NCLEX-RN Practice Questions with complete solutions.

NCLEX-RN Practice Questions with complete solutions. A client is referred to a surgeon by the general practitioner. After meeting the surgeon, the client decides to find a different surgeon to continue treatment. The nurse supports the client's action, utilizing which ethical principle? 1. Beneficence 2. Veracity 3. Autonomy 4. Privacy - correct answers.Answer: 3 Rationale: Autonomy is the right of individuals to take action for themselves. Beneficence is an ethical principle to do good and applies when the nurse has a city to help others by doing what is best for them. Veracity refers to truthfulness. Privacy is the nondisclosure of information by the health care team. Cognitive Level: Applying Client Need: Management of Care Integrated Process: Nursing Process: Implementation Content Area: Fundamentals Strategy: The core issue of the question is the ability to interpret which ethical principle is operating in a specific situation. Eliminate beneficence and veracity next because they focus on the obligation of the nurse rather than on a right of the client. A nurse forgets to administer a client's diuretic and the client experiences an episode of pulmonary edema. The charge nurse would consider the medication error to constitute negligence because the situation contains which element? 1. Purposeful failure to perform a health care procedure 2. Unintentional failure to perform a health care procedure 3. Act of substituting a different medication for the one ordered 4. Failure to follow a direct order by a physician - correct answers.Answer: 2 Rationale: Negligence is the unintentional failure of an individual to perform or not perform an act that a reasonable person would or would not do in the same or similar circumstances. A purposeful failure to perform a procedure would be the opposite of negligence, which is unintentional. Substituting a different medication does not fit the description of the situation in the question. Failure to follow a direct order does not fit the description in the situation in the question. Cognitive Level: Applying Client Need: Management of Care Integrated Process: Nursing Process: Assessment Content Area: Fundamentals Strategy: Two options are opposites, which is a clue that one of them may be correct. Choose unintentional failure to carry out a procedure over purposeful failure because it matches the definition of negligence. A client asks why a diagnostic test has been ordered and the nurse replies, "I'm unsure but will find out for you." When the nurse later returns and provides an explanation, the nurse is acting under which principle? 1. Nonmaleficence 2. Veracity 3. Beneficence 4. Fidelity - correct answers.Answer: 4 Rationale: Fidelity means being faithful to agreements and promises. This nurse is acting on the client's behalf to obtain needed information and report it back to the client. Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth for example, not lying to a client about a serious prognosis. Beneficence means doing good, such as by implementing actions (e.g. keeping a salt shaker out of sight) that benefit a client (heart condition requiring sodium-restricted diet). Cognitive Level: Understanding Client Need: Management of Care Integrated Process: Nursing Process: Implementation Content Area: Fundamentals Strategy: Use the process of elimination. The correct answer is the one that matches the description in the stem; that is, the nurse made a promise to a client and kept it, which constitutes fidelity. An individual has a seizure while walking down the street. During the seizure, a nurse from a physician's office is noticed driving past without stopping to assist. The individual sues the nurse for negligence but fails to win a judgement for which reason? 1. The nurse had no duty to the individual. 2. The nurse did what most nurses would do in the same circumstance. 3. The nurse did not cause the client's injuries. 4. The nurse was off-duty at the time. - correct answers.Answer: 1 Rationale: To be guilty of negligence, the nurse must have a relationship with the client that involves a duty to provide care. The relationship is usually a component of employment. The nurse did not necessarily do what others would do in this situation. Although the nurse did not cause the client's injuries, it does not prevent the nurse from assisting in this situation. Although the nurse was off-duty, the nurse could have assisted if motivated to do so. Cognitive Level: Understanding Client Need: Management of Care Integrated Process: Nursing Process: Implementation Content Area: Fundamentals Strategy: Use the process of elimination and nursing knowledge. The correct answer is the one that recognizes that the nurse was not in the role of employee at the time of the incident, removing the requirement of acting on the client's behalf. An adult female ambulatory care client receiving an oral anticoagulant is given aspirin for a headache while visiting a neighbor, who is a nurse. The client subsequently has a bleeding episode because of a drug interaction. The legal nurse consultant interprets that which necessary elements of malpractice are missing from this case? Select all that apply. 1. Breech of duty 2. Duty owed 3. Injury experienced 4. Causation between nurse's action and injury 5. Intent to cause harm or injury - correct answers.Answer: 2, 5 Rationale: There was no nurse-client relationship because the nurse was acting as a neighbor and not in an employment capacity. Thus, there can be no duty owed. Intent is not a necessary element of malpractice, because malpractice can occur because of unintended actions as well. There was no breach of duty because there was no official nurse-client relationship, which accompanies an employment situation. There was injury experiences because of this event. The bleeding was caused by the interaction of the aspirin with the anticoagulant. Cognitive Level: Analyzing Client Need: Management of Care Integrated Process: Nursing Process: Evaluation Content Area: Fundamentals Strategy: Use the process of elimination. The wording of the question indicates more than one option is correct, and the focus is on necessary elements that must be present. First eliminate the intent to cause harm or injury, since this is not necessary to a charge of malpractice. Next note that there is no duty owed, and because of this, there can be no breach of duty, to choose these two options as the necessary missing elements. A client with cancer has decided to discontinue further treatment. Although the nurse would like the client to continue treatment, the nurse recognizes the client is competent and supports the client's decision using which ethical principle? 1. Justice 2. Fidelity 3. Autonomy 4. Confidentiality - correct answers.Answer: 3 Rationale: Autonomy refers to the right make one's own decisions, which is the principle supported in this situation. Justice refers to fairness. Fidelity refers to trust and loyalty. Confidentiality refers to the right to privacy of personal health information. Cognitive Level: Understanding Client Need: Management of Care Integrated Process: Nursing Process: Implementation Content Area: Fundamentals Strategy: Use the process of elimination. The wording of the question indicates that only one option is correct and that you need to select the principle that is consistent with the circumstances in the question. The health care provider orders a medication in a dose that is considered toxic. The nurse administers the medication to the client, who later suffers a cardiac arrest and dies. What consequence can the nurse expect from this situation? Select all that apply. 1. The health care provider can be charged with negligence, being the person who ordered the dose. 2. As the employing agency, only the hospital can be charged with negligence.