Unit 1 NCLEX practice questions

The health care facility has sponsored a continuing education offering on Emergency Management of pandemic influenza. At lunch, a nurse is overheard saying "I'm not going to take care of anyone who might have that flu. I have kids to think about." What is true of this statement? 1. The nurse has a greater obligation than a lay person to care for the sick or injured in an emergency 2. This statement reflects defamation and may result in legal action against the nurse 3. This statement is a breach of the code of ethics for nurses 4. The nurse has this right as no nurse-patient contract has been established

Answer: 1, 3 1. Because nurses have greater ability to provide care, their obligation to provide care is higher than that of laypersons 2. The nurse has not made an inflammatory or false statement 3. According to the code of ethics, nurses need to care for patients without judgment 4. Caring for a patient is an expectation of the role. Nurses did not establish contracts with patients to deliver care

Which best describes the difference between patient privacy and patient confidentiality? 1. Confidentiality occurs between persons who are close, whereas privacy can affect anyone 2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a person's information 3. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection 4. Privacy involves protection from being watched, whereas confidentiality involves protection from verbal exchanges

Answer: 2 1. Confidentiality is an expectation of anyone who is under treatment 2. Privacy is the condition of being free from being observed or disturbed by other people. Confidentiality has to do with the sharing of someone else's information 3. Technology often causes breaches in confidentiality 4. Confidentiality goes beyond verbal exchanges; Breaches can occur electronically or in writing

An RN sees an older woman fall in the mall. The RN helps the woman. The woman later complaints that she twisted and sprained her ankle. The RN is protected from litigation under: 1. Hospital malpractice insurance 2. Good faith agreement 3. Good Samaritan law 4. Personal professional insurance

Answer: 3 1. The incident occurred outside of the hospital a good faith agreement implies that contract exists 2. The Good Samaritan law protects persons who assist at an accident scene if they act in good faith 3. Professional insurance is not in effect because the actions were not performed while on duty 4. Professional liability insurance does not necessarily cover this type of litigation

A registered nurse calls a healthcare provider to report that a patient condition is deteriorating. The physician gives orders on the telephone to draw arterial blood gases. What should the nurse do next when receiving telephone orders from a health care provider? 1. Call the respiratory therapist to obtain the blood gases 2. Give the order to the unit secretary to ensure it is entered quickly 3. Enter the order directly into the system as it was given to the registered nurse 4. Write down the order and read it back to the provider

Answer: 4 1, 2, and 3 are all steps the nurse needs to take; however, verifying the order is the most important action to take first 4. The Joint Commission on National Safety goals requires that all telephone orders be written down and read back. This ensures the accuracy of the order. Failure to follow this procedure leaves the nurse and the facility open to negligence because it is a standard of care

A nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. Under which ethical principle should the nurse practice? 1. Justice 2. Veracity 3. Autonomy 4. Nonmaleficence

Answer: 1 1. All patients are entitled to the best possible care regardless of their socioeconomic status, culture, or situations 2. Veracity refers to truthfulness 3. Autonomy is the right to make one's own decisions 4. Nonmaleficence means to do no harm

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education

Answer: 3 1. Continuing education furthers knowledge and skills within the professional domain 2. Graduate education leads to a higher level degree such as a master's or doctorate 3. In-service education takes place within an institution or agency. It is usually directed at teaching nurses who work in the institution about a new policy, standard, or type of equipment 4. Professional RN education is the basic nursing education to sit for licensure

Nursing has its origins with: 1. Florence Nightingale 2. The Knights of Columbus 3. Religious orders 4. Wars and battles

Answer: 3 1. Florence Nightingale formalized nursing practice 2. The Knights of Columbus was an organization but not a religious order 3. Religious orders such as the Sisters of Mercy assumed the role of nursing the sick and infirm 4. Wars and battles required nurses

The NCLEX for nurses is exactly the same in every state in the US. The exam: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a RN in practice

Answer: 4 1. The exam ensures minimally safe practice 2. Standards of care are designated by evidence-based practice 3. Honest and ethical care is expected and guided by the code of ethics 4. The NCLEX exam ensures that the RN has achieved the minimum knowledge and skills needed to enter practice

