NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 481:

  Wilms' tumor is a form of __________.

  A. renal cancer

  B. liver cancer

  C. basal cell carcinoma

  D. brain cancer

  Correct Answer: A

  Wilms' tumor, although rare, is a type of renal cancer.

  People of all ages can be affected with it, however, it is most common among members of the pediatric

  population.

  The treatments for Wilms' tumor include radiation therapy, chemotherapy and surgical removal.

• Question 482:

  Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen and Osler's nodes.

  What disorder would you most likely suspect?

  A. Tuberculosis

  B. AIDS/HIV

  C. Pericarditis

  D. Endocarditis

  Correct Answer: D

  The signs and symptoms of endocarditis are fever, night sweats, occult hematuria, gross hematuria, tenderness of the spleen, fatigue, edema and Osler's nodes which are tender, red spots that can be seen under the skin of the fingers.

• Question 483:

  Which patient is exercising their right to autonomy in the context of patient rights?

  A. An 86-year-old female who remains independent in terms of the activities of daily living.

  B. An unemancipated 16-year-old who chooses to not have an intravenous line.

  C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves.

  D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.

  Correct Answer: D

• Question 484:

  Your 32-year-old female patient has erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems and skin nodules.

  What disorder would you most likely suspect based on these signs and symptoms?

  A. Leukemia

  B. Histoplasmosis

  C. Pneumocystis jirovec

  D. Rheumatoid arthritis

  Correct Answer: D

  Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems and skin nodules are the signs and symptoms of rheumatoid arthritis. Some of the signs and symptoms of leukemia are fever, bleeding and bruising, shortness of breath, loss of appetite, pain in the bones or stomach and painless lumps in the neck, groin and/or underarm. Histoplasmosis, a fungal infection, is characterized with fever, chills, cough, chest pain, joint pain, mouth sores and erythema modosum. Lastly, the signs and symptoms of Pneumocystis jirovec, among others, can include fever, shortness of breath, rapid breathing and a dry cough.

• Question 485:

  Which legal document will most likely contain the patient's decision to not get cardiopulmonary resuscitation?

  A. Healthcare surrogacy

  B. Healthcare proxy

  C. Advance directives

  D. Durable power of attorney

  Correct Answer: C

  Advance medical care directives, also referred to as living wills, contain the wishes of the client in terms of

  treatments and interventions that they do and do not want carried out when they are no longer able to

  competently provide these consents and rejections of treatment.

  These legal documents typically include choices relating to cardiopulmonary resuscitation (CPR),

  mechanical ventilation, intravenous solution administration, life support measures and tube feedings.

• Question 486:

  Which of the following healthcare providers can legally have access to all, or part, of a patient's medical record because they have a "need to know"? (Choose all that apply.)

  A. Student nurses caring for a particular patient.

  B. Registered nurses when they are not caring for a particular patient.

  C. The Vice President for Nursing who is investigating a patient fall.

  D. Licensed practical nurses caring for a particular patient.

  E. A quality assurance nurse collecting data for a performance improvement activity.

  Correct Answer: ACDE

  Medical records are restricted to only those who have a "need to know". Student nurses caring for a particular patient have the "need to know" so they can properly care for their patient assignment. The Vice President for Nursing, as an administrator, who is investigating a patient fall also has a "need to know" because they are collecting data and information to prevent future falls. Licensed practical nurses caring for a particular patient have the "need to know" so they can provide care to the patient; and the quality assurance nurse has the "need to know" because they are collecting data for a performance improvement activity. No nurse, including registered nurses, are allowed access to all or part of a patient's medical record unless they have a "need to know" because they are providing either direct or indirect care to the patient.

• Question 487:

  You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Face book.

  This nurse was fired because the nurse has __________.

  A. violated the law

  B. acted in a negligent manner

  C. not completed the proper documentation

  D. violated an ethical principle

  Correct Answer: A

  This nurse was fired because the nurse has violated a federal law, namely, the U.S. government's Health Insurance Portability and Accountability Act (HIPAA). This law protects the patients' rights to the privacy and confidentiality of all medical information, including written, oral electronic information, and personal identity information like photograph taking unless the client has expressly consented to it in writing. Negligence is failing to do something in the proper manner; this invasion of patient privacy is far more serious than a breach of an ethical principle. Lastly, photographs and Facebook posting should never be done so proper documentation is not required. It is still illegal documented or not.

• Question 488:

  Which skin disorder most closely resembles and mimics dandruff?

  A. Lice infestation

  B. Scabies

  C. Dematitis

  D. Acne vulgaris

  Correct Answer: A

  Lice infestation with nits most closely resembles and mimics dandruff.

  Other signs and symptoms of lice infestation include itching and small, red bumps on the scalp, shoulders

  and/or neck.

  Scabies is characterized with itchiness and thin, irregular mite burrow tracks that appear like tiny blisters or

  bumps on the skin.

  Dermatitis is evidenced with an itchy rash on swollen, reddened skin.

  Acne vulgaris appears as blackheads and/or whiteheads, papules, pustules, nodules, and/or cysts.

• Question 489:

  Select the ethical principles that are paired with their description. (Choose all that apply.)

  A. Justice: Being honest and fair

  B. Beneficence: Do no harm

  C. Veracity: Treating all patients equally

  D. Self-determination: Facilitating patient choices

  E. Beneficence: Do good

  F. Nonmaleficence: Do no harm

  G. Self-determination: Accountability

  Correct Answer: DEG

  The principle of justice requires us to be fair and just to all.

  Fidelity is being faithful to one's promises. By the very nature of the implicit nurse-client relationship, the

  nurse must be faithful and true to their professional promises and responsibilities by providing high quality,

  safe care in a competent, scientifically grounded manner while upholding the clients' choices, desires and

  innate rights.

  Beneficence means doing good, it is more than not doing harm. Nonmaleficence is "Do not harm", as

  stated in the historical Hippocratic Oath. Patient self-determination and autonomy is the ethical principle

  that supports the patient's right to make their own choices without coercion or the undue influence of

  others.

  Lastly, veracity is truthfulness and being honest with the patients.

• Question 490:

  Who should document care?

  A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.

  B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.

  C. All staff members should document all of the care that they have provided.

  D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.

  Correct Answer: C

  All staff members, including unlicensed assistive staff like nursing assistants, document and sign, all of the care that they have personally provided. For example, the nursing assistants will document the vital signs that they have taken; the licensed practical nurses will document all of the treatments and medications that they have given to the patient; and the registered nurse will document nursing diagnoses and assessments that they have completed.