NCLEX - Management of Care, Interprofessional Collaboration, Delegating & Supervising
A nursing instructor asks the nursing student to describe the definition of a critical path. Which statement, if made by the student, indicates a need for further teaching regarding critical paths?
"They are nursing care plans and use the steps of the nursing process."
Which tasks should the registered nurse (RN) delegate to the licensed practical nurse (LPN)? Select all that apply.
Urinary catheterization Endotracheal suctioning Intramuscular medication administration Subcutaneous medication administration
The registered nurse is creating the plan for client assignments for the day. Which is the most appropriate assignment for the assistive personnel (AP)?
A client on bed rest who requires range-of-motion (ROM) exercises every 4 hours
A nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. The nurse is told that the nursing model is a team nursing approach. The nurse determines that which scenario is characteristic of the team-based model of nursing practice?
An RN leads 2 licensed practical nurses (LPNs) and 3 APs in providing care to a group of 12 clients.
A registered nurse is delegating activities to the nursing staff. Which activities are most appropriate for the assistive personnel (AP)? Select all that apply.
Collecting a urine specimen from a client Obtaining frequent oral temperatures on a client Accompanying a client being discharged to his or her transportation to home
The home health nurse develops a plan of care for the client. Which actions should the nurse include in the plan as a case manager of the client's care?
Organize, manage, and balance health care services needed for the client.
The registered nurse (RN) has provided instructions to a licensed practical nurse (LPN) regarding administering enemas to a client scheduled for a barium enema. The RN has instructed the LPN to administer enemas until they are clear. The LPN tells the RN that 3 enemas were administered and that the returns are still not clear. What most appropriate instruction should be given to the LPN?
Stop administering the enemas.
A registered nurse (RN) is observing a licensed practical nurse (LPN) preparing a client for treatment with a continuous passive motion (CPM) machine. Which action by the LPN requires follow-up by the RN?
The LPN places the client's knee in a slightly externally rotated position.
The nurse is planning the client assignments for the day. Which clients can be safely assigned to the assistive personnel (AP)? Select all that apply.
The client receiving continuous oxygen at 2 L/min The client recovering from Guillain-Barré syndrome The client on isolation for methicillin-resistant Staphylococcus aureus
The nurse manager is planning the clinical assignments for the day. Which staff members cannot be assigned to care for a client with herpes zoster? Select all that apply.
The nurse who never had chickenpox The nurse who never received the varicella-zoster vaccine
The nurse is planning the client assignments for the shift. Which client should the nurse assign to the assistive personnel (AP)?
A client requiring frequent temperature measurements
The graduate nurse is interviewed by the manager of a unit and is told that the manager's leadership style is laissez-faire or one of letting the staff nurses make the decisions about the unit's operations. Which question by the graduate nurse indicates the best understanding of the laissez-faire leadership style?
"As the manager, do you assume a passive, nondirective approach?"
A registered nurse (RN) who is working with a nursing student assigns the student to care for a client with a diagnosis of Cushing's syndrome. The RN asks the student questions about this disorder. Which statement made by the student indicates understanding of Cushing's syndrome?
"Cushing's syndrome is caused by excessive amounts of cortisol."
The staff members working at the trauma center have characterized their nurse manager as task oriented and directive. Which leadership style does the nurse manager exhibit?
Autocratic
The nurse is preparing the client assignment. Which should be assigned to a licensed practical nurse (LPN)?
Administration of a new oral medication to a client with Alzheimer's disease
The nurse takes a newly admitted client's vital signs, completes an admission assessment history on the client, and assists the client to change into a hospital gown. By completing these tasks, the nurse is demonstrating which role of the nurse?
Caregiver
The nurse educator presents an in-service training session on case management to nurses on the clinical unit. During the presentation the nurse educator clarifies that what is a characteristic of case management?
Promotes appropriate use of hospital personnel
The nurse is responsible for the care of a client who has begun to experience hallucinations more frequently. Which activity in the care of the client can be most appropriately delegated to an assistive personnel (AP)?
Providing distraction for the client by engaging the client in a board game
The nurse is caring for a client with acute glomerulonephritis. The nurse instructs the assistive personnel (AP) to implement which action when caring for the client?
Remove the water pitcher from the bedside.
The nurse should instruct the assistive personnel (AP) to avoid the use of a straight razor for which client?
The client taking warfarin
The registered nurse (RN) is planning assignments for the clients on a nursing unit. The RN needs to assign 4 clients and has 1 RN, 1 licensed practical nurse, and 2 assistive personnel (APs) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse?
The client with an abdominal wound requiring frequent wound irrigations
The nurse employed in a long-term care facility is planning assignments for the clients on a nursing unit. The nurse needs to assign four clients and has a licensed practical nurse and 3 assistive personnel (APs) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse?
A client requiring abdominal wound irrigations and dressing changes every 3 hours
The nurse is planning the client assignments for a group of clients and has a licensed practical nurse (LPN) and an assistive personnel (AP) on the nursing team. Which client would the nurse most appropriately assign to the LPN?
A client with emphysema who is receiving oxygen at 2 L/min by nasal cannula and becomes dyspneic on exertion
When creating an assignment for a team consisting of 1 registered nurse (RN), 1 licensed practical nurse (LPN), and 2 assistive personnel (AP), which is the best client for the LPN?
