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Certification Path for NCLEX-RNî Examination
The NCSBN Board of Directors (BOD) reevaluates the passing standard once every three years. The criterion that the BOD uses to set the standard is the minimum level of ability required for safe and effective entrylevel nursing practice.
To assist the BOD in making this decision, they are provided with information on:
- Information describing the educational readiness of high school graduates who express an interest in nursing
- The results of a standard setting exercise performed by a panel of experts with the assistance of psychometricians
- The historical record of the passing standard with summaries of the candidate performance associated with those standards
- The results of a standard setting survey sent to educators and employers; and
Once the passing standard is set, it is applied uniformly to every examination according to the procedures laid out in the Scoring the NCLEX section. To pass the NCLEX, a candidate must perform above the passing standard. There is no fixed percentage of candidates that pass or fail each examination.
NEW QUESTION 297
Which of the following individuals may legally give informed consent?
- A. an 86-year-old male with advanced Alzheimer's disease
- B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- C. a 6-month-old baby needing bowel surgery
- D. a 72-year-old female scheduled for a heart transplant
Answer: D
Explanation:
Section: Safe and Effective Care Environment
Explanation:
The 72-year-old client scheduled for heart transplant surgery may give informed consent for the surgery. There are no age limitations with the exception of minors.
Choices "an 86-year-old male with advanced Alzheimer's disease", "a 14-year-old girl needing an appendectomy who is not an emancipated minor" and "6-month-old baby needing bowel surgery" are incorrect.
An individual with advanced Alzheimer's disease is incompetent to make decisions.
Only an emancipated minor may give consent (a 14-year-old child who lives alone, away from family, and is totally independent).
Infants are unable to give consent.
NEW QUESTION 298
A woman is in the active phase of labor. An external monitor has been applied, and a fetal heart deceleration of uniform shape is observed, beginning just as the contraction is under way and returning to the baseline at the end of the contraction. Which of the following nursing actions is most appropriate?
- A. No action is necessary.
- B. Administer O2.
- C. Turn the client on her left side.
- D. Notify the physician.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
It is an early deceleration as a result of head compression, and at this time no action is necessary. Close observation of the mother and baby is needed. Physiological Adaptation
NEW QUESTION 299
For a client requiring total oral care, it is important for the nurse to __________.
- A. place client in Fowler's position, prepare the equipment, and tell the client what to do
- B. assemble all equipment, assist the client to semi-Fowler's position, and place a towel on his chest
- C. assemble all equipment, place the client in a side-lying position, and place a towel under his chin
- D. use gloves and clean the client's mouth, including the tongue
Answer: C
Explanation:
Section: Physiological Integrity
Explanation:
Assemble all equipment first; place the client in a side-lying position so that fluid can easily flow out or pool in the side of the mouth for suctioning (to prevent aspiration); and then place a towel under the client's chin and a curved basin against the chin. Gloves should be worn.
NEW QUESTION 300
The nurse seeks to assess the renal function of an elderly client who is about to receive a nephrotoxic medication. Which of the following labs provides the best indicator for renal function?
- A. creatinine clearance
- B. chemistry of electrolytes
- C. urinalysis
- D. creatinine and blood urea nitrogen
Answer: A
Explanation:
Due to decreases in lean body mass, blood creatinine is not as good an indicator of the elderly client's renal function as creatinine clearance. Urinalysis and blood urea nitrogen reflect hydration status and other clues to health but are not specific for renal function. The electrolytes might be deranged in renal failure but are not a direct correlation to the kidneys' capability to eliminate waste. Therefore, the best lab for renal function in the elderly is thought to be creatinine clearance, which is a widely used test for glomerular filtration rate.Safety andInfection Control
NEW QUESTION 301
Major competencies for the nurse giving end-oflife care include:
- A. keeping all sad news away from the family and client.
- B. demonstrating respect and compassion, and applying knowledge and skills in care of the family and the client.
- C. setting goals, expectations, and dynamic changes to care for the client.
- D. assessing and intervening to support total management of the family and client.
Answer: B
Explanation:
There are many competencies that the nurse must have to care for families and clients at the end of life. Demonstration of respect and compassion as well as using knowledge and skills in the care of the client and family are major competencies.Basic Care and Comfort
NEW QUESTION 302
Referral for client education in the community can be accomplished through all of the following except
__________.
- A. home health care agencies
- B. community agencies such as the American Heart Association
- C. unlicensed massage therapists
- D. parish nurses
Answer: C
Explanation:
Section: Safe and Effective Care Environment
Explanation:
Client education should be completed by an individual or individuals with acknowledged expertise in the subject area and credentials to support activity within the health care community.
NEW QUESTION 303
A patient has recently been diagnosed with symptomatic bradycardia. Which of the following medications is the most recognized for treatment of symptomatic bradycardia?
- A. Nitroglycerin
- B. Atropine
- C. Questran
- D. Digitalis
Answer: B
Explanation:
Explanation/Reference:
Explanation:
Atropine encourages increased rate of conduction in the AV node.
NEW QUESTION 304
As part of a routine health screening, the nurse notes the play of a 2-year-old child.
Which of the following is an example of age-appropriate play at this age?
- A. tries to color within the lines
- B. says "Mine!" when playing with toys
- C. builds towers with several blocks
- D. tries to jump rope
Answer: B
Explanation:
Section: Health Promotion and Maintenance
Explanation:
Toddlers are possessive and struggle for independence.
The other play activities are too advanced for a 2-year-old child.
NEW QUESTION 305
Which type of diet should the nurse provide to help a client who has major burns maintain a positive nitrogen balance?
