NGN/NCLEX PREP QUESTIONS/RATIONALES QUESTONS AND ANSWERS WITH SOLUTIONS 2024

NGN/NCLEX PREP
QUESTIONS/RATIONALES QUESTONS
AND ANSWERS WITH SOLUTIONS 2024
TheTnurseTnotesTtheTpresenceTofTaTPTwave,TQRSTcomplex,TflattenedTTTwaves,TandToccasionalTUTwavesTonTaT
client'sTcardiacTmonitorTscreen.TFillTinTtheTcorrectTmissingTinformationTbyTchoosingTfromTtheTlistsTofToption
sTinTtheTdrop-downTmenus.T-TANSWERTTheTnurseTshouldTsuspect

YourTAnswer:ThypokalemiaCorrectTAnswer:Thypokalemia

becauseTofTthe

YourTAnswer:TflattenedTTTwavesTandToccasionalTUTwavesCorrectTAnswer:TflattenedTTTwavesTandToccasional
TUTwaves




Rationale:CardiacTchangesTinThypokalemiaTincludeTimpairedTrepolarization,TresultingTinTaTflatteningTofTtheT
TTwaveTandTeventuallyTtheTemergenceTofTaTUTwave.TTherefore,TtheTnurseTshouldTsuspectThypokalemia.TTh
eTincidenceTofTpotentiallyTlethalTventricularTdysrhythmiasTisTincreasedTinThypokalemia.TTheTnurseTshouldTi
mmediatelyTassessTtheTclient'sTvitalTsignsTandTcardiacTstatusTforTsignsTofThypokalemia.TTheTnurseTshouldTal
soTcheckTtheTclient'sTmostTrecentTserumTpotassiumTlevelTandTthenTcontactTtheTprimaryThealthTcareTprovid
erTtoTreportTtheTfindingsTandTobtainTprescriptionsTtoTtreatTtheThypokalemicTstate.



TheTnurseTisTpreparingTaTclientTforTaTchestTx-
rayTandTnotesTthatTtheTclientTisTwearingTaTreligiousTmedalTonTaTchainTaroundTtheTneck.TWhatTshouldTtheTnu
rseTdoTwithTregardTtoTthisTpersonalTitem?TClickTtoThighlightTtheTcorrectTanswerTfromTtheToptionsTprovided.T
-TANSWERTTheTnurseTshould:T(SelectT1Toption)

✓AskTtheTclientTifTtheTchainTandTmedalTcanTbeTremovedTduringTtheTprocedure.

Because:T(SelectT1Toption)

✓TheTchainTandTmedalTmayThaveTculturalTsignificance.



Rationale:BeforeTcertainTdiagnosticTprocedures,TitTisTtypicalTtoThaveTaTclientTremoveTpersonalTobjectsTthatT
areTwornTonTtheTbodyTbecauseTofTclientTsafetyTandTtheTpossibilityTofTcompromisingTtestTresults.TTherefore,
TtheTnurseTshouldTaskTtheTclientTaboutTtheTsignificanceTofTsuchTanTitemTandTitsTremovalTbecauseTitTmayThav

eTculturalTorTspiritualTsignificance.TIfTso,TtheTnurseTshouldTaskTtheTclientTifTtheTitemTcanTbeTeitherTremovedT
temporarilyTorTplacedTonTanotherTpartTofTtheTbodyTduringTtheTprocedureTifTappropriate.

,WhileTpreparingTaTclientTforTsurgeryTscheduledTinT1Thour,TtheTclientTstatesTtoTtheTnurse:T"IThaveTchangedTm
yTmind.TITdon'tTwantTthisTsurgery."TClickTtoThighlightTtheTcorrectTanswerTfromTtheToptionsTprovided.T-
TANSWERTTheTnurseTshould:T(SelectT1Toption)



CancelTtheTsurgery.

ContactTtheTsurgeon.

✓DiscussTtheTclient'sTconcerns.

CallTtheTidentifiedTsupportTperson.

Because:T(SelectT1Toption)

ClientTconsentTisTrequiredTpriorTtoTanyTprocedure.

✓FurtherTquestionsTorTconcernsTshouldTbeTdeterminedTandTaddressed.T

EthicalTconsiderationsTareTimportantTforTaTclientTundergoingTsurgery.T

TheTnursingTscopeTofTpracticeTplacesTlimitationsTonThowTtheTnurseTcanTrespond.



