NCLEX-PN Practice Exam #7 -> answers with explanation
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Practice Tests: NCLEX-PN Practice Exam #7 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. Following the change of shift report, the nurse should analyze the information and set priorities accordingly. When the plan has been formulated, at what point during the shift can or should the nurse's plan be altered or modified?
- halfway through the shift
- at the end of the shift before the nurse reports off
- when needs change
- after the top-priority tasks have been completed
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2. The intent of the Patient Self Determination Act (PSDA) of 1990 is to:
- enhance personal control over legal care decisions
- encourage medical treatment decision making prior to need
- give one federal standard for living wills and durable powers of attorney
- emphasize client education
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3. In the process of an annual physical exam, a client is diagnosed with Benign Prostatic Hypertrophy (BPH). Which type of physician this client is likely to have a consult with?
- gynecologist
- physiatrist
- urologist
- proctologist
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4. Legal protection of confidentiality.
- extends only to written documentation
- extends to the electronic dissemination of information not identifiable to a specific client
- is important only within the court system
- extends to both written and verbal information
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5. Mr. H. is upset regarding 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:
- the right to examine and question the bill
- the right to reasonable response to requests
- the right to refuse treatment
- the right to confidentiality
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6. A fifty-five-year-old man suffered a left frontal lobe CVA. The patient's family is not present in the room. Which of the following should the nurse watch most closely for?
- changes in emotion and behavior
- monitor loss of hearing
- observe appetite and vision deficits
- changes in facial muscle control
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7. All of the following are common reasons that nurses are reluctant to delegate except:
- lack of self-confidence
- desire to maintain authority
- confidence in subordinates
- getting trapped in the "I can do it better myself" mindset
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8. A client with massive chest and head injuries is admitted to the ICU from the Emergency Department. All of the following are true except:
- the physician in charge of the case is the only person allowed to decide whether organ donation can occur.
- the client's legally responsible party may make the decision for organ donation for the donor if the client is unable to do so.
- the organ procurement organization makes the decision regarding which organs to harvest.
- a declaration of wishes or documentation of wishes regarding organ donation by the donor is necessary for organ harvesting
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9. Referral for client education in the community can be accomplished through all of the following except:
- community agencies such as the American Heart Association
- parish nurses
- home health care agencies
- unlicensed massage therapists
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10. The focus of a nurse case manager is:
- nursing care needs at discharge
- the comprehensive care needs of the client for continuity of care
- client education needs upon discharge
- financial resources for needed care
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11. A two-year old has been in the hospital for 3 weeks and seldom seen family members due to isolation precautions. Which of the following hospitalization changes is most like to be occurring?
- Guilt
- Trust
- Separation anxiety
- Shame
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12. Which of the following factors can impact an individual's ability to give informed consent?
- IQ
- educational level
- pain medications
- financial status
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13. A nurse runs into the significant other of a patient with end stage AIDS crying during her smoke break. Which of the following is most appropriate action for the nurse to take?
- Allow her to grieve by herself.
- Tell her go ahead and cry, after all your husband's pretty bad off.
- Tell her you realize how upset she is, but you don't want to talk about it now.
- Approach her, offering tissues and encourage her to verbalize her feelings.
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14. The LPN is helping a patient get out of bed to use the restroom. Which of these actions represents proper ergonomic practice?
- Aid the patient in sitting/standing by lifting with the legs and keeping the back straight.
- Bend over the patient to get a good grip when sitting the patient up.
- Lift the patient into a standing position by using your leg and back muscles.
- Let the patient use your body to pull up in a sitting, then standing, position.
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15. If your patient is acutely psychotic, which of the following independent nursing interventions would not be appropriate?
- Conveying calmness with one on one interaction.
- Recognizing and dealing with your own feelings to prevent escalation of the patient's anxiety level.
- Encourage client participation in group therapy.
- Listen and identify causes of their behavior.
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16. The nurse and a colleague are on the elevator after their shift, and they hear a group of health caregivers discussing a recent client scenario. Which client right might be breached?
- right to refuse treatment
- right to continuity of care
- right to confidentiality
- right to reasonable responses to requests
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17. A 45-year-old client with type I diabetes is in need of support services upon discharge from a skilled rehabilitation unit. Which of the following services is an example of a skilled support service?
- shopping for groceries
- house cleaning
- transportation to physician's visits
- medication instruction
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18. Which of the following individuals may legally give informed consent?
- an 86-year-old male with advanced Alzheimer's disease
- a 14-year-old girl needing an appendectomy who is not an emancipated minor
- a 72-year-old female scheduled for a heart transplant
- a 6-month-old baby needing bowel surgery
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19. The greatest time savers when planning client care include all of the following except:
- reacting to the crisis of the moment
- setting goals
- planning
- specifying priorities
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20. A wrong committed by one person against another (or against the property of another) that might result in a civil trial is:
- a tort
- a crime
- a misdemeanor
- a felony
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21. People who live in poverty are most likely to obtain health care from.
- their primary care physician (family doctor)
- a neighborhood clinic
- specialists
- Emergency Departments or urgent care centers
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22. A nurse discharge planner is preparing a client for discharge from an acute care setting. The nurse assesses that skilled home care services are clinically indicated. This assessment is based on all of the following indicators except:
- the client has been admitted to the hospital three times in the last 2 months.
- the client has a Foley catheter.
- the client's family is available to care for him 24 hours a day.
- the client is ordered to continue IV antibiotics 5 days post discharge.
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23. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?
- a radiologist
- a gynecologist
- a physiatrist
- an oncologist
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24. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:
- assessment
- crisis intervention
- empathetic concern
- unwarranted intrusion
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25. The power a nurse exerts when he or she works to accomplish goals and effect change in an agency or in policy is considered type of power.
