NCLEX Prep for Safe and Effective Care Environment



These questions are one of the NCLEX prep samples for Safe and Effective Care Environment. This post has a 25 set of questions with the accompanying answers and rationale located at the bottom. If you want to answer all of our NCLEX questions interactively then be one of our member today. Click here to join. It’s Free.

1.    Nurse Paul has asked a nursing assistant to ambulate an elderly client. While walking, the client becomes dizzy and falls, fracturing a hip. The nurse understands that who is accountable for this injury to the client?

a.    The client
b.    The hospital
c.    The nurse
d.    The nursing assistant

2.    Nurse Marlon understands that the delivery of quality care to a specific client is primarily the responsibility of the:

a.    Institution providing the care
b.    Joint Commission for Accreditation of Healthcare Organizations
c.    Individual care provider
d.    Institution’s medical staff and nursing administration

3.    Nurse Marlon is aware that a durable power of attorney for health care allows the designated decision-maker to:

a.    Refuse treatment for the client
b.    Access client’s finances to assure payment for health care
c.    Be the executor of the client’s estate
d.    Agree to active euthanasia when there is no chance of recovery for the client

4.    A male client is returning form a skilled nursing care facility following rehabilitation from a cerebrovascular accident (CVA) and now walks with a walker. Nurse Lindon rearranges the furniture, removes throw rugs, and has grab bars installed in the client’s bathroom. These actions reflect the nurse’s attention to which ethical principle?

a.    Beneficence
b.    Nonmaleficence
c.    Fidelity
d.    Justice

5.    Nurse Jane is planning interventions for a group of overweight teenage girls. What can the nurse do to best improve commitment to a long-term goal for weight loss for these clients?

a.    Involves family members in the process
b.    Keep detailed records of each girl’s progress
c.    Use a system of rewards for reinforcement of behavior
d.    Attempt to develop self-motivation

6.    Which client situation would the nurse know to be most likely handles by a case management approach to health care?

a.    Post-op care of a client following laparoscopic cholecystectomy
b.    Delivery of a full-term infant to a married woman
c.    A client with residual problems following a cerebrovascular accident
d.    A child with a fracture of his dominant arm

7.    Which situation would require the completion of a variance or incident report by nurse Leslie?

a.    A disagreement with the medical care ordered by the physician
b.    A dispute with a co-worker about client assignments
c.    The identification of a safety concern with a piece of equipment used on a regular basis
d.    The discovery that a pre-op client has received and eaten a breakfast tray

8.    What is one way that nurses can participate in the organ donation process?

a.    Making sure that all clients have advanced directives
b.    Encouraging all clients to be tissue typed
c.    Discouraging do not resuscitate orders so that organs can be retrieved
d.    Presenting the option of organ donation to all suitable clients and families

9.    A female client who received a sedativehypnotic medication at bedtime becomes confused during the night. The client gets out of bed and falls, sustaining a laceration that requires suturing. Which statement would be included as part of the nurse’s documentation in the client’s chart?

a.    “Client fell due to confusion caused by sleeping medication.”
b.    “Client found lying on the floor in a pool of blood. Nursing assistant forgot to put siderails up at bedtime.”
c.    “Client found sitting in the floor. 3cm laceration above left eyebrow. Oriented to name only.”
d.    “Client slipped in water on floor cause by leaking faucet that was reported to the maintenance department two days ago.”

10.    The  nurse’s role in developing a continuum of care for a group of case managed clients involves:

a.    Ensuring that care the nurse personally delivers meets all standards of care
b.    Focusing on outcomes and client’s movement through various setting and services.
c.    Making suggestions to other professions regarding the client’s care
d.    Personally performing all aspects of the client’s care

11.     When asked to explain how a health maintenance organization changes for its services. The nurse’s best answer is:

a.    Services are billed based on the client’s ability to pay
b.    Clients are required to pay for all routine services completely out of their own pocket
c.    A predetermined set of service is provided for a fixed, prepaid charge
d.    Only charges incurred while an inpatient will be covered by an HMO

12.    Nurse Dominique knows a client who is a devout Seventh Day Adventist will feel most comfortable if:

a.    Allowed to have a crucifix in the room
b.    A bible is available for scripture readings
c.    Assigned a room with windows facing east
d.    Assigned a private room