Rationale:IfTtheTclientTindicatesTthatTheTorTsheTdoesTnotTwantTaTprescribedTtherapy,Ttreatment,TorTprocedu
reTsuchTasTsurgery,TtheTnurseTshouldTfurtherTinvestigateTtheTclient'sTrequest.TIfTtheTclientTindicatesTthatTheT
orTsheThasTchangedThisTorTherTmindTaboutTsurgery,TtheTnurseTshouldTassessTtheTclientTandTexploreTwithTth
eTclientThisTorTherTconcernsTaboutTnotTwantingTtheTsurgery.TTheTnurseTwouldTthenTwithholdTfurtherTsurgic
alTpreparationTandTcontactTtheTsurgeonTtoTreportTtheTclient'sTrequestTsoTthatTtheTsurgeonTcanTdiscussTtheT
consequencesTofTnotThavingTtheTsurgeryTwithTtheTclient.TFurtherTassessmentTandTfollow-
upTrelatedTtoTtheTclient'sTrequestTneedTtoTbeTdone.TItTisTtheTclient'sTrightTtoTrefuseTtreatment;Thowever,Tfur
therTinvestigationTisTneededTsoTtheTinterventionsTcanTbeTtailoredTtoTspecificTneeds.



TheTnurseTnotesTthatTthereThasTbeenTanTincreaseTinTtheTnumberTofTintravenousT(IV)TsiteTinfectionsTthatTde
velopedTinTtheTclientsTbeingTcaredTforTonTtheTnursingTunit.THowTshouldTtheTnurseTproceedTtoTimplementTaT
qualityTimprovementTprogram?ForTeachTaction,TclickTtoTspecifyTwhetherTtheTactionTwouldTbe:

Indicated:TanTactionTthatTtheTnurseTshouldTtakeTtoTresolveTtheTproblem

Non-
essential:TanTactionTthatTtheTnurseTcouldTtakeTwithoutTharmingTtheTclient,TbutTtheTactionTwouldTnotTbeTlike
lyTtoTaddressTtheTproblem

Contraindicated:TanTactionTthatTcouldTharmTtheTclientTandTshouldTnotTbeTtakenT-
TANSWERTCollectTidentifyingTpatientTinformation



Contraindicated

NoteTtheTmentalTstatusTofTtheTclient

Non-essential

, NoteTprimaryTandTsecondaryTdiagnosesTofTclientsTaffected

Indicated

NoteTtheTtypeTofTIVTcatheterTused

Indicated

NoteTtheTtypeTofTIVTsiteTdressingsTbeingTused

Indicated

NoteTtheTmedicationTtypesTbeingTinfused

Non-essential

NoteTfrequencyTofTassessmentsTofTIVTsites

Indicated

NoteTtheTexpectedTdurationTofTtheTIVTsite

Non-essential

NoteTcareTproceduresTtoTtheTIVTsite

Indicated

NoteTfrequencyTofTchangingTIVTsites

Indicated



Rationale:QualityTimprovement,TalsoTknownTasTperformanceTimprovement,TfocusesTonTprocessesTorTsyste
msTthatTsignificantlyTcontributeTtoTclientTsafetyTandTeffectiveTclientTcareToutcomes;TcriteriaTareTusedTtoTmo
nitorToutcomesTofTcareTandTtoTdetermineTtheTneedTforTchangeTtoTimproveTtheTqualityTofTcare.TIfTtheTnurseT
notesTaTparticularTproblem,TsuchTasTanTincreaseTinTtheTnumberTofTintravenousT(IV)TsiteTinfections,TtheTnurs
eTshouldTcollectTdataTaboutTtheTproblem.TThisTshouldTincludeTinformationTsuchTasTtheTprimaryTandTsecond
aryTdiagnosesTofTtheTclientsTdevelopingTtheTinfection,TtheTtypeTofTIVTcathetersTbeingTused,TtheTsiteTofTtheTc
atheter,TIVTsiteTdressingsTbeingTused,TfrequencyTofTassessmentTandTmethodsTofTcareTtoTtheTIVTsite,TandTlen
gthTofTtimeTthatTtheTIVTcatheterTwasTinserted.TOnceTtheseTdataTareTcollectedTandTanalyzed,TtheTnurseTshou
ldTexamineTevidence-
basedTpracticeTprotocolsTtoTidentifyTtheTbestTpracticesTforTcareTtoTIVTsitesTtoTpreventTinfection.TTheseTprac
ticesTcanTthenTbeTimplementedTandTfollowedTbyTevaluationTofTresultsTbasedTonTtheTevidence-
basedTpracticeTprotocolsTused.TCollectingTidentifyingTclientTinformationTisTcontraindicatedTbecauseTofTconf
identialityTandTisTunnecessaryTinTthisTqualityTimprovementTeffort.TNotingTtheTmentalTstatusTofTtheTclientsTc
anTbeTdoneTbutTisTnotTlikelyTtoTaddressTthe



TheTnurseTperformsTanTAllen'sTtestTonTaTclientTscheduledTforTanTarterialTbloodTgasTdrawTfromTtheTradialTart
ery.TOnTreleaseTofTpressureTfromTtheTulnarTartery,TcolorTinTtheThandTreturnsTafterT20Tseconds.THowTshouldT