- A. high protein
- B. high carbohydrate
- C. low carbohydrate
- D. low protein
Answer: A
Explanation:
Explanation/Reference:
Explanation:
Clients with burns are hypermetabolic and require increased protein levels to maintain a positive nitrogen balance. Choices 2 and 3 are incorrect; carbohydrate levels do not help clients to meet this goal. Choice 4 is incorrect; a client with major burns requires a high-protein diet. Basic Care and Comfort
NEW QUESTION 306
A 27-year-old female patient comes in complaining of calf pain.
Which question, if asked by the LPN, would be the least helpful?
- A. Have you traveled recently?
- B. Are you on birth control?
- C. What herbal supplements do you take?
- D. Do you smoke?
Answer: C
Explanation:
Section: Physiological Integrity
NEW QUESTION 307
A nurse gave medications to the wrong client. She stated the client responded to the name called. What is the nurse's appropriate documentation?
- A. Completely fill out an incident report
- B. Note the client's orientation
- C. Note in medication records the drug given
- D. The client was not hurt, no need for documentation
Answer: A
Explanation:
The incident report should always be filled out involving medication errors.
NEW QUESTION 308
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:
- A. "Has this been going on for a while?"
- B. "I will talk to the doctor about it."
- C. "Teenagers often exhibit signs of sexual interest in females."
- D. "How do you know this?"
Answer: C
Explanation:
Explanation/Reference:
Explanation:
Adolescents exhibiting signs of sexual development and interest are normal.
NEW QUESTION 309
The mother of a newborn child is very upset. The child has a cleft lip and palate. The type of crisis this mother is experiencing is:
- A. situational.
- B. maturational.
- C. reactive.
- D. adventitious.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
The arrival of the imperfect child that the mother had not envisioned places the mother in a situational crisis.
Choice 1 is not an option. Choice 2 is an identified specific time period in normal development when anxiety and stress increase. Choice 4 is a crisis that occurs outside the person's control so that the person has a disruption in social norms. Psychosocial Integrity
NEW QUESTION 310
Acute hyphema is associated with what type of injury?
- A. eye
- B. orthopedic
- C. gynecological trauma
- D. insect sting or snakebite
Answer: A
Explanation:
Explanation/Reference:
Explanation:
An acute hyphema occurs as a result of a blunt injury to the eye and is manifested by a half-moon appearance or a horizontal line across the globe when the client is upright (due to blood collected in the anterior chamber). Safety and Infection Control
NEW QUESTION 311
A nurse is working in an outpatient orthopedic clinic. During the patient's history the patient reports, "I tore 3 of my 4 Rotator cuff muscles in the past." Which of the following muscles cannot be considered as possibly being torn?
- A. Teres minor
- B. Infraspinatus
- C. Supraspinatus
- D. Teres major
Answer: D
Explanation:
Section: Physiological Integrity
Explanation/Reference:
Explanation:
Teres Minor, Infraspinatus, Supraspinatus, and Subscapularis make up the Rotator Cuff.
NEW QUESTION 312
Client education by the nurse entails:
- A. giving the client medication when pain is experienced.
- B. telling the client everything about his disease, what is going to happen in the course of the disease, and the outcome.
- C. giving information to the client that is accurate and understandable.
- D. telling the client that the pain he experiences might not be real.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
Client education entails giving the client accurate and understandable information. Basic Care and Comfort
NEW QUESTION 313
The nurse is teaching a client about the use of Rifampin for prophylaxis after an exposure to meningitis.
What change in bodily functions should the nurse advise the client about?
- A. The client remains infectious to others for 48 hours.
- B. The client's skin might take on a crimson glow.
- C. The client's contact lenses might be stained orange.
- D. The client's urine might turn blue.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
Rifampin has the unusual effect of turning body fluids an orange color. Soft contact lenses might become permanently stained. Clients should be taught about these side effects to avoid unnecessary concern.
Safety and Infection Control
NEW QUESTION 314
The nurse is caring for a postpartum woman who has relinquished her baby for adoption.
The care plan for the client should include which of the following priority strategies?
- A. Inform the woman she has the right to change her mind about relinquishment.
- B. Allow the woman to see her baby initially, and then discourage further visits.
- C. Provide opportunities for the woman to express her feelings.
- D. Make a referral for grief counseling.
Answer: C
Explanation:
Section: Health Promotion and Maintenance
Explanation:
Most women who relinquish their infants at birth have come to that decision with a great deal of love and pain.
They have made plans in advance.
The nurse needs to first provide them with opportunities to express their feelings that might include grief, loneliness, and guilt.
A referral for grief counseling might be appropriate if no other support system exists or the mother indicates that she wants assistance working through her grief. If the nurse assesses that the grief process is abnormal, a referral is also appropriate.
The mother has probably already made a decision about whether or not she wants to see her baby. The nurse should ask her and make arrangements for that to happen if the mother requests it. Seeing the baby might aid in the grief process. Until relinquishment occurs, this is the mother's baby and she should be allowed to see it as often as she wants. The mother does have the right to change her mind until final legal arrangements are made. But suggesting this option might lead her to think that the nurse believes she shouldn't relinquish her baby.
NEW QUESTION 315
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A candidate for licensure is required to pass the appropriate NCLEX examination, NCLEX-RN for registered nurses and the NCLEX-PN for vocational or practical nurses. NCLEX examinations are designed to test the knowledge, skills and abilities essential for the safe and effective practice of nursing at the entry-level. Usually, NCLEX exams cover the following areas: Physiological Integrity, Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity.
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