A client with a spinal cord injury requiring urinary catheterization every 6 hours
A case manager is reviewing the records of the clients in the nursing unit. Which occurrence, if noted in a client's record, would the nurse identify as a positive variance?
A postoperative client is discharged home 1 day earlier than expected.
The registered nurse (RN) is planning client assignments and cannot take a client assignment today. Two assistive personnel (AP) and a licensed practical nurse (LPN) also are assigned to the unit. Which client should the RN most appropriately assign to the LPN?
A client scheduled for a cardiac catheterization
The nurse employed in a long-term care facility is planning assignments for the clients on a nursing unit. The nurse needs to assign 4 clients and has 1 licensed practical nurse and 3 assistive personnel (APs) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse?
A client requiring abdominal wound irrigations and dressing changes every 3 hours
The nurse manager meets with the staff nurses and announces that management has developed a new policy and procedure that is significantly different from old practices. Which statement by the nurse manager reflects the manager's use of legitimate power?
"Every manager has the responsibility to see that these new policies and procedures are followed 100% of the time. Please join me in this organization's effort to continue to improve quality care."
The nurse is planning the client assignments for the day. Which clients can be safely assigned to the assistive personnel (AP)? Select all that apply.
A client needing a bed bath A client needing to ambulate A client requiring assistance with feeding A client needing to have vital signs checked A client needing to use the bedside commode
The registered nurse is planning the client assignments for the day. Which is the most appropriate assignment for the assistive personnel (AP)?
A client who requires assistance with ambulation every 4 hours
The registered nurse is planning the client assignments for the day. Which is the most appropriate assignment for an assistive personnel (AP)?
A client who requires urine specimen collections
When creating an assignment for a team consisting of a registered nurse (RN), 1 licensed practical nurse (LPN), and 2 assistive personnel (AP), which is the best client for the LPN?
A client with a spinal cord injury requiring urinary catheterization every 6 hours
The nurse is planning the client assignments for the day. Which clients can be safely assigned to the assistive personnel (AP)? Select all that apply.
A confused older client who requires feeding A client who requires turning every 2 hours A client admitted with dehydration who is on strict intake and output A client 4 days postoperative after exploratory laparotomy who requires ambulation in the hallway 4 times a day
The nurse is seeking a leadership style that will empower staff to achieve excellence. Which leadership style should the nurse select to achieve this goal?
Democratic
The nurse manager has involved all staff members in the development of goals and decision making. Which leadership style has the unit manager exercised?
Democratic
The nurse is rearranging the client assignments after several discharges and admissions occurred. Which tasks should be assigned to the assistive personnel (AP)? Select all that apply.
Cleaning a client's dentures Ambulating a postoperative client Taking 4:00 p.m. vital signs on clients Assisting a client with a urinary drainage catheter into a chair
The nurse is planning client assignments for the day. Which clients can be safely assigned to assistive personnel (APs)? Select all that apply.
Client who is 72 hours postoperative recovering from a total knee replacement and needs assistance with bathing and dressing Client who is 48 hours postoperative recovering from an open reduction and fixation of the right forearm and needs assistance with feeding
The nurse is developing a client care assignment for a group of assistive personnel (APs). What is the nurse's first step in planning and assigning clients?
Determine what skills can be delegated.
The registered nurse (RN) is planning her client assignments for the day. She has a licensed practical nurse and an assistive personnel (AP) on her team. Which task should the RN delegate to the AP?
Empty a client's urinary catheter bag.
The nurse is giving a report to an assistive personnel (AP) who will be caring for a client who has hand restraints (safety devices). The nurse instructs the AP to check the skin integrity of the restrained hands how frequently?
Every 30 minutes
The nurse is giving report to an assistive personnel (AP) who will be caring for a client in hand restraints (safety devices). How frequently should the nurse instruct the AP to check the tightness of the restrained hands?
Every 30 minutes
The newly appointed vice president for nursing operations has announced that the authority for decision making will be decentralized and distributed throughout the organization. Which term describing this organizational chart should the vice president employ while talking with the employees?
Flat
The nurse is preparing to perform a general survey of a client who was admitted to the hospital a few hours ago. Which components of the general survey may be delegated to the assistive personnel (AP)? Select all that apply.
Measuring the client's height and weight Monitoring oral intake and urinary output
The nurse manager is discussing the facility protocol in the event of a tornado with the staff. Which instructions should the nurse manager include in the discussion? Select all that apply.
Move beds away from windows. Close window shades and curtains. Place blankets over clients who are confined to bed.
A client with diabetes mellitus is admitted to the hospital for eye surgery. Which task can be delegated to the assistive personnel (AP)?
Orient the client to the hospital surroundings.
The registered nurse (RN) directs the licensed practical nurse (LPN) to assist with the care of a client who has a sacral ulcer. Which is the most appropriate activity for the RN to delegate to the LPN?
Place the client in a side-lying position.
The charge nurse is planning the assignment for the day. Which factors should the nurse remain mindful of when planning the assignment? Select all that apply.
The acuity level of the clients Client needs and workers' needs and abilities
The nurse is delegating the morning hygienic care of a man to the assistive personnel (AP). In reviewing the assigned tasks, the nurse should instruct the AP to use an electric razor for which client?
The client with thrombocytopenia related to chemotherapy
