NCLEX-RN Practice Test 1 — Questions and Answers

Question 1: Which of the following principles is affected by a nurse’s cultural or ethnic background?

Veracity
Code of conduct
Ethics
Morals (Correct answer)

Correct answer: Morals

Morals are an individual's personal beliefs about right and wrong, which are deeply shaped by their cultural background, upbringing, and life experiences. While ethics are professional guidelines and a code of conduct outlines expected behaviors, morals are the foundational, culturally-influenced principles that guide a nurse's personal and professional actions and decision-making.

Question 2: The doctrines found in the Nursing Code of Ethics have all of the following attributes EXCEPT they are not.

meant to guide a nurse’s practice.
mandatory.
universal.
optional. (Correct answer)

Correct answer: optional.

The Nursing Code of Ethics provides a fundamental framework that guides professional nursing practice and ethical decision-making. Its doctrines are considered mandatory for all nurses, outlining universal principles of conduct and patient care. Therefore, these guidelines are not optional but are integral to the professional responsibilities of a nurse.

Question 3: The right to self-determination refers to the

nurse’s and physician’s rights to make the most appropriate decision, regarding a patient’s care.
physician’s right to make decisions about a patient’s care if the patient is no longer able to make decisions.
patient’s right to make decisions regarding care. (Correct answer)
patient’s right to choose a physician.

Correct answer: patient’s right to make decisions regarding care.

The right to self-determination, also known as autonomy, is a core ethical principle in healthcare. It asserts that competent patients have the fundamental right to make informed decisions about their own medical care, including accepting or refusing treatments. This principle empowers patients to control their health journey without coercion.

Question 4: What is the final step in the ethical decision-making process?

Carry out the decision.
Identify the issue.
Make changes based on an evaluation of the original plan. (Correct answer)
Consult an ethics expert or committee.

Correct answer: Make changes based on an evaluation of the original plan.

The ethical decision-making process is not complete after implementing a decision; it requires ongoing evaluation. The final step involves assessing the outcomes of the decision and making necessary changes or adjustments to the original plan. This iterative process ensures continuous improvement and refinement of ethical practice based on real-world results.

Question 5: Which term listed below describes the idea that the nurse should do no harm to the patient?

Autonomy
Beneficence
Veracity
Nonmaleficence (Correct answer)

Correct answer: Nonmaleficence

Nonmaleficence is a foundational ethical principle in nursing and medicine, meaning 'do no harm.' It obligates healthcare providers to actively avoid causing harm to their patients, whether intentionally or unintentionally. This principle guides clinical decisions to ensure patient safety and well-being above all else.

Question 6: Which of the following theories describes the idea that ethical conflicts should be resolved, according to the obligations of the nurse?

Utilitarianism
Virtue
Deontology (Correct answer)
Egoist

Correct answer: Deontology

Deontology is an ethical theory that emphasizes duties and rules, asserting that the morality of an action is determined by whether it adheres to a set of moral obligations, regardless of the consequences. In nursing, a deontological approach means that ethical conflicts are resolved by focusing on the nurse's adherence to professional duties, rules, and principles.

Question 7: All of the following provisions are included in the Health Insurance Portability and Accountability Act EXCEPT

protection of patients’ privacy.
prevention of patients from sharing their private medical information with their insurance carrier. (Correct answer)
establishment of the need for institutions and providers to protect their patients’ health records.
prevention of health care providers from sharing medical information with other providers not directly involved in their patients’ care.

Correct answer: prevention of patients from sharing their private medical information with their insurance carrier.

The Health Insurance Portability and Accountability Act (HIPAA) primarily aims to protect the privacy and security of patient health information. It establishes stringent rules for healthcare providers and institutions regarding the handling and sharing of medical records. However, HIPAA does not prevent patients themselves from choosing to share their own private medical information with their insurance carrier or any other entity.

Question 8: All of the following statements about informed consent are correct EXCEPT

the nurse should never sign consent forms with a patient as this is the physician’s role. (Correct answer)
consent should be voluntary and can only be given by the patient or a legally appointed representative.
the nurse should obtain consent from the patient after the physician has counseled the patient.
informed consent should be obtained before every procedure.

Correct answer: the nurse should never sign consent forms with a patient as this is the physician’s role.

While the physician is responsible for explaining the procedure and obtaining informed consent, the nurse's role often includes witnessing the patient's signature on the consent form. The nurse confirms that the patient signed voluntarily and understands the information provided by the physician. Therefore, stating that a nurse should never sign consent forms with a patient is incorrect, as witnessing is a common and appropriate nursing duty.