13.    Communication is an essential skill for the nurse acting as an advocate. When the nurse says to the client, “Let me see if I understand what you mean…., “the nurse is involved in the process of:

a.    Verification
b.    Amplification
c.    Clarification
d.    Affirming

14.    Nurse Olivia understands that the best person to discuss the option of organ donation with a family of a potential donor is:

a.    The nurse who has been caring for the client
b.    Someone that the family knows personally
c.    Someone who is comfortable with discussing the organ donation process
d.    The primary care physician

15.    One of the biggest challenges facing nurses who want to act as a client advocate is:

a.    Dealing with their own reactions to client decisions that conflict with the nurse’s personal belief system
b.    A lack of reimbursement for activities involved in this role
c.    A lack of time to spend with clients
d.    Dealing with conflicts that can arise with other health care providers

16.    Jannie, presents to the emergency department following a motor vehicle collision and the nurse learns the client is a Jehovah’s Witness. The nurse is aware that this causes a concern in this situation because the client will:

a.    Insists on having family in the room at all times
b.    Not consent to any surgical interventions for the sustained injuries
c.    Not consent to any necessary blood transfusions
d.    Not consent to being undressed and examined by a physician of the opposite sex

17.    Maintaining a continuum of care is dependent on a variety of factors. Which factor does the nurse understand to be most important?

a.    Development of a multidisciplinary and multi agency plan that addresses the desired outcome for the client
b.    Assessing the client’s progress on a monthly basis
c.    Accessing community resources early in the process
d.    Keeping accurate assessments and documentation

18.    Nurse Gail has interviewed for a position in a medical-surgical unit. The nurse’s best action following the interview is to:

a.    Waiting for the interviewer to contact you regarding a possible job offer
b.    Seek input from staff members on the unit about your chances for getting the job
c.    Send a note of thanks to the interviewer
d.    Make daily phone calls to check if a decision has been made

19.    Which statement is consistent with the role of a nurse as advocate?

a.    Advocacy does not involve any personal or professional risks
b.    Advocacy is a new concept in nursing, becoming important in the last 20 years
c.    Power base has no impact on the effectiveness of the nurse in the advocate role
d.    Interpreting information for the clients is an example of advocacy

20.    Nurse Kim is involved in the statewide organ procurement programs as a transplant coordinator. Why is it important for the nurse to encourage members of all racial groups to become organ donors?

a.    All persons should be offered organ donation as an option because it is the fair thing to do
b.    Organ and tissue transplantation can only be successful within racial groups
c.    A better match of immunogenetic factors can be obtained within racial groups and increase the success of the transplantation
d.    Members of minority racial groups have a high incidence of organ failure

21.    Nurse Ben is interviewing an elderly client that may have been abused by a neighbor who provides much of the care for this person. The nurse’s interview questions should:

a.    Not directly ask if the client has ever been hurt by someone
b.    Be confrontational
c.    Be non-threatening  and non-judgmental
d.    Include as much information as possible

22.    What does nurse Annie understand to be the impact of computerized charting on the maintenance of confidentiality of client records?

a.    The same problem are associated with computerized and paper records
b.    Computers afford greater security of client records
c.    The use of computers presents different challenges to maintaining confidentiality of client records
d.    Technology is not at the advanced level needed to ensure security of client records

23.     In which situation would nurse Ricky be protected form from any legal action?

a.    Stopping at an accident scene and providing first aid
b.    Reporting suspected cases of abuse of dependent adults to the appropriate authorities
c.    Teaching health maintenance practices to a group of women
d.    Performing CPR on a drowning victim

24.    Nurse Ley is discharging a client with congestive heart failure after making a referral for follow up with a community health agency. The ultimate goal for this client receiving care from a public health nursing agency will focus on:

a.    Assistance with personal care
b.    Adequate nutrition
c.    Proper immunization
d.    Client independence

25.    Nurse Jenny new to the intensive care unit identifies a fellow staff nurse who is respected for exceptional knowledge and skill in delivering care to critically ill clients. This nurse is also respected by other nurses, physicians, and administration. What is the source of this nurse’s power?

a.    Legitimacy
b.    Coercive
c.    Expert
d.    Charismatic

Answers and Rationale for Safe and Effective Care Environment



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