ANSWER KEY NCLEX PRACTICE QUESTIONS
CHAPTER 1 THE ART OF NURSING
Question 1
A nurse is caring for a patient who is anxious about an upcoming surgery. Which action by the nurse best demonstrates the “art of nursing”?
a) Explaining the surgical procedure in detail.
b) Administering prescribed anti-anxiety medication.
c) Sitting with the patient and actively listening to their concerns.
d) Checking the patient’s vital signs frequently.
Rationale: Option (c) exemplifies the “art of nursing” by focusing on the patient’s emotional well-being through empathetic listening. While the other options are part of nursing care, they primarily address physical or procedural aspects.
Question 2
Which of the following statements best reflects the integration of the “art of nursing” with evidence-based practice (EBP)?
a) The art of nursing is outdated and has no place in modern healthcare.
b) EBP should solely guide nursing care, minimizing the need for subjective judgment.
c) The art of nursing enhances EBP by considering patients’ individual needs and preferences.
d) The art of nursing and EBP are separate entities with no connection.
Rationale: Option (c) accurately describes the complementary relationship between the “art of nursing” and EBP. The “art of nursing” adds a layer of patient-centered care to the scientific foundation of EBP.
Question 3
Florence Nightingale’s contributions to nursing primarily emphasized:
a) The importance of research and data collection in nursing.
b) The significance of caring and compassion in nursing practice.
c) The need for nurses to have advanced medical knowledge.
d) The role of technology in improving patient care.
Rationale: Nightingale viewed nursing as a calling that required both technical competence and a deep sense of caring. Her emphasis on compassion continues to influence the “art of nursing” today.
Question 4
A novice nurse asks her preceptor how to develop the “art of nursing”. Which response by the preceptor is most appropriate?
a) “Focus on perfecting your technical skills; the rest will come with time.”
b) “Read nursing journals to stay updated on the latest research and procedures.”
c) “Observe experienced nurses and try to imitate their bedside manner.”
d) “Engage in reflective practice to gain insights from your patient interactions.”
Rationale: Reflective practice encourages nurses to examine their experiences, which helps integrate the art of nursing into their approach. While other options have merit, reflective practice is crucial for developing self-awareness and refining one’s “art.”
Question 5
Which of the following is NOT a key element of the “art of nursing”?
a) Intuition and insight.
b) Empathy and compassion.
c) Strict adherence to standardized protocols.
d) Skillful communication.
Rationale: While following protocols is important for patient safety, the “art of nursing” goes beyond standardized care. It emphasizes individualized care based on a patient’s unique needs, which involves elements like intuition, empathy, and skillful communication.
Question 6
Historically, what social factor significantly shaped the perception of nursing?
a) Traditional gender roles linking women to caregiving.
b) The high academic requirements for nursing education.
c) The emphasis on technology and innovation in healthcare.
d) The financial incentives associated with the nursing profession.
Rationale: The sources note that nursing was historically perceived as an extension of women’s domestic roles. This social context influenced the image and development of nursing as a profession.
Chapter 2 Social Determinants of Health
Question 1
A new graduate nurse is feeling overwhelmed and unprepared for the demands of their role. Which of the following factors is LEAST likely contributing to their experience?
a) Heavy patient loads
b) High turnover rates
c) Inexperienced coworkers
d) Supportive learning environments
Rationale: Challenges faced by new graduate nurses, including heavy patient loads, high turnover rates, and inexperienced coworkers. Supportive learning environments, while crucial for professional development, are not directly mentioned as a contributing factor to the overwhelming experiences of new nurses.
Question 2
Which teaching practice is MOST likely to prepare nursing students for the realities of modern nursing practice?
a) Focusing primarily on didactic lectures
b) Integrating cognitive unmooring questions into patient assessments
c) Limiting simulation experiences to basic skills
d) Emphasizing individual learning over teamwork
Rationale: Incorporating “cognitive unmooring” questions into patient assessments to encourage students to consider potential complications and take proactive steps to ensure patient safety. This practice helps students develop critical thinking and clinical judgment skills necessary for real-world practice.
Question 3
A nursing student is struggling to balance their personal life with the demands of their nursing program. Which university resource is MOST likely to provide direct support in addressing this challenge?
a) Nurse coach
b) Campus sports activities
c) Career coach
d) SON writing tutors
Rationale: A nurse coach can provide individualized support and guidance to nursing students, helping them develop strategies for managing stress, balancing responsibilities, and achieving their academic and personal goals.
