NCLEX for FINAL

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NCLEX for FINAL
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2012-09-11 23:21:54
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NCLEX FINAL
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NCLEX Questions for NURS4920
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  1.  While conducting
    an initial assessment of an infant, a home health nurse notices that the infantis wearing a soiled piece of braided yarn around the neck.  Which action by the nurse is most
    appropriate?

     

    A.   
     Leave the yarn in place, but wash it with a
    cloth and mild soap.

    B.    
    Ask about its
    significance and suggest that it be placed more safely on the body.

    C.    
    Explain that the
    yarn offers no benefit and ask the parents to remove it.

    D.   Remove the yarn
    because it is soiled and could lead to strangulation.
    • B. 
    • Ask about its
    • significance and suggest that it be placed more safely on the body.
  2. A Native American client who has a low grade fever tells the nurse on the reservation that he will only use a sweat lodge to treat his illness.  Which approach by the nurse would be the most therapeutic?

     

    A.   
     Explain to the client that the sweat lodge is
    likely to worsen the fever.

    B.    
    Alert the
    physician and ask him or her to talk to the medicine man of the tribe.

    C.    
    Continue to
    monitor the client’s status.

    D. Ask the client’s family to convince him not to
    use the sweat lodge
    • C. Continue
    • to monitor the client’s status
  3.   
    A male nurse
    needs to check the vital signs and oxygen saturation level of a female client
    from a different culture.  As the nurse
    approaches, the client moves to the other side of the bed and draws up the
    blanket.  What is the best nursing action
    at this time?

     


    A.   
    Invite a family
    member to be present and to assist with the oxygen saturation reading.

    B.    
    Ask a female
    nurse to perform the procedures.

    C.    
    Perform the
    assessments without acknowledging her reaction.

    D.   
    Before touching
    the client, explain the procedure and ask for permission to continue.
    • D.Before
    • touching the client, explain the procedure and ask for permission to continue
  4. 1.     
    A nurse is caring
    for two clients who have had abdominal surgery. 
    One client is of Hispanic heritage, who writhes in pain and moans when
    touched.  The other is an Asian client,
    who appears calm and rarely verbalizes pain or discomfort.  The nurse appropriately draws which
    conclusion?

     

    A.   
     Hispanic client is exaggerating his pain.

    B.    
    Asian client is
    not experiencing pain.

    C.    
    Two clients have
    different culturally influenced ways of coping with pain.

    D.
    Hispanic client may be exhibiting drug-seeking
    behavior
    C.    Two clients havedifferent culturally influenced ways of coping with pain.
  5. 1.     
    A hospice nurse
    in a small Appalachian community is caring for a client at home who is an
    active member of the community church. 
    As death nears, the minister and several members of the congregation
    come together in the home for a “death watch.” 
    Which action by the nurse is most therapeutic?

     

    A.   
     Ask the minister to have church members come
    in scheduled time blocks to avoid overcrowding.

    B.    
    Observe client’s
    religious beliefs and allow family and minister unlimited access to the client.

    C.    
    Allow family and
    three other visitors at a time to stay with the client, but keep everyone else
    in the next room.

