nclex rn 1

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nclex rn 1
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  1. 127. An ethical dilemma is one in which:1. there is a clear-cut treatment decision.2. there is no duty to provide care or treatment.3. a problem exists in decision making because there is no right or wrong choice.4. all involved parties agree on actions to be taken.
    (3) An ethical dilemma is one in which there is no clear-cut treatment decision or there is disagreement about thecourse of action to take. There is usually a clear duty to provide care, but the type of care is under contention.
  2. 127. An ethical dilemma is one in which:1. there is a clear-cut treatment decision.2. there is no duty to provide care or treatment.3. a problem exists in decision making because there is no right or wrong choice.4. all involved parties agree on actions to be taken.
    (3) An ethical dilemma is one in which there is no clear-cut treatment decision or there is disagreement about thecourse of action to take. There is usually a clear duty to provide care, but the type of care is under contention.
  3. 128. Withdrawal of medical care includes:1. withdrawal of comfort care.2. withdrawal of nursing care.3. withdrawal of socialization.4. withdrawal of curative treatment.
    (4) Cure is no longer a goal of therapy when the decision has been made to withdraw treatment. A discussion of potentialoutcomes will have been part of the discussion leading to the decision of withdrawing care. Choices 1, 2, and 3 areincorrect. Nursing care, socialization, and comfort continue to be mechanisms to provide quality end-of-life care.
  4. 129. Nursing qualities described in ANA code of ethics include all of the following except:1. maintenance of competence.2. providing care with respect for privacy and dignity.3. collaborating with colleagues to meet public health need.4. care for patients without professional boundaries.
    (4) The code of ethics supports all of these aspects of professional nursing and delineates the practice of nursing withinthe profession.
  5. 130. Types of patient care scenarios in which ethical dilemmas arise include all of the following except:1. technology versus cost.2. withholding food and fluids.3. private room versus patient’s preference.4. right to die at home versus remaining in the hospital.
    (3) Ethical dilemmas occur when there is conflict resulting in two conflicting choices that have major consequences.A private room for convenience does not meet this definition.
  6. 131. The term ethics has no simple definition but encompasses:1. human relationships with others.2. establishing norms/standards for conduct.3. moral judgment.4. all of the above.
    (4) The definition of ethics includes all of these elements.
  7. 132. At the end of the shift, you and a co-worker ride down the elevator discussing your challenging shift’s events.Which of the following ethical principles did you both breach?1. HIPPA2. confidentiality3. fidelity4. beneficence
    (2) Confidentiality is a patient right that nurses are bound to honor according to ethical codes. HIPPA is a law thatmandates protection of personal information. Fidelity is the ethical principle of keeping promises. Beneficence is theethical principle to do good for others.
  8. 133. A patient with massive chest and head injuries is admitted to the ICU from the ER. You know that all of thefollowing are true except:1. a declaration of wishes or documentation of wishes regarding organ donation by the donor is not necessaryfor organ harvesting.2. the physician in charge of the case is the only person allowed to decide whether organ donation will occur.3. only the patient’s legally responsible party may make the decision for organ donation for the donor if thepatient is unable to do so.4. the organ procurement organization is involved in the decision regarding which organs to harvest.
    (2) The donor or legally responsible party for the donor, the physician, and the organ procurement organization are allinvolved in the decision regarding whether organ donation is appropriate for a specific donor.
  9. 134. Because I carry a donor card for organ donation, I know that:1. my medical care will be altered if I have serious injuries in order to get my organs for donation.2. my family and legally responsible party will have no decision-making authority in the event that I amconsidered as an organ donor.3. I am allowed to revoke my decision for organ donation at any time.4. I will be considered as an organ donor for only one organ or tissue.
    (3) Revocation of the decision for organ donation may occur at any time, by either the patient or responsible party.When organ donation is considered, as many organs as the donor wished to donate are considered and accepted fordonation if found appropriate. Medical care for an individual during immediate care and/or resuscitation are not alteredin order to declare a patient dead and ready for organ donation.
  10. 135. You are the ICU nurse caring for a patient who has just been declared brain dead. You know that one place youmight find evidence of the patient’s wishes regarding organ donation is:1. on the driver’s license of the patient.2. in the patient’s safety deposit box.3. in the patient’s last will and testament.4. on the patient’s insurance company card.
    (1) In most states, indication of organ donor status is found on the driver’s license. Evidence in a last will and testament orin a safety deposit box would not be readily accessible for decision making if the need arose. Insurance company cards donot contain such information. Another source might be the patient’s primary care physician’s health record documentation.
