Thursday, May 22, 2008

Sample NCLEX Questions

1. Your patient is considering participating in a multi-site trial of a new cancer medication. According to the " Patient's Bill of Rights," it is important for the patient to know that:

all costs of research are paid by the patient.

he has the right to refuse to participate in research without fear of loss of care.

the physicians will no longer be caring for him if he does not participate in the research.

the research study is his only hope of treatment.

2. At 8:30 a.m. on a Thursday morning, several small canisters exploded in a bus station. Later in the day, many of the people who were present at the time of the explosion developed shortness of breath and muscle and chest pain. The hazardous materials (Hazmat) team has determined the canisters contained Ricin. All of the following statements about Ricin are correct except:

inhaled Ricin attacks the respiratory system, causing pneumonia and pulmonary edema.

ingested Ricin causes gastrointestinal bleeding, which can lead to death.

Ricin can be produced in an aerosolized form and solid form.

symptoms of Ricin toxicity begin 48 to 72 hours after exposure.

3. While attending closed medical case rounds, you are giving as a part of the teaching-learning process a detailed written case that is to be further discussed. In the course of the discussion, the identity of the patient becomes known to the group. You should:

dispose of any class notes in the regular trash.

stop the discussion immediately after the identity of the patient is known.

participate in the discussion while in class, but dispose of the case information in the shredded trash after the presentation.

respect the patient's confidentiality by leaving the presentation at the point at which the identity of the patient becomes known.

4. Family members had a variety of negative reactions to the restraining of their relative in acute care settings. These reactions were:

"She didn't do anything and she's tied up."

"My mother was overjoyed over the restraint as it felt secure. "

"The restraints are a good thing for older people."

"Collaboration is always excellent here concerning restraints."

5. The goal of delegation is:

staff satisfaction.

workload distribution.

effective management.

prioritizing patient care needs.

6. Which activity is part of the termination phase of the therapeutic relationship?

Selecting behaviors that will terminate the relationship.

Discussing the expectations of the nurse and client.

Relating feelings generated by separation to former losses.

Selecting alternative responses to situations.

7. Priority setting occurs during which step of the nursing process ?

Assessment.

Planning.

Intervention.

Evaluation.

8. A client and nurse contracted to meet for 10 weeks. Beginning at the seventh week, the client starts arriving late to the meetings and engages mostly in superficial talk. The nurse recognizes this behavior is:

because the client has other responsibilities.

due to the client's anger over the upcoming termination.

the client oversleeping due to increased depression.

a relapse of the progress made earlier in the relationship.

9. The teaching plan for a comprehensive sex education program should include all of the following goals except:

teach appropriate values, beliefs, and attitudes about sexuality.

communicate accurate information about sexuality.

help students develop relationships and interpersonal skills.

encourage the exercise of responsibility in sexual relationships.

10. Potential quality indicators that may be the focus of unit-based quality improvement (CQI) activity on a med-surg unit are all of the following except:

medication errors.

incisional wound infections.

incidence of pneumonias post-operatively.

number of readmissions with primary diagnosis of CHF.

11. All of the following are true as a nurse designates a task as high priority except:

priorities are physiological.

priorities are psychological.

if untreated could result in harm to the client.

involve a quick response to needs as determined by the nurse independently from the client involved.

12. At 11:00 a.m., Mr. P. is brought to the unit from the emergency room for admission. Lying on the transport cart, he is complaining of severe nausea and is dry heaving into an emesis basin. His wife and son are with him. What would be the most appropriate action for the nurse to take at this time?

Help get Mr. P. into bed and orient him to the bed controls.

Help get Mr. P. into bed and begin to fill out the detailed admission assessment form.

Ask him whether he has valuables for the safe.

Help get Mr. P. into bed, properly positioned for comfort, and begin focused abdominal assessment targeting his nausea.

13. Which cranial nerve is responsible for chewing movement?

Facial.

Abducens.

Trigeminal.

Hypoglossal.

14. Which of the following signs or symptoms would alert a nurse to increasing intracranial pressure in a client with acute head trauma?

Widening pulse pressure.

Narrowing pulse pressure.

Tachycardia.

Regular respirations.

15. Which of the following terms describe a complication of rheumatoid arthritis where the fingers become bent outward?

Hallux valgus

Wwan-neck deformity.

Boutonniere deformity.

Ulnar drift.

16. Which of the following statements by a client indicates a need for further teaching by the nurse regarding prevention and treatment of Lyme disease?

"I will spray insect repellant on myself."

"I will tell my doctor about a bull's eye rash."

"If I see a tick, I will twist it out of my skin."

"I will avoid walking in tall grass."

17. A client who is an intravenous drug abuser had an appendectomy. He requests morphine sulfate for pain relief every hour, and it is only ordered every four hours. What is the appropriate response of the nurse?

Tell him it is only ordered every four hours.

Let him know his addiction may get worse.

Notify the physician of his request.

Instruct him on possible side effects.

18. Where should a nurse administer eye drops?

Inner corner of the eye.

Outer corner of the eye.

Directly over the cornea.

Center of conjunctival sac.

19. If a patient is deemed "incompetent," this means that:

he/she can't afford to pay the hospital bill.

he/she won't follow medical direction.

a court proceeding has declared him/her unable to make his/her own decisions.

as a nurse you have assessed that he/she is not making good choices or decisions.

20. A "DNRCC" code means that:

the patient should not have their symptoms actively treated.

the patient's care is less priority than another patient whose code status is full code.

therapies and treatments have been limited to those that promote comfort.

it's no longer necessary to take the patient's vital signs.