    D.   
    Explain that the
    watch will not be a problem as long as it does not conflict with medical care.
    B.    Observe client’sreligious beliefs and allow family and minister unlimited access to the client.
  6. The
    nurse is providing postmortem care for a client. Which intervention would be
    appropriate prior to allowing the family to visit? Select all that apply.
    1. Prepare the body to look as clean and natural as possible.
    2. Keep the sheet over the client's face until the family is comfortably seated
    in the room.
    3. Wear sterile gloves to pack the anal canal with gauze.
    4. Remove the external tubes and drains.
    5. Call the physician to verify the time of death before taking the body to the
    morgue.
    1,4
  7. A
    90-year-old client expresses a wish to die at home after being told that an
    esophageal stricture prevents swallowing. The client refuses a feeding tube.
    The family fully supports this decision. What would be the most appropriate
    resource for the nurse to call?
    1. Hospice care
    2. The rabbi
    3. An attorney
    4. the medical examiner's office
    1
  8. the
    nurse anticipates that which client newly diagnosed with a terminal illness is
    least likely to have difficulty facing his or her mortality?
    1. A 71-year-old female whose grandson, sister, and best friend died over the
    past 6 months.
    2. A 59-year-old male who never married, is an only child, and whose parents
    are both healthy.
    3. A 70-year-old male who has planned his funeral and enjoys riding his
    motorcycle at high speeds in rural areas.
    4. A 68-year-old female who is an atheist.
    3
  9. The
    mental health nurse is counseling a client who is grieving his father's death.
    Based on Rando's process of bereavement, in what order would the mental health
    nurse expect a client to make the following statements as he moves through the
    bereavement process? Select all that apply.
    1. "This is the second anniversary of my father's death."
    2. "My father was an alcoholic, so every Christmas I make certain that local
    AA groups have coffee and chocolates to help the members through the
    holidays."
    3. "It was so much fun to rummage through the antique stores
    together."
    4. "It's too difficult to be around his stepfamily, so I visit friends on
    vacation."
    5. "The homestead has run down since his death. It was hard to drive past
    and see the lack of care in his vegetable garden."
    • 1,
    • 5, 3, 4, 2.
  10. While talking to adult children of a dying male client, the nurse finds
    them tearful, with ambivalent feelings toward the client. The client often
    expresses beliefs of a wasted life. The children say that their father often
    showed love but followed it with criticism, anger, and emotional abuse. The
    nurse would suggest which intervention as most likely to be helpful at this
    time?
    1. Listen to relaxation tapes before visiting each other. If negative feelings
    arise, listen to the tapes together.

    2. Have a nurse stay in the room when a family member visits the client
    so the nurse can intervene with conflict resolution if problems arise.

    3. Assure the client and children that what matters is the present and
    the future, not the past. Encourage the children to spend more time with their
    father.

    4. Videotape each adult child speaking of a time when their father
    showed love, while the client tells of a special love for each child. Plan a
    time for them to watch the tape together.
    4
  11. The nurse working with a terminally ill client wishes to support the
    client’s decisions concerning end-of-life care. To do this appropriately, the
    nurse should plan to do which of the following?

    1. Be comfortable in assisting the client with euthanasia when
    requested to do so.

    2. Ask another nurse to provide care if the client has a belief system
    that differs from own belief system.

    3. Respect the client’s wishes about death to the extent possible by
    law.

    4. Encourage the client to request a do-not-resuscitate order because
    of terminal illness.
    3
  12. The nurse concludes that which behaviors indicate grief resolution in a
    bereaved client whose husband died a year ago? Select all that apply.

    1. Becoming future-oriented when discussing details of everyday life.

    2. Considering the opinions of the deceased prior to making decisions
    about everyday life.

    3. Experiencing occasional waves of grief triggered by pictures or
    events.

    4. Sharing stories of good times that the client and her husband shared
    over the years.

    5. Being unable to visit places that hold happy memories of times spent
    with her husband.
    1,3,4
  13. A client is dying, is in great pain, and refuses anything for relief
    that alters his sensorium. The nurse checks the psychosocial data part of the
    medical record, expecting that which religion is likely to be practiced by the
    client? Select all that apply.

    1. Islam.

    2. Judaism.

    3. Buddhism.

    4. Catholicism.

    5. Hindu.
    3,5
  14. The family of a client dying from heart failure is concerned about
    making certain their mother is comfortable as she goes through the dying
    process. Which statement indicates to the nurse that the family understands
    that lack of fluid and nutrition can promote comfort as a client dies? Select
    all that apply.

    1. “There will be less nausea and vomiting, since gastrointestinal
    secretions will be decreased.”

    2. “Natural analgesia from the body’s endorphin production will help
    with pain control.”

    3. “A dry mouth will not be a problem, even after fluids are
    discontinued.”

    4. “Coughing and mucus production will continue, even after the fluids
    are discontinued.”

