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NCLEX-RN Practice Test Questions with Rationales.

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Module
NURSING 101

Institution
NURSING 101

. 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...

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–NCLEX-RN Practice Test

NCLEX-RN Practice Test Questions
The NCLEX-RN Test Plan is organized into four major Client Needs categories. Two of the four
categories are divided into subcategories as shown below:

1. Safe and E ective Care Environment (https://www.registerednursing.org/nclex/#category-1-
safe-e ective-care-environment)
1. Management of Care - 17% to 23%
2. Safety and Infection Control - 9% to 15%
2. Health Promotion and Maintenance (https://www.registerednursing.org/nclex/#category-2-
health-promotion-maintenance) - 6% to 12%
3. Psychosocial Integrity (https://www.registerednursing.org/nclex/#category-3-psychosocial-
integrity) - 6% to 12%
4. Physiological Integrity (https://www.registerednursing.org/nclex/#category-4-physiological-
integrity)
1. Basic Care and Comfort - 6% to 12%
2. Pharmacological and Parenteral Therapies - 12% to 18%
3. Reduction of Risk Potential - 9% to 15%
4. Physiological Adaptation - 11% to 17%

 Jump to Section
Click on the section names below to jump to a particular section of the RegisteredNursing.org
NCLEX-RN Practice Exam.

The Safe and E ective Care Environment: The Management of Care
The Safe and E ective Care Environment: Safety and Infection Control
S HARES
Health Promotion and Maintenance

, Psychosocial Integrity
Physiological Integrity: Basic Care and Comfort
Physiological Integrity: Pharmacological and Parenteral Therapies
Physiological Integrity: Reduction of Risk Potential
Physiological Integrity: Physiological Adaptation

 The Safe & E ective Care Environment: The Management of Care
Practice Questions
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?
A. You should respond to the couple by stating that only unanticipated treatments and
procedures that are not included in the advance directive can be made by the legally
appointed durable power of attorney for healthcare decisions.

B. You should be aware of the fact that the wife of the client has a knowledge de cit relating to
advance directives and durable powers of attorney for healthcare decisions and plan an
educational activity to meet this learning need.

C. You should be aware of the fact that the client has a knowledge de cit relating to advance
directives and durable powers of attorney for healthcare decisions and plan an educational
activity to meet this learning need.

D. You should reinforce the wife’s belief that legally married spouses automatically serve for the
other spouse’s durable power of attorney for health care decisions and that others than the
spouse cannot be legally appointed while people are married

Correct Response: A

You should respond to the couple by stating that only unanticipated treatments and
procedures that are not included in the advance directive can be made by the legally
appointed durable power of attorney for healthcare decisions.

S HARES

, Both the client and the client’s spouse have knowledge de cits relating to advance directives.
Legally married spouses do not automatically serve for the other spouse’s durable power of
attorney for health care decisions; others than the spouse can be legally appointed while
people are married.

2. The Patient Self Determination Act of the United States protects clients in terms of their rights to
what? Select all that apply.
A. Privacy and to have their medical information con dential unless the client formally approves
the sharing of this information with others such as family members.

B. Make healthcare decisions and to have these decisions protected and communicated to
others when they are no longer competent to do so.

C. Be fully informed about all treatments in term of their bene ts, risks and alternatives to them so
the client can make a knowledgeable and informed decision about whether or not to agree to
having it

D. Make decisions about who their health care provider is without any coercion or undue
in uence of others including healthcare providers.

Correct Response: B, D

The Patient Self Determination Act, which was passed by the US Congress in 1990, gives
Americans the right to make healthcare decisions and to have these decisions protected and
communicated to others when they are no longer competent to do so. These decisions can
also include rejections for future care and treatment and these decisions are re ect in
advance directives. This Act also supports the rights of the client to be free of any coercion or
any undue in uence of others including healthcare providers.

The Health Insurance Portability and Accountability Act (HIPAA) supports and upholds the
clients’ rights to con dentially and the privacy of their medical related information regardless
of its form. It covers hard copy and electronic medical records unless the client has formally
approved the sharing of this information with others such as family members.

The elements of informed consent which includes information about possible treatments and
procedures in terms of their bene ts, risks and alternatives to them so the client can make a
knowledgeable and informed decision about whether or not to agree to having it may be part
of these advanced directives, but the law that protects these advance directives is the Patient
Self Determination Act.

S HARES

, 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 rst thing that you,
as the nurse, should do?
A. Call the doctor and advise them that the client’s physical status has signi cantly 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.

Correct Response: B

You must immediately begin cardiopulmonary resuscitation and all life saving measures as
requested.by the client in their advance directive despite the nurse’s own beliefs and
professional opinions. Nurses must uphold the client’s right to accept, choose and reject any
and all of treatments, as stated in the client’s advance directive.

You would not call the doctor rst; your priority is the sustaining of the client’s life; you would
also not immediately notify the family for the same reason and, when you do communicate
with the family at a later time, you would not ask them what should or should not be done for
the client when they wishes are already contained in the client’s advance directive.

Finally, you would also insure that the client is without pain and all other distressing signs and
symptoms at the end of life, but the priority and the rst thing that you would do is
immediately begin cardiopulmonary resuscitation and all life saving measures as requested
by the client in their advance directive, according to the ABCs and Maslow’s Hierarchy of
Needs.

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
signi cantly jeopardize the fetus’ life and viability and other decisions can preserve the fetus’s life at
theSexpense
HARES of the pregnant woman’s life. Which role of the nurse is the priority at this time?

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