Nursing practice in the 21st century is an art and science that focuses on: 1. The client 2. The nursing process 3. Cultural diversity 4. The health-care facility

Answer: 1 1. Health care reform and nursing practice focus on client or patient centered care 2. The nursing process is a scientific method used by nurses to ensure the quality of patient care 3. Cultural diversity is the existence and understanding that various cultures exist within populations 4. The health care facility is the physical place where care occurs

A patient asks a nurse if he has to agree to the health care provider's treatment plan. The nurse asks the patient about his concerns. Which ethical principle is the nurse applying in this situation? 1. Beneficence 2. Autonomy 3. Veracity 4. Justice

Answer: 2 1. Beneficence is to do good 2. The principle of autonomy indicates that the client has independence to make decisions and take action for himself or herself. When the nurse asks the patient about his concerns, the nurse is exploring the reasons and allowing the patient to make his own decision 3. Veracity is to be truthful 4. Justice is to treat all patients equally

Who stated that the "function of nursing is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or a peaceful death)"? 1. Henderson 2. Rogers 3. Robb 4. Nightingale

Answer: 4 1. Henderson was built on Nightingale's theory 2. Rogers developed a theory of nursing known as the Science of Unitary Human Beings 3. Robb was the first superintendent of nurses at Johns Hopkins School of Nursing 4. Florence Nightingale defined nursing function in both the sick and well state

Several studies have shown that although care planning and advance directives are available to clients, only a minority actually complete them. Which of the following has been shown to be related to completing an advance directive? 1. African American race 2. Younger age 3. Hx of chronic illness 4. Lower socioeconomic status 5. Higher education

Answer: 5 People are more likely to complete advanced directives about their care when they are informed and they understand the ramifications of doing so. Studies have shown that certain populations are more likely to follow through with completing advanced directives when compared to others; these populations include those who have higher levels of socioeconomic status, those with higher levels of education, and people who have already suffered from a chronic disease

Which common practice puts the nurse at liability for invasion of patient privacy? 1. During care, the nurse reveals information about the patient to those in the room 2. The nurse releases information about the patient nursing students who be caring for the patient the next day 3. The nurse conducts a patient care session about a patient whose care is difficult and challenging 4. Confidential information regarding an admitted patient is released to 3rd party payers

Answer: 1 1. Giving out information about a patient without permission is an invasion of privacy 2. Providing information about the patient to those who will be caring for him or her is appropriate 3. Sharing information with those who are responsible for the patient care in order to ensure safe and effective care is appropriate 4. Patient signed release of information forms to allow this; If a form has not been signed, third party payers will not reimburse

A patient is transported to the emergency department by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating that he's having trouble breathing. Oxygen is started, but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: 1. Malpractice 2. Negligence 3. Nonmaleficence 4. Equipment failure

Answer: 1 1. Malpractice occurs when an unintentional tort causes an injury to a client 2. Malpractice falls under negligence 3. Non maleficence is an ethical principle 4. The nurse failed to open the valve; There's not any evidence that the equipment malfunctioned

After three years of uneventful employment, the nurse made a medication error that resulted in patient injury. What hospital response to this event is ethical? 1. The hospital was supportive and assisted as the nurse coped with this event 2. The nurse was dismissed for incompetence 3. The hospital quality department advised the nurse not to tell the patient about the error 4. The nurse was reassigned to an area in which there was no direct patient care responsibility

Answer: 1 1. Nurses must be held accountable for errors but should be treated in a professional and assistive manner 2. Dismissal for incompetence fails to demonstrate ethical or supportive behavior 3. Advising a professional not to discuss the error is unethical 4. Reassigning is punitive

The ANA code of ethic with interpretive statements guides nurses in ethical behaviors. Provision 3 of the code of ethics says: "the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." Which of the following best describes an example of this provision? 1. Respecting the patient's privacy and confidentiality when caring for them 2. Serving on a committee that will improve the environment of patient care 3. Maintaining professional boundaries when working with a patient 4. Caring for oneself before trying to care for another person