    5. “Swelling and edema might decrease once we stop giving fluids.”
    1,2,5
  15. A newly hired nurse is beginning to work with dying clients in a
    hospice unit. In which order does the nurse expect to move through the stages
    of adaptation when working with this population? Place these stages in expected
    order of occurrence.

    1. Deep compassion.

    2. Emotional survival.

    3. Depression.

    4. Intellectualization.

    5. Emotional arrival.
    • 4,
    • 2, 3, 5, 1.
  16. Describe
    why role stress is more prevalent now
    than ever before in nursing.
    Increased role stress can be attributed to:

     

    A.
    The nursing shortage and increased job
    satisfaction

     

    B.
    job
    requirements that are often highly
    uncertain, unexpected, and unpredictable.

     

    C. inadequate
    socialization, rapid organizational
    change, and accelerated technology.

     

    D.
    role responsibilities and
    obligations of nurses that are often vague,
    ambiguous, and conflicting
    D
  17. In
    which of Benner's (2001) Stages of
    Nursing Expertise, has the nurse
    experienced enough real situations to make
    judgments about them?

     

    A.
    Stage 1 Novice

     

    B.
    Stage 2 Advanced Beginner

     

    C.
    Stage 3 Competent Practitioner

     

    D.
    Proficient Practitioner
    B.
  18. When a
    professional nurse's perceived role comes into conflict with the role
    performed, which of the following occurs?

     

    A. burnout

     

    B. transition or reality
    shock

     

    C. Role expectation
    conflict

     

    D. Professional
    resocialization
    •  
    • Answer
    • D:


    •  
    • Transition or reality
    • shock
  19. A new RN who is recently off
    orientation is preparing for a busy day on a
    medical nursing unit. Prioritize the
    tasks and place the options in order. All options must be used.

     

    1
    Irrigate a NG tube on a client who had a colectomy the previous day

     

    2
    Flush a poorly draining urinary catheter on an older adult client.

     

    3
    Check vital signs on a 30 year old client with a BP of 114/68 and a HR of 94

     

    4
    Change a dressing on a client with an infected diabetic foot ulcer.

     

    5
    begin a unit of packed RBC’s for a client with a Hematocrit of 23.2%
    • 5,
    • 1, 2, 4, 3
  20. The nurse preceptor observes the new RN administering
    medications. The receptor concludes there is a risk for
    medication error when the new RN takes which action?

     

    A
    Answers a physicians page while passing medications

     

    B
    uses military time to document

     

    C
    asks for help with a dosage calculation

     

    D
    does not give a medication that the client questions.
    a
  21. A client with cancer has decided to
    discontinue further
    treatment. Although the nurse would like the client to continue treatment, the
    nurse recognizes the client is competent and supports the client’s decision
    using which ethical principle?

     

     

     

    Justice

     

    Fidelity

     

    3. Autonomy

     

    4.  Confidentiality

     
    Autonomy
  22. The health care provider orders a
    medicine in a dose that is
    considered toxic. The nurse administers the medication to the client, who later
    suffers a cardiac arrest and dies. What consequence can the nurse expect from
    this situation? Select all that apply.

     

     

     

    1. The
    health care provider can be charged with negligence, being the person who
    ordered the drugs.  

     

    2. As
    the employing agency, only the hospital can
    be charged with negligence. 

     

    3. The
    nurse and the physician may be terminated
    from employment to prevent a charge of negligence to the hospital.

     

    4. Negligence
    will not be charged, as this event
    could happen to any reasonable person.


    5. The
    nurse can be charged for negligence for administering the toxic dose.
    1,5
  23. A nurse and a teacher are discussing
    legal issues related to
    practice of their professions. The teacher asks what the functions are of the
    Nurse Practice Act (NPA) in the state. The nurse would include which thoughts
    in the response? Select all that apply.

     

     

     

    1. Accredit
    schools of nursing

     

    2. Enforcing
    ethical standards of behavior

     

    3. Protect the public

     

    4. Define the scope of practice

     

    5. Determine
    liability insurance rates

     
    3,4
  24. A staff nurse concerned about
    maintaining client
    confidentiality would take which action while carrying out assign duties?