  11. 277. At what age should an individual with a family history for early cardiovascular disease or hyperlipidemia firstbe screened for cholesterol levels?1. 5 years2. 20 years3. when symptoms arise4. 11–14 years
    (4) The child should be screened in early adolescence if there is a significant family history for early cardiovasculardisease.
  12. 278. A nurse notes that a toddler is rubbing his eyes and blinking frequently as well as holding objects close. Whichof the following is the nurse’s best action based on this information?1. Do nothing; this is normal for toddlerhood.2. Ask the parent whether the child is fatigued.3. Refer the child for vision screening.4. Assess the child’s intake of Vitamin A.
    (3) The noted symptoms indicate possible vision impairment. The child should be referred for vision screening. Thesesymptoms are not normal for toddlerhood, fatigued children, or children who require more Vitamin A.
  13. 279. During a routine health screening for lice, the school nurse finds several kindergarten children with lice. Whichof the following is important information for her to tell the parents?1. Bedding and clothing should be washed in hot water.2. Pesticide should be sprayed in the home.3. Once cured, the child may share his combs again with others.4. The child may return to school after the second treatment with medicated shampoo.
    (1) Bedding must be washed in hot water. Spraying the home is not recommended with small children. Children shouldnever share their combs with others. Most children may return to school after the first shampoo treatment is completed.
  14. 280. Blood pressure screening is recommended periodically in women age 18 years and older. The nurse knows thisrecommendation is which of the following?1. every 6 months2. annually3. at least every 2 years4. every 5 years
    (3) The recommendation is at least every two years.
  15. 281. When teaching breast self exam to a postmenopausal client, the nurse should recommend that the client dowhich of the following?1. The client no longer needs to perform breast self exam.2. The client should vary when she performs breast self exam so she can determine how her breast changesduring the month.3. The client should perform breast self exam during the same time each month.4. The client should perform breast self exam whenever she remembers each month.
    (3) Postmenopausal women should select a specific day each month to perform breast self exam. Because of breastchanges throughout the month, it is important to compare the breast tissue month to month during the same time of themonth.
  16. 282. The nurse knows that client teaching for breast self exam has been effective when the client verbalizes whichof the following?1. “I should perform breast self exam about 1 week after my period.”2. “I should lay on my left side and feel in a circular motion on my breast.”3. “I should expect to see discharge from my nipple when squeezed.”4. “I should recognize that dimpling of the breast is normal.”
    (1) Breast self exam is to be performed 7–10 days after menses. The client should lay flat on her back to examine herbreasts. There should not be any discharge when the nipple is squeezed, and dimpling of the breast is not normal andmust be evaluated by a physician.
  17. 283. The nurse knows that client teaching for testicular self exam has been effective when the 20-year-old clientverbalizes which of the following?1. “I should vary when I perform testicular self exam so I can determine changes during the month.”2. “I should perform testicular self exam during the same time each month.”3. “I should perform testicular self exam whenever I remember each month.”4. “I am too young for testicular cancer and do not need to do testicular self exam.”
    (2) Testicular self exam is to be performed during the same day each month. Age does not impact the recommendationfor regular testicular self exam.
  18. 284. The nurse knows that client teaching for testicular self exam has been effective when the client verbalizeswhich of the following?1. “I need to examine each testicle by gently rolling it between the thumb and fingers of the other hand.”2. “I need to examine each testicle by palpating in a circular motion.”3. “I need to perform the exam after a cool shower.”4. “I need to perform the exam while the penis is erect.”
    (1) Testicular self exam is performed after a warm bath or shower and involves examining each testicle separately bygently rolling it between the thumb and fingers of the other hand.
  19. 285. The mother of a 4-year-old asks the nurse when her child should have her first dental check up. The nurseknows that which of the following is most accurate?1. Children need to see a dentist when they start school.2. Children need to see a dentist when they experience pain or have a problem with a tooth.3. Children need to see a dentist after they lose their first tooth.4. Children need to see a dentist by about age 3.
    (4) The recommendation is that children have their first dental appointment by about age 3.
  20. 286. A mother brings her 14-year-old daughter to the clinic for an annual checkup. The nurse recognizes thatimportant part of the exam will be to screen for which of the following?1. sexual behavior2. truancy behavior3. defiant behavior4. cleanliness behavior
    1) An important screening during adolescence is to assess sexual behavior. Sexual behavior may be life threatening.

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