- political
- personal
- positional
- professional
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26. At what point in the nurse-client relationship should termination first be addressed?
- in the working phase
- in the termination phase
- in the orientation phase
- when the client initially brings up the topic
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27. Client self-determination is the primary focus of:
- malpractice insurance.
- nursing's advocacy for clients.
- confidentiality.
- health care.
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28. Quality is defined as a combination of all of the following except:
- conforming to standards
- performing at the minimally acceptable level
- meeting or exceeding customer requirements
- exceeding customer expectations
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29. On first meeting, a new nurse manager makes eye contact, smiles, initiates conversation about the previous work experience of nurses, and encourages active participation by nurses in the dialogue. Her behavior is an example of:
- aggressiveness
- passive aggressiveness
- passiveness
- assertiveness
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30. The physician's role in case management includes all of the following except:
- participating in interdisciplinary planning for clients.
- serving as the expert for resource utilization.
- consulting with the case management team to facilitate timely orders as needed.
- contributing to the documentation of a client's needs for services.
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31. A 22-year-old patient in a mental health lock-down unit under suicide watch appears happy about being discharged. Which of the following is probably happening?
- The patient is excited about being around family again.
- The patient's suicide plan has probably progressed.
- The patient's plans for the future have been clarified.
- The patient's mood is improving.
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32. The death of a beloved spouse places the surviving partner in type of crisis.
- maturational
- reactive
- nonreactive
- situational
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33. A nurse is covering a pediatric unit and is responsible for a 15-year-old male patient on the floor. The mother of the child states, "I think my son is sexually interested in girls." The most appropriate course of action of the nurse is to respond by stating:
- "I will talk to the doctor about it."
- "Has this been going on for a while?"
- "How do you know this?"
- "Teenagers often exhibit signs of sexual interest in females."
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34. All of the following tasks could be delegated to a nursing assistant or unlicensed assistive personnel (UAP) except:
- monitoring intravenous infusion.
- assisting a client to the bathroom.
- offering fluid intake every 1-2 hours.
- monitoring/recording the amount of fluid taken.
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35. You are working in a pediatric unit of the hospital and caring for a six-year-old boy who is hospitalized with cystic fibrosis and respiratory compromise. Which developmental task is the challenge for this boy at his age?
- To cough, deep breath and improve respiratory status.
- To establish industry and self-confidence.
- To develop autonomy and self-control.
- To develop initiative and a sense of purpose.
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36. A nursing advocate is one who:
- makes decisions for others
- encourages persons to make decisions for themselves and acts with or on behalf of the person to support those decisions
- manages the care of others
- is the legal representative for a person
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37. The ethical principle of keeping professional promises or obligations is:
- veracity
- autonomy
- fidelity
- beneficence
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38. Carrying a donor card for organ donation means that:
- medical care is altered in the event of serious injuries to get organs for donation
- the family or legally responsible party of a client has no decision-making authority in the event that the client is considered for organ donation
- a client is allowed to revoke his decision for organ donation at any time
- a client is considered an organ donor for only one organ or tissue
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39. A 14-year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse first response be?
- Create an atmosphere of seclusion for the boy according to procedures.
- Remove other patients from the area via wheelchairs for added speed.
- Ask the patient, "What is making you mad?"
- Ask the patient, "Why are you doing this, have you thought about what your parents might say?"
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40. An advance directive is written and notarized according to law in the state of Colorado. This document is legal and binding.
- internationally
- in the state of Colorado only
- in the continental United States
- in the county of origination only
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41. As a type of quality indicator, an example of a structure standard is:
- a written philosophy.
- a procedure for a straight catheterization.
- a protocol for treatment of a client with chest pain.
- the diagnostic work-up for a client with abdominal pain.
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42. While walking in the hallway of an acute care unit of the hospital, the nurse overhears the change of shift report. The nurse should:
- make the charge nurse on the unit aware of the situation so that he or she can take the necessary steps to maintain the confidentiality of the information being reported
- disregard the information because it changes quickly on the acute care unit and is outdated within 2-3 hours anyway
- return to his or her own unit and not disclose that confidential information has been overheard
- ignore the situation
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43. According to the ANA Code of Ethics for Nurses, professional nurses have an ethical obligation to:
- clients (patients)
- the profession of nursing
- provide high-quality care
- all of the above
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44. The nurse uses prioritization to determine all the following except:
- time allotment for certain tasks
- appropriate interventions
- treatment procedures
- the need for client education
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45. There are many types of torts that can be committed against clients. They include all of the following except:
- assault
- battery
- negligence
- felony
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46. Delegation of tasks to appropriate personnel allows the nurse to:
- take a break
- keep other members of the team productive
- maintain tight control of all aspects of the workflow
- realize the importance of her role by making all decisions
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47. A young female teenager describes a brutal assault and rape to the nurse on duty. Which of the following actions should the nurse take first?
- Check with case manager on duty about possible police intervention.
- Provide an environment of concern and emotional stabilization.
- Clean the patient's wounds with normal saline and gauze.
- Recommend a good attorney to the patient.
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48. Common problems for supervisors include all of the following except:
- the supervisor facilitates development of staff members.
- the supervisor micromanages staff members.
- the supervisor wants to control the style in which a staff member correctly performs a task.
- the supervisor does not delegate.
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49. The nurse acts as an advocate for the nursing profession by performing all of the following activities except:
- encouraging political involvement by nurses with their legislators.
- acting as a first-aid provider for a children's athletic team.
- precepting newly licensed nurses in the work situation.
- encouraging as many persons to become nurses as possible.
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50. Activities of effective supervisors can be task-related or people-related activities. An example of a task-related supervisory activity is:
- coaching
- evaluating
- delegating
- facilitating
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