     

     

     

    1. Read
    the records of clients not assigned to the
    nurse to become more familiar with disease process.

     

    2. Share
    information about a client with nurses
    from the unit to which the client may eventually be transferred.

     

    3. Allow
    the client’s family to review the medical
    record to obtain answers to their questions.

     

    4. Share information about the client with
    those involved in planning nursing care.

     
    4
  25. The nurse working in an acute care
    environment would utilize
    which strategies to reduce the risk of malpractice litigation? Select all that
    apply.

     

     

     

    1. Discuss
    any errors with the client and family in
    detail.

     

    2. Keep
    incident reports on file.

     

    3. Maintain expertise in practice.

     

    4. Offer
    opinions to clients when the situation
    warrants.

     

    5. Reports unsafe staffing levels to
    supervisor

     

     
    3,5
  26. Which intervention would the
    nurse use to implement Imogene King’s theory of goal attainment?

     

    A. Interactions with the
    environment

    B. Determining how the client
    adapts to stress

    C. Purposeful transactions

    D. Listing self-care deficits
    c
  27. The client is being taught to
    self-administer insulin. Learning goals most likely will be attained when they
    are established by the.



    A. Nurse and client because both
    need to be responsible for teaching.
    B.  Physician and client because the
    physician is the manager of care and the client is the main participant.
    C. Client because the client is best able to identify his or her own needs and
    how to meet those needs.
    D. Client, nurse, and physician so the client can participate in planning care
    with the nurse and physician.
    D
  28. Which of the following is not a
    concept related to personal systems in Imogene King’s theory?

    A. Perception

    B. Self

    C. Body image

    D. Organization
    D
  29. Which nursing theory states that
    'nursing is the interpersonal process of action, reaction, interaction and
    transaction?

    A. Roy's adaptation model

    B. Self-care deficit theory

    C. Imogene King's theory

    D. Roger's unitary human beings
    C
  30. Leininger's theory of cultural care diversity
    and universality specifically addresses:
    A. Caring for clients from unique cultures
    B. Understanding the humanistic aspects of life
    C. Identifying variables affecting a client's response to a stressor
    D. Caring for clients who cannot adapt to internal and external environmental
    demands
    a
  31. 1.      
    A nurse is preparing a client who is scheduled
    to have a right modified radical mastectomy. Which of the following statements
    accurately describes the nurse’s role in the informed consent process?

     

    A.      Answering
    the client’s questions about information she did not understand.

    B.     
    Verifying
    that the client received the information and understands the procedure.

    C.      Explaining
    the pain that the client could encounter after surgery.

    D.      Clarifying
    information regarding the client’s alternative options for treatment.
    b.
  32. 1.      
    The health care provider orders a medication in
    a dose that is considered toxic. The nurse administers the medication to the
    client, who later suffers a cardiac arrest and dies. What consequence can the
    nurse expect from this situation? Select all that apply.

     

    A.     
    The
    healthcare provider can be charged with negligence, being the person who
    ordered the dose.

    B.      As
    the employing agency, only the hospital can be charged with negligence.

    C.      The
    nurse and physician may be terminated from employment to prevent a charge of
    negligence to the hospital.

    D.      Negligence
    will not be charged, as this event could happen to any reasonable person.

    E.     
    The
    nurse can be charged with negligence for administering the toxic dose.

     
    A, E
  33. 1.      
    The nurse working in an acute care environment
    would utilize which strategies to reduce the risk of malpractice litigation?
    Select all that apply.

     

    A.      Discuss
    any errors with the client and family in detail.

    B.      Keep
    incident reports on file.

    C.     
    Maintain
    expertise in practice.

    D.      Offer
    opinions to clients when the situation warrants.

    Report
    unsafe staffing levels to supervisor
    C,E
  34. 1.      
    A nurse and teach are discussing legal issues
    related to the practice of their profession. The teacher asks what the
    functions are of the Nurse Practice Act (NPA) in that state. The nurse would
    include which thoughts in a response? Select all that apply.