Question 4
Which nursing intervention BEST reflects the principles of relational ethics in patient care?
a) Completing tasks efficiently without engaging in personal conversations
b) Actively listening to the patient’s concerns and perspectives
c) Prioritizing the physician’s orders over the patient’s preferences
d) Maintaining a detached and professional demeanor at all times
Rationale: Active listening is a core tenet of relational ethics, demonstrating respect for the patient’s autonomy and promoting a collaborative approach to care.
Question 5
A nurse is caring for a patient who is recovering from a stroke and has limited mobility. The patient lives in a rural area with limited access to public transportation. Which of the following SDOH is most likely to impact the patient’s ability to attend follow-up appointments and participate in rehabilitation?
a) Access to healthy food options
b) Environmental pollution
c) Transportation barriers
d) Social isolation
Rationale: This question focuses on how transportation barriers can directly affect a patient’s access to healthcare services. In this scenario, the patient’s limited mobility and lack of reliable transportation options in a rural area pose significant challenges to attending essential follow-up appointments and engaging in rehabilitation activities.
Question 6
A nursing student is working with a preceptor in a community clinic. The student observes that many patients struggle to afford their medications. Which action by the nursing student demonstrates an understanding of the impact of SDOH on patient care?
a) Suggesting that the patients ask their families for financial assistance
b) Providing patients with information about prescription assistance programs
c) Explaining to the patients that they should try to prioritize their medications over other expenses
d) Recommending that the patients switch to less expensive, over-the-counter alternatives
Rationale: This question highlights the role of nurses in addressing the financial barriers that patients may face in accessing healthcare. By providing information about prescription assistance programs, the nursing student is actively seeking solutions to address the patient’s financial constraints and ensure they can access essential medications.
Chapter 3 Transcultural Nursing Care
Question 1
A nurse is caring for a patient who immigrated from a different country. The patient is refusing pain medication after surgery. Which action by the nurse best demonstrates culturally congruent care according to Madeleine Leininger’s theory?
a) Administer the pain medication as prescribed, explaining that it is essential for recovery.
b) Ask the patient about their beliefs and practices regarding pain management in their culture.
c) Consult with a physician to order a different type of pain medication that might be more acceptable.
d) Encourage family members to persuade the patient to take the pain medication.
Rationale: This response aligns with Leininger’s emphasis on understanding the patient’s (emic) perspective before presenting professional (etic) knowledge. By asking the patient about their cultural beliefs and practices related to pain management, the nurse demonstrates respect for the patient’s individuality and seeks to provide culturally congruent care. This approach is crucial for building trust and understanding the patient’s needs.
Question 2
Which of the following statements best describes Leininger’s concept of “emic” perspective in nursing care?
a) The nurse’s professional understanding of the patient’s health condition.
b) The patient’s own understanding and beliefs about their illness and treatment.
c) The use of scientific evidence to guide nursing interventions.
d) The application of universal nursing practices regardless of cultural differences.
Rationale: The emic perspective refers to the insider’s or the patient’s viewpoint. It emphasizes understanding the patient’s unique cultural knowledge, beliefs, and practices related to health and illness. This concept highlights the importance of incorporating the patient’s perspective into care planning and decision-making.
Question 3
According to Leininger’s Sunrise Model, which factor should a nurse primarily consider when providing culturally congruent care?
a) The patient’s age and gender.
b) The availability of healthcare resources.
c) The patient’s social structure dimensions, such as religion and kinship.
d) The nurse’s own cultural background and beliefs.
Rationale: Leininger’s Sunrise Model emphasizes that quality of life is influenced by social determinants of health. The model guides nurses to consider the patient’s social structure dimensions, including religion, kinship, and economic factors. Understanding these dimensions helps the nurse provide culturally congruent care that aligns with the patient’s values and beliefs.
Question 4
Which nursing action is an example of “culture care accommodation/negotiation,” according to Leininger’s theory?
a) Encouraging a patient to continue their traditional healing practices alongside prescribed medical treatment.
b) Providing educational materials about the patient’s health condition in their native language.
c) Respecting a patient’s decision to refuse a blood transfusion due to religious beliefs.
d) Modifying a patient’s diet plan to incorporate culturally preferred foods.
Rationale: Culture care accommodation/negotiation involves finding ways to integrate the patient’s cultural practices with the healthcare plan. This option demonstrates a willingness to adapt care to the patient’s preferences, as long as it doesn’t compromise safety or effectiveness.