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2 comments:

  1. the link to the answers dont work!!!!!!!!

    ReplyDelete
  2. Sorry about that: here are the answers:

    ANSWER/RATIONALE
    1. (2) The "Patient's Bill of Rights" describes the right of the patient to refuse to participate in research without the fear of loss of care by the health care team. He will still be cared for by physicians and nurses on the team and other treatment options may be offered. The costs of research are commonly at least partially paid by the research study.

    2. (4) Ricin effects begin 1-12 hours; Ricin is a toxin isolated from castor beans; Ricin is a potent toxin that can be isolated from the "mash" that remains after castor beans are processed to make castor oil. Two to four castor beans contain enough Ricin to kill an adult. Ingestion of one castor bean can be lethal to a child; Ricin causes tissue necrosis pneumonia, internal bleeding, and vascular collapse. Ricin is not volatile; therefore, secondary inhalation is not a hazard. However, skin contact should b avoided, and the patient should be washed with diluted bleach solution, soap and water.

    3. (3) Many times in medical teaching-learning situations, the identity of the patient is known through the presentation information. When a patient's identity is known, the teaching-learning process may still occur while maintaining the confidentiality of the information presented and the learner need not remove him/herself from this process. It is important, however, to remember not to continue the spread of he information through discussions where information may he dispersed publicly. It is also important to appropriately shred written documents which may carry information that may be identified as belonging to a specific patient.

    4. (1) Kansi and co-workers found that family members of patient being restrained in acute care settings had a variety of negative reactions to this intervention. The authors give examples of family members' statements such as these. "She didn't do anything and she's tied up." "It made me mad--They just walked in, put on the restraint and never said a word. " "She didn't need to be restrained. She couldn't move her right arm and uses her left hand to position her right arm. My mother started to cry when they tied her wrist. "

    5. (2) Delegation is an effective method of workload distribution as tasks are shared within a team.

    6. (4) The determination phase is the most difficult phase, but is also an essential part of the relationship. Tasks during this phase include evaluating progress, exploring feeling of rejection, making referrals if necessary, and relating the feelings generated by the anticipated loss to other losses the client has experienced.

    7. (2) After formulating specific diagnoses as part of the planning process, the nurse uses critical thinking skills to establish priorities by ranking them in the order of their importance.

    8. (2) Clients may display covert anger as termination of the relationship is approaching by arriving late, missing meetings, and engaging in superficial talk. When the nurse recognizes this happening, the nurse can help the client identify and explore the feelings behind the behavior.

    9. (1) The nurse should provide opportunities for the students to develop their own values, beliefs and attitudes about sexuality, but should not determine for the student what those should be teaching "appropriate" values. Options 2, 3, and 4 are all goals of a comprehensive sex education program. Many times students have not gotten accurate information about sexuality because too few parents discuss sexual issues with their children and many schools focus only on biological facts to avoid controversy. The comprehensive program will help students develop positive views of sexuality, gain factual information about sexual health and the skills to maintain it, and provide students with the opportunity to acquire decision- making abilities related to sexual issues. The goal is not to just provide facts because knowing about sexual issues doesn't necessarily change sexual behavior.

    10. (4) A quality indicator is a quantitative measure of an important aspect of care that determines whether standards are being met. It is a standard of performance. On a med-surg unit, specific care indicators could include: medications errors, incisional wound infections, post-op incidence of pneumonia. The number of re-admissions with a primary diagnosis of CHF would be more likely to be institutional focused due to the high volume potential exceeding that of the unit activity in caring for those patients.

    11. (4) Priority setting by the nurse should always include the patient in the decision making whenever possible. A nurse's perception of a priority task may be different than that of a patient's. Respecting the right of autonomy, the patient should be involved in the decision making.

    12. (4) Although the process for admission is an important one, in this instance the priority for the nurse becomes intervening on behalf of the patient for comfort. Once the symptoms are alleviated, the patient can then better participate in the rest of the admission process.

    13. (3) The trigeminal nerve is responsible for chewing movement. The remaining options are cranial nerves with other functions.

    14. (1) Widening pulse pressure is a classic sign of increasing intracranial pressure, not the other options.

    15. (4) Ulnar drift describes a complication of rheumatoid arthritis, where the fingers become bent outwards. The remaining terms describe other types of deformities associated with rheumatoid arthritis.

    16. (3) If a tick is seen on the skin, it should be gently pulled straight out. This will ensure getting all of the tick removed. The other statements are correct and indicate correct understanding of Lyme disease.

    17. (3) This is the only correct response. An intravenous drug abuser may require greater doses of morphine sulfate in order to obtain adequate pain relief. Pain is whatever the client says that it is, and the nurse must respond accordingly.

    18. (4) Eye drops should be administered in the center of the conjunctival sac. If they are placed directly over the cornea, some may cause corneal damage. Pressure over the inner corner of the eye is often held during some eye drop administration in order to avoid systemic absorption. Instilling into the outer corner of the eye would not facilitate maximal distribution of the medication.

    19. (3) is correct. Only the court can determine incompetency status based on medical and psychological evaluation. Choices 1, 2, and 4 are incorrect. Choice 1 speaks to financial status only, which is not an issue of incompetence. Choice 2 is nonadherance. Choice 4 falsely implies that a nurse may judge incompetence based on his/her perceptions of the quality of decision making.

    20. (3) is correct. Patients with this status should have quality symptom management to ensure comfort without efforts for sustaining/prolonging life. Choices 1, 2, and 4 are incorrect. All patients should have equal access to care regardless of code status. Ongoing patient assessment needs to be ongoing to monitor and ensure that comfort goals are met.

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