Management Of care NCLEX Questions- (Practice Mode) Www.Rnpedia.Com

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1. Britney is admitted with a diagnosis of schizophrenia. The client refuses to take medication and states “I don’t think I need those medications. They make me too sleepy and drowsy. I insist that you explain their use and side effects.” The nurse should understand that: 

Explanation

Clients have a right to informed consent which includes information about medications, treatments, and diagnostic studies.

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2. Carol has a nasogastric tube after colon surgery. Which one of these tasks can be safely delegated to an unlicensed assistive personnel (UAP)? 

Explanation

Skin care around a nasogastric tube is a routine task that is appropriate for UAPs. The other tasks would be appropriate for a PN or RN to do since they are advanced skills or require evaluation.

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3. Mrs. Jefferson is an 88-year-old client at a long-term care facility. Prior to administering any medication or treatment to this client the nurse must confirm identity by: 

Explanation

An alert, oriented client should be asked to state her full name so that there is no confusion in identity. The ID bracelet will confirm identity when the client is not alert or oriented to person. Reading the name on the client’s ID bracelet is the most accurate way to confirm identity. Reading the client’s medical record will not confirm identity. The roommate is not an accurate source for client identification.

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4. An adult client has continued slow bleeding from the graft after repair of an abdominal aortic aneurysm. Because of the client’s unstable condition, he is in the intensive care unit where visitors are limited to the family. The client insists on having a visit from a medicine man whom the family visits regularly. How should the nurse interpret this request? 

Explanation

The client’s spiritual needs must be met within the framework of his personal belief systems, even if those beliefs differ from those of the nursing staff. The client’s spiritual needs must be met within the framework of his personal belief systems, even if those beliefs differ from those of the nursing staff. The client’s spiritual needs must be met within the framework of his personal belief systems, even if those beliefs differ from those of the nursing staff. The client’s spiritual needs must be met within the framework of his personal belief systems, even if those beliefs differ from those of the nursing staff.

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5. A client frequently compliments and invites the nurse to go out. The nurse should: 

Explanation

The nurse-client relationship is one with professional not social boundaries. Consistent adherence to the limits of the professional relationship builds trust.

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6. John, a client frequently admitted to the locked psychiatric unit repeatedly compliments and invites one of the nurses to go out on a date. The nurse’s response should be to: 

Explanation

The nurse-client relationship is one with professional not social boundaries. Consistent adherence to the limits of the professional relationship builds trust.

Submit
7. A client asks the nurse to call the police and states: “I need to report that I am being abused by a nurse.” The nurse should first: 

Explanation

Obtain more details of the client’s claim of abuse. The advocacy role of the professional nurse as well as the legal duty of the reasonable prudent nurse requires the investigation of claims of abuse or violation of rights. The nurse is legally accountable for actions delegated to others. The application of the nursing process requires that the nurse gather more information, further assessment, before documentation or the reporting of the complaint.

Submit
8. Helen, a nurse from the maternity unit is floated to the critical care unit because of staff shortage on the evening shift. Which client would be appropriate to assign to this nurse? A client with:

Explanation

This client is the most stable with minimal risk of complications or instability. The nurse can utilize basic nursing skills to care for this client.

Submit
9. Robin, an adult male is scheduled for exploratory surgery this morning. After he is premedicated for surgery the nurse reviews his chart and discovers that he has not signed a consent form. The nurse’s action is based on which of the following understandings? 

Explanation

It cannot be legally assumed that the client consents to a procedure for which he has not given consent. This is not legally defensible. All invasive procedures require informed consent. The surgery is prescheduled and described as exploratory and therefore is not an emergency. If the client is an adult and has not been declared incompetent the client must sign the form. This client should not have surgery performed without written consent. The nurse must notify the physician immediately. The client has been premedicated for surgery and is not alert. He cannot give legal consent when under the influence of mind-altering drugs. The client is an adult and there is no evidence that he has been declared incompetent to make his own decisions. The surgery is exploratory. There is no indication it is for an immediately life-threatening condition. It is not appropriate to ask the next of kin to sign his consent form.

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10. Zantac is ordered for an adult client. The nurse mistakenly administered Xanax. What is the most appropriate action for the nurse to take? 

Explanation

In addition to notifying the physician and documenting it, the nurse should complete an incident report. The physician must be notified. An incident report should be completed. However, no record of the incident report should appear in the nurse’s notes. The physician must be notified. An incident report should be completed. However, no record of the incident report should appear in the nurse’s notes. The physician must be notified of the medication error. An incident report should be completed. However, no record of the incident report should appear in the nurse’s notes. The nurse should document that the physician was notified and any assessments completed.

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11. James with a diagnosis of bipolar disorder has been referred to a local boarding home for consideration for placement. The social worker telephoned the hospital unit for information about the client’s mental status and adjustment. The appropriate response of the nurse should be which of these statements?

Explanation

In order to release information about a client there must be a signed consent form with designation of to whom information can be given, and what information can be shared.

Submit
12. After working with a very demanding client, a nursing assistant tells the nurse, "I have had it with that client. I just can’t do anything that pleases him. I’m not going in there again." The nurse’s BEST response is: 

Explanation

This response explains the clients behavior without belittling the nursing assistant’s feelings. The nursing assistant is encouraged to help solve the problem with the nurse.

