NCLEX-PN Test #18 1

Question 1

A competent adult patient refuses a blood transfusion based on religious beliefs, despite knowing it may result in death. What is the nurse's most appropriate action?

Accepted Answer

Respect the patient's decision, document it, and notify the physician

Answer

Competent adults have the legal and ethical right to refuse any treatment, including life-saving interventions, based on informed decision-making. The nurse must respect patient autonomy, document the refusal and the patient's understanding of the consequences, and notify the provider.

Question 2

A nurse overhears a colleague discussing a patient's HIV status in the hospital elevator with non-care team members. The nurse should take which action first?

Accepted Answer

Speak to the colleague privately about the confidentiality violation

Answer

The initial action is to address the colleague directly and privately. HIPAA regulations protect patient health information. Discussing a patient's diagnosis in public areas with unauthorized individuals is a confidentiality violation. If the behavior continues, escalation to management is appropriate.

Question 3

A nurse discovers a medication error made by another nurse earlier in the shift. The medication did not cause patient harm. What is the nurse's ethical and professional obligation?

Accepted Answer

Complete an incident report, notify the charge nurse and physician, and document in the patient record

Answer

All medication errors, whether or not harm occurred, must be reported via an incident (variance) report, disclosed to the provider, and documented objectively in the medical record. Transparency and accurate reporting are essential for patient safety, quality improvement, and legal protection.

Question 4

A patient is scheduled for surgery and the nurse learns the patient does not understand the risks explained by the surgeon. The nurse should take which action?

Accepted Answer

Refuse to witness the consent and notify the surgeon that the patient needs further explanation

Answer

Obtaining informed consent is the physician's (or surgeon's) legal responsibility. The nurse's role is to witness that the signature is voluntary and the patient appears competent. If the patient does not understand the procedure or risks, the nurse must notify the surgeon for clarification before witnessing the consent.

Question 5

A patient is admitted to the emergency department unconscious with no identification. Emergency surgery is needed to save the patient's life. Which type of consent applies?

Accepted Answer

Implied consent

Answer

Implied consent allows healthcare providers to treat an unconscious patient in a life-threatening emergency when the patient is incapable of giving consent and there is no time to locate a surrogate decision-maker. The law implies that a reasonable person in this situation would consent to life-saving treatment.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #18 1