     

    A.      Accredit
    schools of nursing.

    B.      Enforce
    ethical standards of behavior.

    C.     
    Protect
    the public.

    D.     
    Define
    the scope of nursing practice.

    E.       Determine
    the liability insurance rates.
    C,D
  35. 1.      
    A staff nurse concerned about maintaining client
    confidentiality would take which action while carrying out assigned duties?

     

    A.      Read
    the records of clients not assigned to the nurse to become more familiar with
    disease processes.

    B.      Share
    information about a client with nurses from the unit to which the client may
    eventually be transferred.

    C.      Allow
    the client’s family to review the medical record to obtain answers to their
    questions.

    D.     
    Share
    information about the client with those involved in planning nursing care.
    D
  36. 1.      
    A nursing graduate who graduated 6 months ago is
    preparing to retake the NCLEX after failing in his first attempt.  What must he provide to the Board?

    a.      
    A new
    application and fee

    b.       A
    letter of recommendation

    c.       
    An official transcript

    d.       All
    of the above

    e.       
    None of the above
    A
  37. 1.      
    A
    first-time applicant for licensure in Alabama may request a nonrenewable
    temporary permit to practice nursing. This temporary permit shall expire under
    which of the following circumstances? (Select all that apply)

    a.      
    If the applicant fails the licensing
    exam

    b.      
    Once a license is issued

    c.       
    The applicant is denied licensure

    d.       The applicant is difficult to work
    with
    a,b,c
  38. 1.      
    What
    content is acceptable as continuing education for license renewal? (Select all
    that apply)

    a.      
    Specialty areas of nursing practice

    b.      
    Nursing research, theory, and practice
    issues

    c.       
    Professional conduct

    d.      
    Clinical technology, procedures, and
    nursing implications
    a,b,c,d
  39. 1.      
    A
    recent nursing graduate is working on a medical-surgical unit under a temporary
    permit until her license is issued. 
    Which of the following requires intervention by the unit manager?

    a.        The Nursing Graduate is providing AM care to a
    patient

    b.       The Nursing Graduate is providing
    nursing care to a COPD patient under the supervision of one of the staff
    nurses.

    c.       
    The Nursing Graduate has been assigned
    Charge duties because the Charge Nurse had to leave the unit for personal
    reasons.

    d.       None of the above
    c
  40. 1.      
    An
    experienced RN has just had his license revoked. What must he do to reinstate
    his license? (Select all that apply)

    a.      
    Complete and submit an Application to
    Reinstate a Nursing License

    b.      
    Wait a minimum of 1 year from the date
    of revocation prior to applying for reinstatement

    c.       
    Present substantial evidence that his
    license should be reinstated.

    d.       Schedule a meeting with a member of
    the Board of Nursing to expedite the process.
    a,b,c
  41. 1.       What are the sciences underpinning nursing
    informatics?

    A Nursing science, information science, and computer
    science

    B Nursing
    science, computer science, and business

    C Nursing
    science, information science, and allied health sciences

    D Nursing
    science, medical science, and computer science

     
    a
  42. 1.       What are the tools and methods used
    in computer and information sciences?

    A Network
    technologies, structures, management, and communication

    B
    Communication technologies, management structures, and networks

    C Information technology, structures, management, and
    communication

    D Information
    technology, management, communication, and networks
    c
  43. 1.       The best description of telehealth is
    which of the following?

    A Telehealth
    is part of communication and information system technology.

    B Telehealth
    seeks to deliver quality care to patients in remote places.

    C Telehealth
    assists nurses to deliver care to patients in underserved areas

    D Telehealth removes time and distance barriers from
    the delivery of health care services or related health care activities.
    d
  44. 1.       The Health Insurance Portability and
    Accountability Act (HIPAA) requires improved efficiency of health care
    delivery. Which of the following is a way to improve efficiency?

    A
    Structuring nursing data and information

    B Using
    ergonomics in computer design

    C Standardizing electronic data interchange

    D Increasing
    access to patient records
    c
  45. 1.       Which type of automated system is
    part of the patient safety strategy?

    A Physician
    automated history and physical record

    B Nursing
    medication administration record

    C Physician order entry system

    D Informed
    consent record
    c

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