Answer: 1 1.The ANA code of ethics is designed to guide nurses towards quality, ethical care of patients. There may be times when it is difficult to discern the most ethical action, particularly when lines are blurred as to the correct decision. The code of ethics provides some guidance that nurses can follow as part of the profession of nursing to uphold standards of ethical care 2. Improving care environments is important but does not address the ANA code 3. Maintaining professional boundaries comes under professional behaviors 4. Caring for self is important; however, it does not address quality and ethical care

Which of the following represent the knowledge and skills expected of the professional nurse? 1. Accountability 2. Advocacy 3. Autonomy 4. Social Networking 5. Participation in nursing blogs

Answer: 1, 2, 3 1. Accountability for one's work and responsibilities 2. Advocating for patients and families 3. Autonomy is making decisions within the scope of practice 4. Social networking is not considered a knowledge or skill unique to professional nursing 5. Participation in nursing blogs is not considered a knowledge or skill unique to professional nursing

Professional accountability serves the following purpose: 1. To provide a basis for ethical decision making 2. To respect the decision of the client 3. To maintain standards of health 4. To evaluate new professional practices and reassess existing ones 5. To belong to a professional organization

Answer: 1, 2, 3, 4 1. To provide a basis for ethical decision making is a characteristic of professional accountability 2. To respect the decision of the client is a characteristic of professional accountability 3. To maintain standards of health is a characteristic of professional accountability 4. To evaluate new professional practices and reassess existing ones is a characteristic of professional accountability 5. Belonging to a professional organization demonstrates commitment to the profession, not necessarily accountability

A patient tells a nurse that he has an advanced directive from six years ago. The nurse looks at the medical record for the advance directive. What content should the nurse expect to find in the advanced directive? 1. Decisions regarding treatments 2. When to take the patient to the hospital 3. DNR orders 4. Who should be notified in the case of illness, injury, or death 5. Durable power of attorney for healthcare 6. HIPAA protocols

Answer: 1, 2, 3, 5 The advanced directive provides instructions for future health care decisions if the patient becomes unable to make personal treatment choices

A registered nurse is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the registered nurse must ensure which of the following? 1. The client is not sedated 2. The doctor is present 3. A family member is a witness 4. The signature is in ink 5. The patient understands the procedure

Answer: 1, 5 1, 5. Before surgery, the nurse needs to ensure that the patient fully understands what the physician told him or her about the procedure and that the consent form has been signed before any preoperative sedation is administered 2. The physician needs to provide the information so that the patient is fully informed; The nurse may obtain the signature but needs to ensure that the patient is aware and understands 3. The nurse acts as a witness 4. Although the signature should be an ink, often electronic signatures are obtained

APRN's generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting 5. Hold advanced degrees

Answer: 1, 5 Although APNs work in a variety of settings, they all: 1. Function independently as guided by the nurse practice acts of the individual states 2. Are educated to provide higher level patient care 3. May work in acute care settings 4. May work in university settings 5. Are educated at the master's level or higher

Which of the following is unique to a professional standard of decision making? 1. Weighs benefits and risks when making a decision 2. Analyzes and examines choices more independently 3. Concrete thinking 4. Anticipates when to make choices without others' assistance

Answer: 1,2 Professional behaviors include accountability and sound decision-making abilities. 1. Professionals look at risks and benefits before making a decision 2. They analyze choices in order to make sound decisions 3. Concrete thinking is literal and focuses on the physical world 4. Professional decision making occurs independently

A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision? 1. The nurse can back up her reasons for why she has decided to provide a certain type of care 2. The nurse can compare the benefits of one choice over another 3. The nurse can communicate the best choice of action to the interdisciplinary team 4. The nurse can provide care based on developed policies and standards

Answer: 2 1. Although important to be able to support reasons, lists do not help with this 2. Creating a list of positives and negatives helps when difficult choices need to be made. The list outlines the positive and negative aspects of a decision. It allows the nurse to compare the benefits of making a choice versus the potential disadvantages. When compared side by side, it could help the nurse to make a difficult decision through an easier method 3. Communicating the choice occurs after the list is created 4. Providing care should always be based on policies and standards

