BNS (VNSG 1323) CH. 1 "Nursing Foundations" NCLEX STYLE QUESTIONS

After an LPN delegates the assessment of a client's blood pressure to a UAP, what is the most important action to take next? A) Check the results of the delegated task B) Recheck the client's blood pressure C) Teach the client about controlling blood pressure D) Assess the client's family history for heart disease

A) Check the results of the delegated task Whenever a task is delegated, the delegator is responsible for ensuring that the task is performed and determining the outcome. The LPN may choose to recheck the client's blood pressure to validate its accuracy, if the reported blood pressure is unusual. Teaching the client about controlling blood pressure and assessing the client's family history for heart disease are important aspects of client care, but neither is the most important action at this time.

A 30 year-old client is admitted to the health care facility with back pain. Which statements should the nurse use while counseling a client with back pain? A) "Maintain good body posture while sitting." B) "Don't worry; it will subside with treatment." C) "Tell me the duration and nature of the pain?" D) "I will give you a back massage to relieve pain."

A) "Maintain good body posture while sitting." Educating the client about body mechanics to prevent back pain is a part of the counseling skill of the nurse. Giving a back massage is as caring skill; inquiring about the duration and nature of the pain indicates assessment skills. Telling the patient that pain would subside with treatment denotes comforting skill.

When an RN determines an LPN's assignment, which client assignment is most reasonable for the LPN to question? A) Client A, who has unrelieved chest pain B) Client B, whose fractured leg is in traction C) Client C, who is recovering after an appendectomy D) Client D, whose white blood cell count is elevated

A) Client A, who has unrelieved chest pain LPNs should be assigned to clients who have predictable outcomes. A client with unrelieved chest pain seems to the most potentially unstable within this mix of assignments. Based on the information in the questions, clients B, C, and D appear to require care that is within the LPN's scope of practice.

The nurse assigned to care for a pre-medicated client has asked the unlicensed assistive personnel (UAP) to help the client to the toilet. The nurse demonstrates proper delegation skills by performing which actions? (select all that apply.) A) Confirming that the UAP has repeatedly completed similar tasks. B) Transferring accountability and responsibility for the client to the UAP C) Giving a report on the client to the UAP and answering questions. D) Confirming the UAP has successfully passed this skill competency. E) Being available for questions from the UAP.

A) Confirming that the UAP has repeatedly completed similar tasks. C) Giving a report on the client to the UAP and answering questions. D) Confirming the UAP has successfully passed this skill competency. E) Being available for questions from the UAP. Confirming that the UAP has successfully passed the skill competency, being available for questions from the UAP, giving a report on the client to the UAP and answering questions, and confirming that the UAP has repeatedly completed similar tasks are part of the guidelines for delegation. Transferring accountability and responsibility for the client to the UAP is not within the guidelines for delegation.

A nurse who recently graduated with a baccalaureate degree is aware of demographic trends that have an impact on the profession. What is a major issue that will impact nursing in the future? A) Many people will live with the effects of chronic illness. B) Acute infections will become prevalent. C) Nurses will remain in one workplace for longer than they currently do. D) Nurses will be educated in informational settings rather than in formal education programs.

A) Many people will live with the effects of chronic illness. The population is living longer than in past decades and the incidence and prevalence of chronic illnesses are increasing. Nurses are increasingly mobile and education is not predicted to become less formal. Acute infections are not predicted to become more widespread in the near future.

A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse is upset and believes the client has the right to know. As the nurse thinks about the significant other's viewpoint, the nurse starts to reason from that perspective. What kind of behavior is the nurse exhibiting? A) Sympathy B) Humility C) Empathy D) Curiosity

A) Sympathy Sympathy is the experience of feeling the same emotion as another person. In this case, the nurse is beginning to take on the spouse's feelings, which is an example of sympathy. Curiosity is a strong desire to know or learn something. Empathy is perceptive awareness of what a client is experiencing. Humility is as modest or low view of one's own importance.

