NCLEX-PN Chapter 6 & 7 Questions

The nurse is assigned to care for four clients. When planning client rounds, which client would the nurse check first? 1 A client in skeletal traction 2 A client who is a dependent on a ventilator 3 A postoperative client preparing for discharge 4 A client admitted during the previous shift with a diagnoses of gastroenteritis

2 A client who is a dependent on a ventilator

The nurse is planning the client assignments for the day. Which is the most appropriate assignment for the assistive personnel? 1 A client who requires wound irrigation 2 A client who requires twice-daily dressing changes 3 A client who is receiving continuous tube feedings 4 A client who requires frequent VS after a cardiac cath

2 A client who requires twice-daily dressing changes

The LPN enters a client's room and finds the client lying on the bathroom floor. The LPN calls the RN who checks the client thoroughly and then assists the client back into bed. The LPN completes and incident report, and the nursing supervisor and PHCP are notified of the incident. Which is the next nursing action regarding the incident. 1 Place the incident report in the client's chart. 2 Make a copy of the incident report for the PHCP 3 Document a complete entry in the client's record concerning the incident. 4 Document in the client's record that an incident report has been completed.

3 Document a complete entry in the client's record concerning the incident.

The nurse has delegated several nursing tasks to staff members. Which is the nurse's primary responsibility after the delegation of task. 1 Document that the task was completed 2 Assign the tasks that were not completed to the next nursing shift 3 Allow each staff member to make judgments when performing the task 4 Perform follow-up with each staff member regarding the performance and outcome of the task

4 Perform follow-up with each staff member regarding the performance and outcome of the task

A client has died, and the nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue, Which is the appropriate nursing action at this time. 1 Show acceptance of feelings 2 Provide information needed for decision making 3 Suggest a referral to a mental health professional 4 Remain with the family member without discussing funeral arrangements

4 Remain with the family member without discussing funeral arrangements

The nurse employed in a long-term care facility is planning the client assignments for the shift. Which client would the nurse assign to the assistive- personnel 1 A client who requires a 24-hour urine collection 2 A client who requires twice daily dressing changes 3 A client with diabetes mellitus who requires daily insulin and the reinforcement of dietary changes 4 A client who has been placed on a bowel management program requires rectal suppository and a daily enema

1 A client who requires a 24-hour urine collection

The nurse is recording a nursing hands-off report for a client. Which info needs to be included? 1 As-needed medications given that shift 2 Normal VS that have been the same since admission 3 All of the tests and treatments the client has had since admission 4 total number of scheduled medications that the client received on that shift

1 As-needed medications given that shift

A client experiences cardiac arrest. The nurse leader quickly responds to the emergency and assigns clearly defined tasks to the work group. In this situation, the nurse is implementing which leadership style? 1 Autocratic 2 Situational 3 Democratic 4 Laissez-fiare

1 Autocratic

The nurse arrives at work and is told to float to pediatric unit for the day because the unit is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the pediatric unit. Which is the appropriate nursing action? 1. Call the hospital lawyer. 2 Call the nursing supervisor 3 Refuse to float to the pediatric unit 4 Report to the pediatric unit and identify tasks that can safely be performed.

4 Report to the pediatric unit and identify tasks that can safely be performed.

An unconscious client, bleeding profusely, is brought to the ED after a serious accident. Surgery is required immediately to save the client's life. With regard to informed consent for the surgical procedure, which is the best action. 1 Call the nursing supervisor to initiate a count order for the surgical procedure. 2 Try calling the client's spouse to obtain telephone consent before the surgical procedure. 3 Ask the friend who accompanied the client to the ED to sign the consent. 4 Transport the client to the Operating Department immediately without obtaining an informed consent.