A nurse's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. What practice is the most appropriate? 1. The nurse is an employee; therefore, access to the chart is permissible 2. Access to the chart requires a signed release form 3. The relationship with the client provides the nurse special access to the chart 4. The nurse can ask the surgeon to discuss the outcome of the surgery

Answer: 2 1. Being an employee does not give permission to access the chart 2. Unless the significant other has authorized any access to information, the only people entitled to information without written consent are the client and those providing direct care 3. The patient still needs to give consent 4. The surgeon cannot discuss the patient's health without consent from the patient

Health insurance portability and accountability act regulations guard confidentiality. In several situations, confidentiality can be breached and information can be reported to other entities. Which of the following meet these criteria? 1. The patient is from a correctional institution 2. The situation involves child abuse 3. An injury occurred from a firearm 4. The patient is a physician 5. The breach of information was unintentional

Answer: 2,3 1. The health information of incarcerated patients is still protected under HIPAA 2. Although HIPAA provides protections for patient privacy, there are some cases in which health care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, I want a patient is injured because of a firearm or some other weapon 3. Although HIPAA provides protections for patient privacy, there are some cases in which health care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, I want a patient is injured because of a firearm or some other weapon 4. Individual occupations and vocations are protected 5. Any breach of information, intentional or unintentional, violates HIPAA

An RN new to the emergency department documented that "the patient was intoxicated and acted in a crazy manner." The team leader told the RN that this type of documentation can lead to: 1. Assault 2. Wrongful publication 3. Defamation of character 4. Slander

Answer: 3 1. Assault is a threat to do harm 2. Wrongful publication refers to erroneous information in writing 3. Charting or saying unsupported defamatory statements can lead to tort litigation 4. Slander is making an untrue statement that causes harm to someone's reputation

A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and health care provider. The nurse realizes this is an example of: 1. Affirming a value 2. Choosing a value 3. Prizing a value 4. Reflecting a value

Answer: 3 1. To affirm means to strongly state a fact, not indicating satisfaction with the choice 2. Choosing is to decide what is important 3. Pricing a value means being satisfied with a choice and being willing to declare the choice to others. The patient made her choice clear to her family and provider 4. Reflecting a value means considering it

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional RNs to guide care decisions. A non-nursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves communication between the nurse and the patient 2. Protects the patient's right of autonomy 3. Ensures identical care to all patients 4. Acts as a guide for professional behaviors in giving patient care

Answer: 4 1. Although good communication is expected, it is not considered an ethical code 2. Protecting autonomy is part of the ethical code 3. All individuals are entitled to equitable care; however, nursing care is patient centered, so care, although equitable, may not be identical 4. Code of ethics provide guidelines for appropriate professional behaviors and guide practice

A registered nurse has asked a licensed practical nurse to trim the toenails of a diabetic patient. The LPN trims one too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital, the RN, and the LPN. What might all three be found guilty of? 1. Unintentional tort 2. Intentional tort 3. Negligence 4. Malpractice

Answer: 4 1. Although this was performed without malice and it is considered unintentional tort, harm occurred, making the action malpractice 2. The licensed practical nurse did not intend to hurt the patient 3. Negligence falls in the category of an unintentional tort 4. Malpractice occurs when an unintentional tort causes an injury to a client

Which of the following demonstrates a nurse as advocating for a patient? The nurse: 1. Calls a nursing supervisor in conflicting situations 2. Reviews and understands the law as it applies to the client's clinical condition 3. Documents all clinical changes in the medical record in a timely manner 4. Assesses the client's POV and prepares to articulate this

Answer: 4 1. Calling the supervisor does not demonstrate speaking or advocating for the patient 2. Values and ethics are beliefs 3. Documenting clinical changes is important; however, this is not advocating 4. Nurses strengthen their ability to advocate for client when nurses can identify personal values and then accurately identify the values of the client and articulate the client's POV