Question 5
What is the primary goal of transcultural nursing, according to Leininger?
a) To eliminate all cultural differences in healthcare settings.
b) To provide care that fits the patient’s cultural values, beliefs, and lifeways.
c) To ensure that all patients receive standardized medical treatments.
d) To promote the adoption of Western medical practices globally.
Rationale: Leininger’s Transcultural Nursing Theory centers on providing culturally congruent care. This means understanding and integrating the patient’s cultural values, beliefs, and practices into the care plan. The goal is to provide care that is beneficial, satisfying, and meaningful to the individual within their cultural context.
Question 6
Which statement by a nursing student demonstrates a good understanding of Leininger’s theory?
a) “Culture has little impact on a person’s health beliefs and practices.”
b) “It’s important to treat all patients the same, regardless of their culture.”
c) “Scientific evidence is the only valid basis for nursing interventions.”
d) “Understanding a patient’s cultural background is essential for providing holistic and effective care.”
Rationale: This statement reflects a key principle of Leininger’s theory. The theory emphasizes the importance of considering the patient’s social and cultural context in providing care. Recognizing and respecting the patient’s cultural background is essential for building a therapeutic relationship and delivering holistic care that addresses their unique needs.
Chapter 4 Skill of Involvement
Question 1
A novice nurse asks her preceptor about the concept of “skill of involvement” (SOI) in nursing. Which response by the preceptor is the most accurate?
a) “SOI is a skill that can only be learned through years of experience.”
b) “SOI primarily focuses on technical skills and medical knowledge.”
c) “SOI is not relevant to novice nurses as they lack experience.”
d) “SOI involves holistic cognitive skills like intuition, empathy, and cultural humility.”
Rationale: The sources define SOI as encompassing holistic cognitive skills such as intuition, empathy, sensitivity, and cultural humility. Options (a), (b), and (c) are incorrect. While experience enhances SOI, it can be taught and improved upon from the beginning of nursing education. SOI is not solely focused on technical skills but rather emphasizes the human and relational aspects of nursing.
Question 2
A nursing student is caring for a patient from a different cultural background. The student feels unsure about how to approach the patient’s spiritual needs. What would be the most appropriate action for the student to take?
a) Avoid discussing spirituality to prevent causing offense.
b) Assume the patient’s spiritual needs based on their religion.
c) Consult a textbook for information on the patient’s specific culture.
d) Respectfully ask the patient about their spiritual beliefs and practices.
Rationale:
Cultural humility, a key component of SOI, involves respectfully engaging with patients to understand their cultural beliefs and practices, including spirituality. Options (a), (b), and (c) are not the best approaches. Avoiding the topic of spirituality may neglect the patient’s needs. Making assumptions or relying solely on general cultural information can lead to misunderstandings.
Question 3
A new graduate nurse is feeling overwhelmed by the demands of the job and is questioning their ability to provide competent care. Which statement reflects a lack of skill of involvement (SOI) that could hinder the nurse’s clinical judgment?
a) “I need to carefully analyze patient data and follow protocols to ensure safe care.”
b) “I should seek guidance from experienced nurses when I’m uncertain about a situation.”
c) “My gut feeling is telling me something is wrong, but the vital signs are stable.”
d) “I’m afraid to make a mistake, so I’m only focusing on the tasks and not the patient.”
Rationale: Focusing solely on tasks and neglecting the patient’s holistic needs reflects a lack of SOI, specifically in areas like empathy and sensitivity. While following protocols and seeking guidance are important, option (d) highlights a disconnect from the patient that can hinder clinical judgment.
Question 4
Which scenario best exemplifies a nurse demonstrating the skill of involvement (SOI) in clinical practice?
a) A nurse efficiently administers medications to all patients on time according to the MAR.
b) A nurse recognizes a subtle change in a patient’s breathing pattern and promptly notifies the physician.
c) A nurse delegates tasks to unlicensed assistive personnel (UAP) to manage time effectively.
d) A nurse uses a standardized assessment tool to collect patient data during the admission process.
Rationale: The nurse’s ability to recognize a subtle cue (change in breathing pattern) and respond proactively demonstrates sensitivity and potentially intuition, both components of SOI8. Options (a), (c), and (d), while important aspects of nursing practice, do not specifically highlight SOI.
Question 5
According to the sources, what is a potential consequence for nurses who do not develop skill of involvement (SOI)?
a) They may have difficulty adapting to new technologies in healthcare.
b) They may be less likely to advance to the level of expert nurse.
c) They may experience higher levels of job satisfaction and burnout.
d) They may struggle to meet the minimum competency requirements for licensure.
