NCLEX RN Test Bank with Rationales
Question 1 of 5.
The nurse is providing medication instructions to a client who is prescribed imipramine daily. Which statement by the client indicates a need for further teaching?
A. I need to avoid alcohol while taking the medication.
B. I need to take the medication in the morning before breakfast.
C. The effects of the medication may not be noticed for at least 2 weeks.
D. A missed dose should be taken as soon as possible unless it is almost time for the next dose.
Explanation: Imipramine is a tricyclic antidepressant (TCA). The client should be instructed to take the medication (a single dose) at bedtime and not in the morning because it causes fatigue and drowsiness. The client is told to avoid alcohol or other central nervous system depressants during therapy and that medication effects may not be noticed for at least 2 weeks. The client is instructed to take the medication exactly as directed, and if a dose is missed, to take it as soon as possible unless it is almost time for the next dose.
Question 2 of 5.
What is the primary goal of multidisciplinary case conferences?
A. To fulfill the nurse's role in terms of collaboration
B. To plan and provide for optimal client outcomes
C. To solve complex multidisciplinary patient care problems
D. To provide educational experiences for experienced nurses
Explanation: The primary goal of multidisciplinary case conferences is to plan and provide for optimal client outcomes by bringing together various professionals to coordinate care and address the client's needs holistically.
Question 3 of 5.
Select the standardized 'hand off' change of shift reporting system that is accurately paired with its elements.
A. SBAR: Symptoms, background, assessment and recommendations
B. ISBAR: Interventions, symptoms, background, assessment and recommendations
C. The Five Ps: The patient, plan, purpose, problems and precautions
D. BATON: Background, assessment, timing, ownership and next plans
Explanation: The Five Ps accurately describes a hand-off system with elements: patient, plan, purpose, problems, and precautions, used to ensure comprehensive communication during shift changes.
Question 4 of 5.
Legal prohibitions against sharing passwords are legally based on:
A. The Security Rule
B. The American Nurses Association's Code of Ethics
C. The American Hospital's Patients' Bill of Rights
D. The Autonomy Rule
Explanation: Legal prohibitions against sharing passwords are based on the Security Rule of HIPAA, which mandates safeguards to protect electronic protected health information.
Question 5 of 5.
Which statement about referrals is accurate?
A. Referrals complement the healthcare teams' abilities to provide optimal care to the client.
B. Referrals simply allow the client to be discharged into the community with the additional care they need.
C. Nurses facilitate referrals to only the resources within the facility.
Explanation: Referrals enhance the healthcare team's ability to provide comprehensive care by connecting clients to specialized services, not limited to discharge or internal resources .