NCLEX-RN Practice Test Questions with Rationales

1. You are caring for a client at the end of life. The client tells you that they are grateful for having considered and decided upon some end of life decisions and the appointments of those who they wish to make decisions for them when they are no longer able to do so. During this discussion with the client and the client’s wife, the client states that “my wife and I are legally married so I am so glad that she can automatically make all healthcare decisions on my behalf without a legal durable power of attorney when I am no longer able to do so myself” and the wife responds to this statement with, “that is not completely true. I can only make decisions for you and on your behalf when these decisions are not already documented on your advance directive.” How should you, as the nurse, respond to and address this conversation between the husband and wife and the end of life? SHARES 2. The Patient Self Determination Act of the United States protects clients in terms of their rights to what? Select all that apply. SHARES 3. Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 45 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do? A. Call the doctor and advise them that the client’s physical status has significantly changed and that they have just had a cardiopulmonary arrest. B. Begin cardiopulmonary resuscitation other emergency life saving measures. C. Notify the family of the client’s condition and ask them what they should be done for the client. D. Insure that the client is without any distressing signs and symptoms at the end of life. 4. You are caring for a high risk pregnant client who is in a life threatening situation. The fetus is also at high risk for death. Clinical decisions are being made that concern you because some of these treatments and life saving measures promote the pregnant woman’s life at the same time that they significantly jeopardize the fetus’ life and viability and other decisions can preserve the fetus’s life at theSeHxApR eE Snse of the pregnant woman’s life. Which role of the nurse is the priority at this time? A. Case manager B. Collaborator C. Coordinator of care D. Advocacy 5. A nurse who organizes and establishes a political action committee (PAC) in their local community to address issues relating to the accessibility and a¦ordability of healthcare resources in the community is serving in which capacity and role of the registered nurse? A. Client advocate B. Collaborator C. Politician D. Entrepreneur . 6. Which of the following are the five Rights of Supervision? SHARES A. The right task, the right circumstances, the right person, the right competency, and the right supervision or feedback B. The right task, the right circumstances, the right person, the right direction or communication, and the right supervision or feedback C. The right competency, the right education and training, the right scope of practice, the right environment and the right client condition D. The right competency, the right person, the right scope of practice, the right environment and the right client condition 7. The registered nurse, prior to the delegation of tasks to other members of the nursing care team, evaluates the ability of sta¦ members to perform assigned tasks for the position as based on which legal consideration? A. The American Nurses Association’s Scopes of Practice B. The American Nurses Association’s Standards of Care C. State statutes D. Federal law SHARES 8. The best way to objectively evaluate the e¦ectiveness of an individual sta¦ member’s time management skills in a longitudinal manner is to: A. Observe the staff member during an entire shift of duty to determine whether or not the nurse has accurately and appropriately established priorities. B. Observe the staff member during an entire shift of duty to determine whether or not the nurse has accurately and appropriately completed priority tasks. C. Ask the staff member how they feel like they have been able to employ their time management skills for the last six months. D. Collect outcome data over time and then aggregate and analyze this data to determine whether or not the staff member has completed reasonable assignments in the allotted time before the end of their shift of duty. .....................................................continued...................................................