A licensed practical nurse is planning a move to a new state and intends to begin practicing as soon as possible. This nurse should be aware that: A) There may be differences in the scope of practice when a practical nurse relocates to a new state. B) An LVN/LPN may not normally practice outside the state where they were educated. C) Practical nurses may have to retake the NCLEX-PN in order to gain an out-of-state license. D) A probationary period of up to one year may be required for the nurse to obtain a job in the new state

A) There may be differences in the scope of practice when a practical nurse relocates to a new state. Scope of practice is described in the nurse practice act in the state in which the nurse is license. Each state interprets the limits of practice differently. The nurse would not normally be required to retake exams or be placed on probation.

Which social force significantly impacted the future supply and demand of nurses? A) Technology B) Aging C) Science D) Economics

B) Aging Social forces, such as aging and the retirement rate that exceeds replacement and attrition of aging faculty, significantly impacts the future supply/demand of nurses. Technology, economics, and science are not social forces that have impacted the future supply and demand for nurses.

After receiving an assignment from the RN in charge, which client should the LPN assess first? A) Client A, who will be discharged in the morning B) Client B, who returned from surgery an hour ago C) Client C, who received recent pain medication D) Client D, who has not urinated in 4 hours.

B) Client B, who returned from surgery an hour ago The LPN's priority is Client B, who is potentially the most unstable. After determining that Client B is recovering safely postoperatively, the LPN can attend to the needs of the other assigned clients.

The nurse is reading about nursing theorists for a class. The theory reveals the following, "individuals who use self-care to sustain life and health, to recover from disease or injury, or to cope with its effects." Which individual developed this theory? A) Virginia Henderson B) Dorothea Orem C) Florence Nightingale D) Sister Callista Roy

B) Dorothea Orem Dorothea Orem wrote the self-care theory, referring to individuals using self-care to sustain life and health, recover from disease or injury, or cope with its effects. Sister Callista Roy, Virginia Henderson, and Florence Nightingale wrote other theories.

The nurse studies Dorthea Dix, an individual who organized women volunteers to care for the Civil War troops. For which other healthcare reforms is this individual credited? (Select all that apply). A) Improved health care for women. B) Improved health care for the blind. C) Improved health care for the mentally ill. D) Improved health care for the homeless. E) Improved health care for the deaf.

B) Improved health care for the blind. C) Improved health care for the mentally ill. D) Improved health care for the homeless. E) Improved health care for the deaf. Dorthea Dix also helped to improve health care for the mentally ill by proposing a bill that established asylums for the indigent insane. She also helped to improve the health care for the deaf, blind, and homelesss. Dorthea Dix is not known to have helped improve health care for women.

A nursing student who is completing a clinical placement on a busy hospital unit has learned about the importance of evidence-based practice from a nurse educator on the unit. Evidence-based practice allows nurses to: A) Disseminate nursing knowledge from more experienced nurses to students and less experienced nurses. B) Predict the likely outcomes of nursing interventions. C) Ensure that hospitals will achieve desired quality improvements. D) Track the consequences of nursing actions in a systemic way.

B) Predict the likely outcomes of nursing interventions. By developing an accumulating body of unique scientific knowledge, it is now possible to predict which nursing interventions are most likely to produce desired outcomes, a process referred to as evidence-based practice (EBP). EBP requires the dissemination of knowledge, but is not the primary goal. It is also not aimed primarily at quality improvement or tracking results, though each of these is consistent with the principles of EBP.

A nurse is providing care for an elderly client who was admitted to the hospital several days ago after she suffered a stroke. What action by the nurse best demonstrates the definition of nursing that was identified by Henderson and adopted by the International Council of Nurses? A) Applying the principles of pharmacology to foster the client's health B) Providing temporary assistance to maximize the clients recovery and rehabilitation C) Facilitating harmony between the client and her psychosocial environment D) Protecting the client's identity in order to benefit her physical health.

B) Providing temporary assistance to maximize the clients recovery and rehabilitation Henderson proposed that nursing involves temporarily meeting the client's health needs with knowledge and skills that neither the client nor family members can provide. Promoting harmony, applying pharmacology, and protecting the client's identity are appropriate actions for the nurse, but meeting the client's health needs is paramount.

