(LEWIS, 2017) | CHAPTERS 1–68 | 120+ NCLEX-STYLE QUESTIONS |
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Topic: Chapter 1 – Professional Nursing Practice
Question 1:
The nurse is caring for a patient who refuses a prescribed blood transfusion
because of religious beliefs. Which action by the nurse is most appropriate?
A. Persuade the patient to accept the transfusion because it is lifesaving
B. Respect the patient’s wishes and notify the health care provider
C. Obtain a court order to give the transfusion
D. Explain to the family that refusal is illegal
Correct Answer: B. Respect the patient’s wishes and notify the health care
provider
Rationale:
The nurse must respect the patient’s right to autonomy which includes the right to
refuse any treatment even if the decision may result in harm or death. Attempting
to persuade the patient violates ethical principles by overriding personal values.
Seeking a court order is unnecessary since the patient is competent, and informing
the family that refusal is illegal is inaccurate because the law protects patients’
rights to refuse treatment. By respecting the decision and notifying the provider,
the nurse demonstrates ethical practice and advocacy.
Reference: Lewis et al., Medical-Surgical Nursing, 10th ed., Chapter 1, p. 6.
,Topic: Chapter 1 – Professional Nursing Practice
Question 2:
A registered nurse is delegating care to an experienced licensed practical nurse
(LPN). Which task is appropriate to delegate?
A. Initial assessment of a new patient admitted with heart failure
B. Administration of IV push morphine
C. Routine wound dressing change for a stable postoperative patient
D. Development of a plan of care for a patient with diabetes
Correct Answer: C. Routine wound dressing change for a stable postoperative
patient
Rationale:
Delegation is safe when the patient is stable, the task is predictable, and the
delegatee is competent. Routine wound care for a stable patient falls within the
scope of practice of an LPN. Initial assessments and care planning are
responsibilities of the RN and cannot be delegated. Administration of IV push
medications is not typically within the scope of an LPN in most practice settings.
Therefore, the correct option is the routine dressing change.
Reference: Lewis et al., Medical-Surgical Nursing, 10th ed., Chapter 1, p. 11.
Topic: Chapter 2 – Health Disparities and Culturally Competent Care
Question 3:
Which nursing action demonstrates cultural competence when caring for a patient
from a minority background?
,A. Providing identical teaching plans to all patients for equality
B. Asking about the patient’s health beliefs and incorporating them into care
C. Avoiding cultural discussions to prevent conflict
D. Expecting patients to conform to the dominant culture
Correct Answer: B. Asking about the patient’s health beliefs and incorporating
them into care
Rationale:
Culturally competent care requires assessment and integration of the patient’s
values, beliefs, and preferences into the nursing plan. Providing the same care to
all patients without considering culture ignores individual needs. Avoiding cultural
discussions prevents important communication, and expecting patients to adapt to
the dominant culture disregards patient-centered care. By asking and incorporating
health beliefs, the nurse provides culturally safe and respectful care.
Reference: Lewis et al., Medical-Surgical Nursing, 10th ed., Chapter 2, p. 23.
Topic: Chapter 2 – Health Disparities and Culturally Competent Care
Question 4:
A community hospital reports higher rates of surgical site infections among
patients from a specific minority group. What should be the nurse’s first step in
addressing this disparity?
A. Suspend surgeries for that patient group
B. Assume the disparity is caused only by patient behavior
C. Analyze possible system factors such as access, follow-up, or bias
D. Provide standardized education without assessing needs
, Correct Answer: C. Analyze possible system factors such as access, follow-up, or
bias
Rationale:
The first step in addressing health disparities is identifying root causes. These may
include systemic barriers such as inadequate access to care, language barriers,
socioeconomic issues, or provider bias. Assuming the cause is patient behavior
disregards systemic influences. Suspending surgeries would be unethical and
discriminatory, and providing standardized education without assessment would
not address specific barriers. Careful analysis guides appropriate interventions.
Reference: Lewis et al., Medical-Surgical Nursing, 10th ed., Chapter 2, p. 25.
Topic: Chapter 3 – Health History and Physical Examination
Question 5:
Which part of the nursing health history provides the most accurate information
about a patient’s baseline functional status?
A. Review of systems
B. Family history
C. Activities of daily living
D. Medication list
Correct Answer: C. Activities of daily living
Rationale:
Documentation of activities of daily living provides essential information about the
patient’s baseline independence, physical function, and ability to manage self-care.
This helps determine changes from baseline during illness or hospitalization. The