Submit
13. Which one of the following could be safely delegated by the nurse to the nursing assistant?

Explanation

The RN may delegate the application and care of rectal pouches to a nursing assistant, who should be capable of performing this task

Submit
14. A client tells the nurse, "I have something very important to tell you if you promise not to tell." The best response by the nurse is: 

Explanation

Secrets are inappropriate in therapeutic relationships and are counterproductive to the therapeutic efforts of the interdisciplinary team. Secrets may be related to risk for harm to self or others. The nurse honors and helps clients to understand rights, limitations, and boundaries regarding confidentiality.

Submit
15. A client with Guillain-Barré syndrome has been on a ventilator for three weeks, and can communicate only with eye blinks because of quadriplegia. The intensive care nursing staff sometimes have no time for this tedious communication process. The client’s family comes infrequently since they run a family-owned restaurant that does not close until visiting hours are over. How should the nurse respond to the family’s request for exemption from visiting hours?

Explanation

The need for family support is vital to prevent discouragement and depression. A volunteer will not take the place of family. The need for family support is vital to prevent discouragement and depression, even at the risk of offending the families of other patients. Loss of a breadwinner during the lengthy recovery process may add financial problems for the family. Guillain-Barré syndrome is characterized by the onset of ascending paralysis, which may include respiratory muscles. Persons with Guillain-Barré syndrome may remain ventilator-dependent for weeks, but have full consciousness. The prognosis for recovery from Guillain-Barré syndrome is good, but is very much dependent upon the level of supportive care during the acute stage

Submit
16. A 24-year-old woman had surgery today. Her father, a physician but not her surgeon, enters the nursing station and asks for her chart. The best action for the nurse to take is: 

Explanation

The nurse must maintain the client’s right of confidentiality. Since he is not the client’s physician and does not have a medical need to see her chart, he should not be allowed to read the chart without written permission from the client, who is above the age of majority. Since he is not the client’s physician and does not have a medical need to see her chart, he should not be allowed to read the chart without written permission from the client, who is above the age of majority. It is not the attending surgeon who can give permission for him to review the chart, it is the client. The client must give written permission for unauthorized persons to review her chart. This client had surgery today and is probably not alert enough to give legal permission, which must be written.

Submit
17. Angelina, an R.N., reports to work looking unkempt. Maegan, another R.N., approaches when she notices her using uncoordinated movements. Angelina’s breath reeks of peppermints and Maegan suspects Angelina may be intoxicated. What is the best initial nursing action for Maegan to take?

Explanation

Calling the supervisor is a secondary measure after confronting the nurse and relieving the nurse of her duties. You cannot always assume the supervisor will be immediately available, and client safety should be addressed first. When another nurse is unable to perform her nursing duties due to substance abuse, she should not be allowed to continue them, as client safety is a primary concern. Ignoring the situation is against the professional code of conduct for nurses. Angelina needs to be relieved of her duties. She probably would not benefit from a lecture in her condition.

Submit
18. When assessing a client, it is important for the nurse to be informed about cultural issues related to the client’s background because: 

Explanation

Culture is an important variable in the assessment of individuals. To work effectively with clients, the nurse must be aware of a cultural distinctive qualities

Submit
19. A client continuously calls out to the nursing staff when anyone passes the client’s door and asks them to do something in the room. The best response by the charge nurse would be to: 

Explanation

Assign 1 of the nursing staff to visit the client regularly. Regular, frequent, planned contact by 1 staff member provides continuity of care and communicates to the client that care will be available when needed.

Submit
20. The nurse is responsible for several elderly clients, including a client on bed rest with a skin tear and hematoma from a fall 2 days ago. What is the best care assignment for this client? 

Explanation

Supervise a nursing assistant for skin care. The nursing assistant can inspect the skin while giving hygiene care, but the nurse should supervise skin care since assessment and analysis are needed.

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Britney is admitted with a diagnosis of schizophrenia. The client...
Carol has a nasogastric tube after colon surgery. Which one of these...
Mrs. Jefferson is an 88-year-old client at a long-term care facility....
An adult client has continued slow bleeding from the graft after...
A client frequently compliments and invites the nurse to go out. The...
John, a client frequently admitted to the locked psychiatric unit...
A client asks the nurse to call the police and states: “I need to...
Helen, a nurse from the maternity unit is floated to the critical care...
Robin, an adult male is scheduled for exploratory surgery this...
Zantac is ordered for an adult client. The nurse mistakenly...
James with a diagnosis of bipolar disorder has been referred to a...
After working with a very demanding client, a nursing assistant tells...
Which one of the following could be safely delegated by the nurse to...
A client tells the nurse, "I have something very important to tell you...
A client with Guillain-Barré syndrome has been on a ventilator for...
A 24-year-old woman had surgery today. Her father, a physician but not...
Angelina, an R.N., reports to work looking unkempt. Maegan, ...
When assessing a client, it is important for the nurse to be informed...
A client continuously calls out to the nursing staff when anyone...
The nurse is responsible for several elderly clients, including a...
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