A post-surgical client required the reinsertion of a urinary catheter after retaining urine for several hours. The registered nurse had delegated the task to a practical nurse. Which action shows that the RN applied the principle of right supervision and evaluation when delegating this task? A) The RN asked the LPN to document the catheter insertion in the client's medical record as soon as possible. B) The RN confirmed that the catheter was inserted correctly after the LPN finished the task. C) The RN watched the LPN insert the catheter into the client's urethra. D) The RN removed the urinary catheter one hour after the catheter was inserted.

B) The RN confirmed that the catheter was inserted correctly after the LPN finished the task. The principle of right supervision and evaluation dictates that nurses should validate that a task was completed correctly. Documentation and direct observation are not evidence of this principle. Correct completion of this task would not normally be followed up by removal of the catheter after one hour.

The nurse is assigned to a client who is newly diagnosed with diabetes. The nurse understands that illness causes feelings of insecurity, which may threaten the client and family's ability to cope. What action should the nurse take with this client? A) Testing the client's glucose levels. B) Asking the client if anyone in the family also has diabetes. C) Comforting the client and family. D) Providing more information about diabetes.

C) Comforting the client and family. Comforting skills are nursing interventions that provide stability and security during a health-related crisis. Is is appropriate for the nurse to use this skill with a client who has recently been diagnosed with diabetes, as evidenced by the nurse comforting the client and family. Providing more information about diabetes, testing the client's glucose levels, and asking the client if anyone in the family has diabetes are examples of counseling, caring, and assessment skills.

Before delegating the task of assessing a client's blood glucose to a UAP, what should the LPN do first? A) Review the client's trends in blood glucose measurements B) Check the diabetic medications prescribed for the client C) Determine whether the UAP is qualified to check the blood glucose D) Asses what the client knows about controlling blood glucose

C) Determine whether the UAP is qualified to check the blood glucose Whenever delegating a task, it is essential to determine the competency of the person who is being assigned to the delegated task. Although all of the other actions are important to perform, ensuring that the delegated task can be performed accurately is most important.

The nurse is caring for a client who had a recent diagnosis of diabetes. Which action demonstrates that the nurse is utilizing the Basic Needs theory? A) Helping client cope with the new diagnosis. B) Teaching the client about disease management. C) Providing foot care for the client. D) Watching the client test daily blood sugar.

C) Providing foot care for the client. Believing that the setting in which a person learns has an effect on patterns for living things is part of Virginia Henderson's Basic Needs theory, as evidenced by the nurse providing foot care. The other actions support different nursing theories.

During the Crimean War what was the major achievement for nursing? A) The funds collected from the war were used for opening the first training school for nurses. B) The nurses provided better living and sanitary conditions for the soldiers. C) The nursing care resulted in a decrease of the death rate of soldiers to 1% from 60%. D) The servicemen and their families recognized the importance of nursing.

C) The nursing care resulted in a decrease of the death rate of soldiers to 1% from 60%. The significant achievement from the Crimean War was the decrease in the death rate of British Soldiers, which went from being as high as 60% to becoming as low as 1%. This was possible due to the care given by the nurses under the guidance of Florence Nightingale. This was made possible by providing better living and sanitary conditions for the soldiers. This achievement of the nurses was appreciated by the servicemen and their families. The first training school for nurses was opened after the Crimean War and not during.

The nurse subscribes to the Basic Needs theory. Which action exemplifies this theory by the nurse? A) Assisting the client to recognize signs of infection and to change dressings. B) Assisting the client in finding a clean, well-lit residence. C) Assisting the client in coping with a new diagnosis. D) Assisting the client to the bedside commode.

D) Assisting the client to the bedside commode. The Basic Needs theory subscribes to the concept that a nurse assists in performing activities that the client would perform if the client could. Therefore, assisting the client to the bedside commode is an example of an action that supports the Basic Needs theory. The other actions do not support this theory.

What information is most important for an LPN to obtain during a report on an assigned postoperative client? A) The client's age B) The client's occupation C) The client's last consumption of food D) The client's most recent blood pressure

D) The client's most recent blood pressure When obtaining a report on a postoperative client, an LPN should expect to be told the client's most recent blood pressure, an indication of the client's recovery status. The client's age and occupation are facts the LPN may wish to know, but they are not essential to the forthcoming plan for care. Whether or not the client consumed food is helpful, but it is not the most important information the LPN needs to know at this time. Cognitive Level - Analyzing;