Question 9: A patient comes into the emergency room with a gunshot wound to his back. He states that the gun accidentally went off while he was cleaning it. What should the nurse do?

Make an anonymous report to the police department.
Do not report the incident as the patient has the right to privacy.
Encourage the patient to report his injury to the police.
Inform the law enforcement authorities, according to hospital protocol. (Correct answer)

Correct answer: Inform the law enforcement authorities, according to hospital protocol.

Gunshot wounds are legally considered reportable incidents in many jurisdictions, overriding patient confidentiality for public safety reasons. Healthcare providers have a legal and ethical obligation to inform law enforcement authorities about such injuries, following established hospital protocols. This is a mandatory reporting requirement, regardless of the patient's explanation or desire for privacy.

Question 10: The physician has ordered a low-potassium diet for a child with acute glomerulonephritis. Which snack is suitable for the child with potassium restrictions?

Raisins
Oranges
Apricots (Correct answer)
Bananas

Correct answer: Apricots

Patients with acute glomerulonephritis often require a low-potassium diet to prevent hyperkalemia, as their kidneys may have impaired potassium excretion. Among the given options, apricots are generally lower in potassium compared to high-potassium fruits like bananas, oranges, and raisins. Therefore, apricots are a more suitable snack choice for a child on potassium restrictions.

Question 11: The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:

Withholding intake after midnight
Telling the client that no special preparation is needed (Correct answer)
Explaining that a small dose of radioactive isotope will be used
Giving an oral suspension of glucose 1 hour before the test

Correct answer: Telling the client that no special preparation is needed

A blood test for H. pylori, which detects antibodies to the bacteria, typically does not require any special preparation from the client. There is no need for fasting or specific dietary restrictions before the test. The nurse should inform the client that they can eat and drink normally, ensuring convenience and clarity.

Question 12: The nurse is preparing to give an oral potassium supplement. The nurse should:

Give the medication without diluting it
Give the medication with 4oz. of juice (Correct answer)
Give the medication with water only
Give the medication on an empty stomach

Correct answer: Give the medication with 4oz. of juice

Oral potassium supplements can be irritating to the gastrointestinal tract and have an unpleasant taste. To minimize GI irritation, improve palatability, and prevent potential esophageal damage, the medication should be diluted with at least 4 ounces of juice or water. Giving it undiluted or on an empty stomach can increase adverse effects.

Question 13: The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?

Stool cultures are preferred for definitive diagnosis.
Pregnant caregivers may obtain cultures.
Collection of one specimen is sufficient.
Accurate diagnosis depends on fresh specimens. (Correct answer)

Correct answer: Accurate diagnosis depends on fresh specimens.

Cytomegalovirus (CMV) is a fragile virus, and accurate diagnosis from cultures relies heavily on the viability of the virus. Therefore, fresh specimens are crucial for successful viral isolation and accurate diagnostic results. Prompt collection and processing of samples are essential to prevent viral degradation and ensure reliable testing.

Question 14: A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:

Will cause dark staining of the surrounding skin
Produces a cooling sensation when applied
Can alter the function of the thyroid
Produces a burning sensation when applied (Correct answer)

Correct answer: Produces a burning sensation when applied

Sulfamylon (mafenide acetate) cream is a topical antimicrobial commonly used for burn treatment. A well-known side effect of this medication is a transient, often intense, burning sensation upon application. The nurse should educate the client about this expected discomfort to prepare them and manage their expectations during dressing changes.

Question 15: The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:

Maintain strict intake and output
Check the pulse before giving the medication
Administer the medication 30 minutes before meals
Provide oral hygiene and gum care every shift (Correct answer)

Correct answer: Provide oral hygiene and gum care every shift

Phenytoin (Dilantin) is an anticonvulsant medication known to cause gingival hyperplasia, or gum overgrowth, as a common side effect with long-term use. To manage and minimize this oral complication, providing regular and meticulous oral hygiene, including gum care, every shift is an essential nursing intervention for clients on phenytoin.

Question 16: A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:

Prevent anemia
Promote relaxation
Prevent nausea (Correct answer)
Increase neutrophil counts

Correct answer: Prevent nausea

Zofran (ondansetron) is an antiemetic medication, specifically a serotonin 5-HT3 receptor antagonist, prescribed to prevent nausea and vomiting. It is frequently administered before chemotherapy sessions because many chemotherapeutic agents are highly emetogenic, meaning they can cause severe nausea and vomiting. Zofran helps to counteract these distressing side effects.

NCLEX-RN Practice Test 1

Which of the following principles is affected by a nurse’s cultural or ethnic background?