteristic of the toddler stage, emphasizing autonomy and self-regulation. Option C, 'Gaining independence from parents,' is more relevant to the adolescent stage, where identity development and autonomy become crucial. Option D, 'Developing a sense of trust in the world,' pertains to the infant stage, highlighting the importance of forming secure attachments.
Therefore, the correct answer is B as it directly corresponds to the developmental tasks associated with an 8-year-old child according to Erikson's theory.
Question 4 of 5
A nurse is caring for an older client who has a bronchopulmonary infection. The nurse monitors the client's ability to maintain a patent airway because of which factor involved in the normal aging process?
Correct Answer: C
Rationale: The correct answer is 'Decreased older client's ability to clear secretions.' Respiratory changes related to the normal aging process decrease an older adult's ability to clear secretions and protect the airway. In healthy older adults, the number of alveoli does not change significantly; their structure, however, is altered. Respiratory system compliance decreases with advancing age because of a progressive loss of elastic recoil of the lung parenchyma and conducting airways, and reduced elastic recoil of the lung and opposing forces of the chest wall. Production of surfactant in the lung does not usually decrease with aging, nor does it increase. However, the production of alveolar cells responsible for surfactant production is diminished.
Choices A, B, and D are incorrect.
Choice A is incorrect because respiratory system compliance decreases with aging.
Choice B is incorrect as the number of alveoli does not significantly decrease in healthy older adults.
Choice D is incorrect as the production of surfactant does not usually decrease with aging.
Question 5 of 5
The nurse notes that a client in later adulthood has tremors of the hands. Based on this finding, what action should the nurse take?
Correct Answer: D
Rationale: When a nurse observes senile tremors, such as intentional tremor of the hands in a client in later adulthood, it is important to document the findings. Senile tremors are benign and a normal age-related occurrence. Referring the client to a neurological specialist (
Choice
A) is unnecessary as senile tremors do not require specialized neurological intervention. Prescribing a muscle relaxant (
Choice
B) is not indicated since senile tremors are benign and not typically treated with muscle relaxants. Notifying the healthcare provider immediately (
Choice
C) is unnecessary as senile tremors do not require urgent intervention.
Therefore, the most appropriate action is to document the findings (
Choice
D) for the client's medical record and to establish a baseline for future assessments.