Rationale: Nurses who do not acquire SOI do not reach the expert level of nursing practice.
Question 6
The NCSBN Clinical Judgment Model highlights the importance of considering “factors of the individual” when making clinical decisions. Which example best reflects this concept?
a) A nurse adjusts pain management strategies based on the patient’s cultural beliefs about pain expression.
b) A nurse uses evidence-based guidelines to determine the appropriate dose of medication for a patient.
c) A nurse follows hospital policy when administering blood transfusions to ensure patient safety.
d) A nurse uses a clinical decision support system to help interpret a patient’s laboratory results.
Rationale: Recognizing and adapting care based on a patient’s cultural beliefs about pain demonstrates consideration for the “individual factors” influencing their experience and needs9. Options (b), (c), and (d) emphasize important aspects of care but focus more on standardized approaches rather than individual patient factors.
Chapter 5 (Practice Questions Not Available in this section.)
Chapter 6 (Practice Questions Not Available in this section.)
Chapter 7 (Practice Questions Not Available in this section.)
Chapter 8 (Practice Questions Not Available in this section.)
Chapter 9 Arts Engagement in Nursing: A Holistic Approach to Mental Health
Question 1
A nurse is caring for a patient experiencing anxiety and depression. Which of the following art-based interventions would be most appropriate for the nurse to suggest?
a) Attending a support group focused on medication management
b) Participating in a guided meditation session
c) Engaging in a painting class at a local community center
d) Reading a self-help book on cognitive behavioral therapy
Rationale: Art-based interventions, like painting, provide a creative outlet for emotions and can be therapeutic for individuals experiencing anxiety and depression.
Question 2
A nursing student is learning about social prescribing. Which of the following is an example of a service that could be offered through social prescribing?
a) Referral to a specialist for a medical diagnosis
b) Prescription for an antidepressant medication
c) Enrollment in a community gardening program
d) Admission to an inpatient psychiatric facility
Rationale: Social prescribing connects people with non-medical community resources to improve health and well-being. Community gardening offers social interaction, physical activity, and a connection with nature, which can be beneficial for mental health.
Question 3
A nurse is developing a trauma-informed care plan for a patient with a history of post-traumatic stress disorder (PTSD). Which of the following principles should guide the nurse’s approach?
a) Focusing primarily on symptom management through medication
b) Avoiding discussions about past traumatic experiences
c) Prioritizing the patient’s sense of safety and control
d) Emphasizing the importance of confronting traumatic memories
Rationale: Trauma-informed care recognizes the impact of trauma and prioritizes patient safety and empowerment. Allowing the patient to control the pace and depth of discussions about their trauma is crucial.
Question 4
A group of nursing students is discussing the benefits of creative health placements. Which of the following statements demonstrates an understanding of the value of these placements?
a) “Creative health placements are primarily focused on teaching students about art therapy techniques.”
b) “Creative health placements can help students develop a deeper understanding of person-centered care.”
c) “Creative health placements are designed to replace traditional clinical placements in acute care settings.”
d) “Creative health placements are only beneficial for students interested in pursuing careers in mental health nursing.”
Rationale: Creative health placements expose nursing students to diverse care approaches and emphasize the importance of holistic, individualized care, which aligns with person-centered principles.
Question 5
A nurse is advocating for the integration of arts into mental health care policies. Which of the following statements accurately reflects the rationale for this advocacy?
a) “Arts engagement can replace the need for traditional mental health treatments, such as medication and therapy.”
b) “Arts engagement is only effective for individuals with a strong background in the arts.”
c) “Arts engagement can promote mental well-being, reduce stigma, and enhance community resilience.”
d) “Arts engagement should be limited to hospital settings to ensure patient safety.”
Rationale: Arts engagement has been shown to have positive effects on mental health by providing emotional expression, reducing isolation, and fostering a sense of belonging, all of which contribute to community resilience.
Question 6
A nurse is working with a community organization to develop a culturally responsive art-based program for a diverse population. Which of the following considerations should be prioritized?
a) Designing a program based on the nurse’s personal artistic preferences
b) Selecting art materials that are readily available and inexpensive
c) Ensuring that the program reflects the cultural values and beliefs of the community
d) Implementing a standardized art curriculum used in other community settings
Rationale: Culturally responsive care respects diversity and tailors interventions to align with the specific needs and beliefs of the target population, ensuring relevance and effectiveness.
