NCLEX Practice Questions HURST REVIEW (Fundamentals) with Correct
Answers
1. C. Assessment: A nurse is caring for a patient with chronic heart failure who
is very ill. The patient has a "no code" order. The patient goes into ventricular
fibrillation and the nurse defibrillates the patient. The nurse states she was unaware
of the "no code" order. What part of the nursing process did the nurse fail to
perform?
A. Planning
B. Evaluation
C. Assessment
B. Implementation
2. B. Implementation: On the morning laboratory report, the patient's potassium is
noted to be 2.5 mEq/L. The nurse does not want to "bother the physician this early."
During the change-of-shift report, the patient develops ventricular tachycardia and
has to be resuscitated. What part of the nursing process did the nurse fail to
perform?
A. Evaluation
B. Implementation
C. Assessment
D. Planning
3. B. Assess and analyze the level of care needed by the patient.: A patient in
the critical care unit has an order to be transported off the unit for a diagnostic
procedure. The nurse fails to ensure that the patient is properly monitored during
transport, and the patient experiences a cardiac arrest. Which of the following
actions did the nurse fail to adequately perform?
,A. Make the proper nursing diagnosis.
B. Assess and analyze the level of care needed by the patient.
C. Act as a patient advocate to postpone the examination.
D. Communicate findings in a timely manner.
4. C. No. There were no damages associated with failure to document: The
nurse fails to record a set of vital signs on a blood transfusion report, which is
against hospital policy. The patient does not sustain any damage as a result. Can
the nurse be charged with malpractice in this case?
, A. No. Documentation is not part of the duty of nurse.
B. Yes. Even though there were no damages, the nurse failed to follow hospital
protocol.
C. No. There were no damages associated with failure to document
D. Yes. Failure to document always results in negligence.
5. A. Beneficence
B. Nonmaleficence
C. Autonomy: A patient with metastatic cancer tells the nurse, "I am tired and
do not want to be put on a breathing machine." The patient's out-of-town son
wants "everything done for my mother" when his mother later develops respiratory
distress. Which ethical principles are involved in this dilemma? (Select all that
apply.)
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
E. Paternalism
6. A. The hospital ethics committee
C. The nursing supervisor
D. The nursing ethics committee: The nurse is concerned that the physician is
ignoring the wishes of the patient and family in the care of a patient. The nurse
should take these concerns to: (Select all that apply.)
A. The hospital ethics committee
B. The ANA (American Nurses Association)
C. The nursing supervisor
D. The nursing ethics committee
E. he policy and procedure committee
7. C. Nonmaleficence: The nurse observes a coworker diverting narcotics by
administering normal saline to a patient in pain. By not reporting this observation,
the nurse is in violation of what ethical principle concerning the patients under the
care of the impaired nurse?
A. Autonomy
Answers
1. C. Assessment: A nurse is caring for a patient with chronic heart failure who
is very ill. The patient has a "no code" order. The patient goes into ventricular
fibrillation and the nurse defibrillates the patient. The nurse states she was unaware
of the "no code" order. What part of the nursing process did the nurse fail to
perform?
A. Planning
B. Evaluation
C. Assessment
B. Implementation
2. B. Implementation: On the morning laboratory report, the patient's potassium is
noted to be 2.5 mEq/L. The nurse does not want to "bother the physician this early."
During the change-of-shift report, the patient develops ventricular tachycardia and
has to be resuscitated. What part of the nursing process did the nurse fail to
perform?
A. Evaluation
B. Implementation
C. Assessment
D. Planning
3. B. Assess and analyze the level of care needed by the patient.: A patient in
the critical care unit has an order to be transported off the unit for a diagnostic
procedure. The nurse fails to ensure that the patient is properly monitored during
transport, and the patient experiences a cardiac arrest. Which of the following
actions did the nurse fail to adequately perform?
,A. Make the proper nursing diagnosis.
B. Assess and analyze the level of care needed by the patient.
C. Act as a patient advocate to postpone the examination.
D. Communicate findings in a timely manner.
4. C. No. There were no damages associated with failure to document: The
nurse fails to record a set of vital signs on a blood transfusion report, which is
against hospital policy. The patient does not sustain any damage as a result. Can
the nurse be charged with malpractice in this case?
, A. No. Documentation is not part of the duty of nurse.
B. Yes. Even though there were no damages, the nurse failed to follow hospital
protocol.
C. No. There were no damages associated with failure to document
D. Yes. Failure to document always results in negligence.
5. A. Beneficence
B. Nonmaleficence
C. Autonomy: A patient with metastatic cancer tells the nurse, "I am tired and
do not want to be put on a breathing machine." The patient's out-of-town son
wants "everything done for my mother" when his mother later develops respiratory
distress. Which ethical principles are involved in this dilemma? (Select all that
apply.)
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
E. Paternalism
6. A. The hospital ethics committee
C. The nursing supervisor
D. The nursing ethics committee: The nurse is concerned that the physician is
ignoring the wishes of the patient and family in the care of a patient. The nurse
should take these concerns to: (Select all that apply.)
A. The hospital ethics committee
B. The ANA (American Nurses Association)
C. The nursing supervisor
D. The nursing ethics committee
E. he policy and procedure committee
7. C. Nonmaleficence: The nurse observes a coworker diverting narcotics by
administering normal saline to a patient in pain. By not reporting this observation,
the nurse is in violation of what ethical principle concerning the patients under the
care of the impaired nurse?
A. Autonomy
