Exam Cram NCLEX RN Practice Questions

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As a nurse, you have been assigned to take over as charge nurse without any report after the previous charge nurse fell during her shift and was taken to the emergency room. At the end of the shift, you have made the assignments for the next shift's nurses and posted them. As the nurses come in, they begin to complain that the assignments make no sense based on patient acuity. One refuses to take her assignment and threatens to go home. What could you have done to prevent their dissatisfaction?

  • A. Reviewed the notes of the previous charge nurse
  • B. Tried to contact the previous charge nurse in the emergency room
  • C. Collaborated with the nurse manager
  • D. Collaborated with the other nurses on your shift
Correct Answer: D

Rationale: Collaborating with the other nurses on your shift would have permitted them to provide the most updated information regarding patient status and acuity. Requesting their input into creating assignments would have provided shared governance and assurance that the unit staffing was arranged appropriately. Reviewing the notes of the previous charge nurse might not capture the real-time changes in patient conditions. Trying to contact the previous charge nurse in the emergency room may not be feasible or timely. Collaborating with the nurse manager could be helpful, but involving the nurses directly impacted by the assignments would have been more effective in addressing their concerns and ensuring appropriate patient care.

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You are turning your patient in bed and notice that a confused and lethargic patient had loose car keys and lipstick in the bed and had been lying on them. What is this person at risk for due to all three of these factors: confusion, lethargy, and items in the bed?

  • A. Falls
  • B. Skin breakdown
  • C. Apnea
  • D. Lack of mobility
Correct Answer: B

Rationale: This patient is at great risk for skin breakdown due to the presence of three specific risk factors: confusion, lethargy, and items in the bed. While confusion puts the patient at risk for falls, confusion and lethargy together may lead to a lack of mobility. However, skin breakdown is the primary concern in this scenario as it is associated with all three risk factors - confusion, lethargy, and the presence of items in the bed. Therefore, the correct answer is 'Skin breakdown'.

Which of the following is a local sign of infection?

  • A. Swelling
  • B. Rapid pulse
  • C. Fever
  • D. High white blood count
Correct Answer: A

Rationale: A local sign of infection refers to symptoms that are specific to the area of infection. Swelling, heat, pain, and redness near the infected site are examples of local signs. In the context of infection, swelling occurs due to an accumulation of fluid and immune cells at the site of infection. Rapid pulse, fever, and high white blood count are more systemic responses to infection and not specific local signs. Rapid pulse can indicate systemic distress or sepsis, fever is a systemic response to infection, and high white blood count is a laboratory finding that suggests an immune response but is not a direct sign of infection at a specific site.

Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a
negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms
of TB. Which information should the occupational health nurse plan to teach the staff nurse?

  • A. Standard four-drug therapy for TB
  • B. Need for annual repeat TB skin testing
  • C. Use and side effects of isoniazid (INH)
  • D. Bacille Calmette-Gurin (BCG) vaccine
Correct Answer: C

Rationale: The nurse is considered to have a latent TB infection and should be treated with INH daily for 6
to 9 months. The four-drug therapy would be appropriate if the nurse had active TB. TB skin
testing is not done for individuals who have already had a positive skin test. BCG vaccine is not
used in the United States for TB and would not be helpful for this individual, who already has a
TB infection.

A complication of osteoporosis is _______________?

  • A. rheumatoid arthritis
  • B. gouty arthritis
  • C. dorsiflexion
  • D. joint deformity
Correct Answer: D

Rationale: Joint deformity is a well-known complication of osteoporosis, leading to structural changes in the joints due to bone loss and fragility. Gouty arthritis and rheumatoid arthritis are distinct types of arthritis that are not direct complications of osteoporosis. Dorsiflexion is a movement related to the foot's range of motion and is not a typical complication of osteoporosis.

Albert B. is incontinent of urine. He also wears glasses and hearing aids. His ____________lead(s) to his risk for falls.

  • A. incontinence and loss of vision
  • B. loss of vision
  • C. incontinence
  • D. loss of hearing
Correct Answer: B

Rationale: Albert B. is at risk for falls due to two factors: his incontinence and his loss of vision. Loss of vision significantly impairs one's ability to navigate and avoid obstacles, thereby increasing the risk of falls. While incontinence is a risk factor for falls, the primary concern in this case is the loss of vision since it directly affects balance and safety. Therefore, the correct answer is 'loss of vision.' Choices A, C, and D are incorrect because they do not address the key factor of impaired vision leading to the risk of falls.

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