4 Transport the client to the Operating Department immediately without obtaining an informed consent.

The nurse enters a client's room and notes that the client's lawyer is present and that the client is preparing a living will. The living will requires that they client's signature be witnessed, and the client asks the nurse to witness the signature. Which is the appropriate nursing action? 1 Decline to sign the will 2 Sign the will as a witness to the signature only. 3 Call the hospital lawyer before signing the will 4 Sign the will, clearly identifying credentials and employment agency

1 Decline to sign the will

An older woman is brought to the ED. When caring for the client. the nurse notes old and new ecchymotic areas on both of the client's arms and buttocks. The nurse asks the client how the bruises were sustained. The client, although reluctant, tells the nurse in confidence that her daughter frequently hits her if she gets in the way. Which is the appropriate nursing response? 1 I have a legal obligation to report this type of abuse 2 I promise I won't tell anyone, but let's see what we can do about this 3 Let's talk about ways that will prevent your daughter from hitting you 4 This should not be happening. If it happens again, you must call the ED

1 I have a legal obligation to report this type of abuse

The nurse is attending an agency orientation meeting about the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. Which of the following described the team-based model of nursing practice? 1 A task approach method is used to provide care to clients 2 Managed care concepts and told are used when providing client care 3 Nursing staff are led by the nurse when providing care to a group of clients 4 A single registered nurse is responsible for providing nursing care to group of clients.

3 Nursing staff are led by the nurse when providing care to a group of clients

The nurse is assigned to care for four clients. When planning client rounds, which client would the nurse collect data from first? 1 A client scheduled for a chest x-ray 2 A client requiring daily dressing changes 3 A postoperative client preparing for discharge 4 A client receiving oxygen who is having difficulty breathing

4 A client receiving oxygen who is having difficulty breathing

The nurse employed in an ED is assigned to assist with the triage of clients arrived at the ED. The nurse would assign priority to which client? 1 A client complaining of muscle ache, headache, and malaise 2 A client who twisted their ankle when they fell in-line skating 3 A client with a minor laceration on the index finger sustained while cutting an eggplant 4 A client with chest pain who states they they just ate pizza that was made with a very spicy sauce

4 A client with chest pain who states they they just ate pizza that was made with a very spicy sauce

The nurse observes that a client received pain medication 1 hour ago from another nurse, but the client still has severe pain. The nurse has previously observed this same occurrence several times. Based on the nurse practice act, the observing nurse would plan to take which action? 1 Report the information to the police 2 Call the impaired nurse organization 3 Talk with the nurse who gave the medication 4 Report the information to a nursing supervisor

4 Report the information to a nursing supervisor

The nurse is education a new nurse about mass casualty events (disasters). Which statement by the new nurse indicated a need for further teaching? Select all that apply. 1 An event is termed a mass casualty when it overwhelms local medical capabilities 2 Mass casualty events do not require an increase in the number of staff that are needed 3 A mass casualty event occurs only within the health care facility and could endanger staff 4Mass casualty events may require the collaboration of many local agencies to handle the situation 5 A mass casualty event occurs if a fight between visitors occurs in the emergency department

2, 3, 5

A nurse lawyer provides an education session to the nursing staff regarding client rights with an emphasis on invasion of these rights. The nurse lawyer asks a staff nurse to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by a staff nurse, indicates an understanding of a violation of this client right? 1 Threatening to place a client in restraints 2 Performing a surgical procedure without consent 3 Taking photographs of the client without consent 4 Telling the client that he or she cannot leave the hospital

3 Taking photographs of the client without consent

Which identifies accurate nursing documentation notations: Select all that apply: 1- The client slept through the night. 2- Abdominal wound dressing is dry and intact without drainage. 3- The client seemed angry when awakened for VS measurement. 4- The client appears to become anxious when it is time for resp treatments. 5- The client's left lower medical lef wound is 3 cm in length without redness, drainage, or edema.

1,2,5

The nurse finds the client lying on the floor. The nurse calls the RN, which checks the client and then calls the nurse supervisor and the PCP to inform them of the occurrence. The nurse completes the incident report for which process. 1 Providing clients with necessary stabilizing treatments 2 A method of promoting quality care and risk management 3 Determining the effectiveness of interventions in relation to outcomes 4 The appropriate method of reporting to local, state, and federal agencies

2 A method of promoting quality care and risk management