NCLEX-RN Practice Questions and Answers with Complete Solutions

NCLEX-RN Practice Questions and Answers 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 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 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 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. 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 Answer: 2, 5 Rationale: