Fundamental
While communicating with a nursing peer, the nurse leader reports, "I allow my team to work freely and accomplish their own tasks without oversight." Which style of leadership is the nurse following? 1 Autocratic style 2 Situational style Incorrect3 Democratic style Correct4 Laissez-faire style
A laissez-faire leader chooses to avoid responsibility by delegating all decision-making to the group. This type of leader would want the group members to feel free to accomplish their own tasks. An autocratic leader is firm, insistent, and dominating. A situational leader makes decisions based on the situations to be handled. A democratic leader encourages the participation of workgroups and facilitates goal accomplishment while stressing the self-worth of each individual.
A nurse must establish and maintain an airway in a client who has experienced a near-drowning. For which potential danger should the nurse assess the client? 1 Alkalosis 2 Renal failure 3 Hypervolemia Correct4 Pulmonary edema
Additional fluid from surrounding tissues will be drawn into the lung because of the high osmotic pressure exerted by the salt content of the aspirated ocean water; this results in pulmonary edema. Hypoxia and acidosis may occur after a near-drowning. Renal failure is not a sequela of near-drowning. Hypovolemia occurs because fluid is drawn into the lungs by the hypertonic saltwater.
A client is receiving albuterol to relieve severe bronchospasms caused by asthma. For which clinical indicators should the nurse monitor the client? Select all that apply. Correct1 Tremors 2 Lethargy Correct3 Palpitations 4 Visual disturbances 5 Decreased pulse rate
Albuterol's sympathomimetic effect causes central nervous stimulation, precipitating tremors, restlessness, and anxiety. Albuterol's sympathomimetic effect causes cardiac stimulation that may result in tachycardia and palpitations. Albuterol may cause restlessness, irritability, and tremors, not lethargy. Albuterol may cause dizziness, not visual disturbances. Albuterol will cause tachycardia, not bradycardia. Test-Taking Tip: The following are crucial requisites for doing well on the NCLEX exam: (1) A sound understanding of the subject; (2) The ability to follow explicitly the directions given at the beginning of the test; (3) The ability to comprehend what is read; (4) The patience to read each question and set of options carefully before deciding how to answer the question; (5) The ability to use the computer correctly to record answers; (6) The determination to do well; (7) A degree of confidence.
To decrease abdominal distention following a client's surgery, what actions should the nurse take? Select all that apply. Correct1 Encourage ambulation 2 Give sips of ginger ale Correct3 Auscultate bowel sounds 4 Provide a straw for drinking 5 Offer an opioid analgesic
Ambulation will stimulate peristalsis, increasing passage of flatus and decreasing distention. Monitoring bowel sounds is important because it provides information about peristalsis. Carbonated beverages, such as ginger ale, increase flatulence and should be avoided. Using a straw should be avoided because it causes swallowing of air, which increases flatulence. Opioids will slow peristalsis, contributing to increased distention. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.
The nurse resolves a conflict with another nurse by using accommodation. In what situations is accommodation appropriate for resolving conflict? Select all that apply. Correct1 When facing trivial issues 2 When defensiveness is avoided 3 When people gather more information Correct4 When the other person's solutions appear better Correct5 When harmonious relationships have to be preserved
Appropriate reasons for accommodating to resolve conflict include when the issues are trivial or not important, when the other person's ideas or solutions are better, or when harmonious relationships have to be preserved. Avoiding defensiveness is not an appropriate reason to accommodate when resolving conflict. Gathering more information is not an appropriate reason to accommodate when resolving conflicts, unless that additional information has shown that the nurse has made a mistake.
Which system thinking theory principle is involved when the nurse considers the decision of a client to terminate clinical treatment? 1 Thinking of the big picture Correct2 Balancing short-term and long-term objectives 3 Using measurable versus non-measurable data systems 4 Recognizing the dynamic, complex, and interdependent nature of systems
Balancing short-term and long-term objectives may involve the nurse considering the decision of the client about termination of clinical treatment in order to have a better quality outcome. Thinking of the big picture involves the nurse explaining the needs of all units of the hospital or all residents in a long-term facility. Using measurable versus non-measurable data systems involves moving beyond the tendency to see only what we measure and analyzing morale, working relationships, and teamwork. Recognizing the dynamic, complex, and interdependent nature of systems involves understanding how clients are connected to families and friends and how, together, they are connected to communities and cultures.
Which nursing actions indicate effective implementation of systems thinking theory principle with respect to "thinking of the Big Picture"? Select all that apply. Correct1 Focusing on the needs of all the residents in a long-term care facility Correct2 Knowing about the complications of emergency department overcrowding in an urban setting Incorrect3 Focusing on analyzing morale, working relationships, team work, and the number of clients Incorrect4 Identifying and understanding the relationships of clients, families, communities, and local economies 5 Recognizing the long-term effects of actions on the organization or client care
Focusing on the needs of all residents in a long-term care facility and knowing about the complications of emergency department overcrowding in an urban setting are actions that indicate effective implementation of the "Big Picture" principle by helping the nurse envision his/her work beyond the immediate tasks. Focusing on analyzing morale, working relationships, team work, and the number of clients indicates effective implementation of "Using Measurable versus Nonmeasurable Data Systems" principle of systems thinking theory. Identifying and understanding the relationships of clients, families, communities, and local economies indicates effective implementation of "Recognizing the Dynamic, Complex, and Interdependent Nature of Systems" principle. Recognizing the long-term effects of actions on the organization or client care indicates the "Balancing Short-Term and Long-Term Objectives" principle of systems thinking theory.
A nursing student is recalling the Stage-Crisis Theory of Robert Havinghurst. Which step listed by the nursing student needs correction according to Havinghurst theory? 1 The number of tasks differs in each age level for individuals. 2 There are six stages and six-to-ten developmental tasks for each stage. 3 Successful resolution of the developmental task is essential to successful progression throughout life. Correct4 This theory includes four periods that are related to age and demonstrates specific categories of knowing and understanding.
Havinghurst's theory does not include four periods that are related to age and does not demonstrate specific categories of knowing and understanding; this statement is associated with Piaget's theory of cognitive development. Havinghurst's theory states that the number of tasks differs in each age level for individuals. Havinghurst's theory consists of six stages and six-to-ten developmental tasks for each stage. Havinghurst's theory believes that the successful resolution of developmental tasks is essential to successful progression throughout life.
The registered nurse instructs a student nurse to perform an action as a community volunteer. Which action should the student nurse perform as a community volunteer? 1 Recording vaccinations 2 Attending a city commission meeting 3 Writing letters to the editor of a newspaper Correct4 Organizing individuals in the community to develop healthcare delivery
Nurses provide unique leadership in community volunteer opportunities. Organizing individuals in the community to develop healthcare delivery is an example of the nurse's role as community volunteer. Recording vaccinations, attending a city commission meeting, and writing letters to the editor of a newspaper are tasks performed by a nurse as a community opinion leader. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
How can the lines of communication be improved in a healthcare organization during the process of delegation? 1 By considering all aspects of client care 2 By selecting experienced nursing assistants as delegatees Correct3 By appreciating and valuing each other's cultural perspectives 4 By selecting a delegatee having similar strengths as that of the delegator
The lines of communication in a healthcare organization can be improved by appreciating and valuing each other's cultural perspectives, which balances strengths between the delegator and delegatee and improves client care outcomes. Considering all aspects of client care ensures that all of the client care needs are addressed. Selecting experienced nursing assistants as delegatees increases the chances of the delegatee adapting to changing situations. Selecting a delegatee having similar strengths as that of the delegator may decrease the lines of communication because the delegatee might do the task of the delegator.
A client has a "prayer cloth" pinned to the hospital gown. The cloth is soiled from being touched frequently. What should the nurse do when changing the client's gown? 1 Make a new prayer cloth. 2 Discard the soiled prayer cloth. Correct3 Pin the prayer cloth to the clean gown. 4 Wash the prayer cloth with a detergent.
The prayer cloth has religious significance for the client and should be preserved as is. Making a new prayer cloth disregards what the prayer cloth means to the client. The prayer cloth is the property of the client and should not be discarded. Washing the prayer cloth with a detergent disregards what the prayer cloth means to the client; this never should be done without the client's permission.
On the third postoperative day following a below-the-knee amputation, a client is refusing to eat, talk, or perform any rehabilitative activities. What is the best initial approach that the nurse should take when interacting with this client? 1 Explain why there is a need to increase activity. 2 Emphasize that with a prosthesis, there will be a return to the previous lifestyle. 3 Appear cheerful and non-critical regardless of the client's response to attempts at intervention. Correct4 Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving.
The withdrawal provides time for the client to assimilate what has occurred and integrate the change in body image. The client is not ready to hear explanations about why there is a need to increase activity until assimilation of the surgery has occurred. Emphasizing a return to the previous lifestyle does not acknowledge that the client must grieve; it also does not allow the client to express any feelings that life will never be the same again. In addition, it may be false reassurance. The client might feel that the nurse has no comprehension of the situation or understanding of feelings if the nurse appears cheerful and noncritical regardless of the client's response to attempts at intervention.
