NCLEX PN ARCHER REVIEW

NCLEX- PN Series: Strategies for Coordination of Care

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NCLEX PN ARCHER REVIEW

689 terms ervan_valdezPreview Exam Cram NCLEX-PN PRACTICE Q...103 terms summer3266Preview NCLEX Teacher Tut Which of the following client-care activities would be appropriate for an LPN to perform?

a) Obtain detailed 24-hour diet recall from client newly admitted with a suspected eating disorder

b) Obtain catheterized urine sample from client with a fever and slight lower abdominal discomfort

c) Collect data for an adolescent client experiencing an acute asthma attack

d) Care for a school-aged client with a new tracheostomy for laryngotracheal bronchitis

b Explanation: LPNs perform activities concerning stable clients with predictable outcomes. A) A 24-hour diet history is an important part of the initial assessment. It helps guide the treatment plan. RNs NOT LPNs provide the initial clinical assessment. B) LPNs routinely collect catheterized urine samples. LPNs are qualified to perform this task. C) This client is unstable. Care of an unstable client with an uncertain outcome would not normally be assigned to an LPN. D) This is an unstable client.The LPN should question which of the following assignments?

a) Obtain a stool sample for occult blood

b) Provide nutrition information to a new mother

c) Adjust the position of a client who has just received medication for pain relief

d) Assess a client who has just returned to the room following abdominal surgery

d Explanation: A) This is a routine procedure and thus can be performed by an LPN. B) This is within the scope of practice of an LPN. C) This is within the scope of practice of an LPN. D) LPNs cannot perform the initial assessment of a client following surgery. This is outside the scope of practice of an LPN.

The nursing unit contains an RN, an LPN, and an AP. Which of the following client care activities would be most appropriate for the LPN to perform?

a) Obtain vital signs for a client who was admitted with several fractures

b) Monitor a client who had an ovarian tumor removed 2 days ago for signs of infection

c) Teach a client recently diagnosed with diabetes mellitus to perform an insulin injection

d) Bathe and change the clothes of a client who is recovering from an appendectomy

b Explanation: A) this client is not in stable condition and needs assessment, part of which is obtaining VS. An RN needs to provide the initial assessment. B) LPNs are trained to observe client for changes in signs and symptoms, such as increase in temperature or other signs of infection and report changes to the supervising RN. C) This is not within the scope of practice of the LPN. An RN performs this type of teaching. D) Although an LPN may perform this task, an AP is more likely to be asked to perform this duty.Which of the following client-care assignments is best for an LPN?

a) Help a client recovering from surgery with bathing, linen change, and ambulation to the bathroom

b) Perform a head to toe assessment, including breath sounds, for a client admitted yesterday with pneumonia

c) Assess a newly admitted client with a fever and productive cough

d) Change the dressing for a stasis ulcer in a client with diabetes

d Explanation: A) An AP would normally be the person to perform this task. B) This would be appropriate but the client is newly admitted and unstable. The RN should do the assessment. C) RNs provide the initial assessment for newly admitted clients. D) LPNs are qualified to change dressings in stable clients.Which of the following client-care activities should be assigned to an LPN?

a) Auscultate breath sounds and collect sputum sample from a client with a history of respiratory problems

b) Assess a client who just returned from surgery to correct a spinal deformity

c) Provide emergency care to a client who suffered cardiac arrhythmia during exercise

d) Care for an unconscious client who is bleeding profusely from a stab wound

a Explanation: A) An LPN can perform these tasks and report findings to the RN. B) Immediate postoperative assessment is the responsibility of an RN, especially in such a serious case as spinal injury. The RN may subsequently ask the LPN to monitor the client, requesting to be alert for specific signs/symptoms. C) LPNs are usually not employed in emergency departments, but if they are they help the RN or primary HCP, following specific instructions. D) This client is not stable and has an unpredictable outcome.Which of the following client-care activities should be assigned to the LPN?

a) Assess a new admission who is reporting severe abdominal pain

b) Review the education on birthing methods provided to a pregnant client

c) Provide bedside care for an infant client with a fever and obvious discomfort

d) Change the dressing of a client who has undergone partial mastectomy

d Explanation: A) Only RNs complete assessments on newly admitted clients. B) LPNs can reinforce teaching for clients, only an RN can evaluate teaching effectiveness. C) This client is unstable and is a serious concern that requires careful assessment and frequent monitoring tasks that should be performed by an RN. D) LPNs are qualified to look for changes in the appearance of a wound and to change dressings as part of their overall monitoring of a stable client recovering from surgery.

The LPN is part of the care team in a medical-surgical unit. The LPN would expect to perform which of the following client-care activities? Select all that apply

a) Educate the pre-surgical client about clean-catch urine sample procedures

b) Assess the client who has just returned to the room following bladder surgery

c) Monitor the client who had a tonsillectomy the day before

d) Call a code on a client found to be found unresponsive

e) Review the effectiveness of client education about nebulizer use

f) Perform the initial dressing change on the client recovering from gallbladder surgery

a, c, d, f Explanation: A) LPNs can educate clients on pre and postsurgical lab tests sample collection procedures B) RN's performs the initial assessment of postsurgical patients. C) LPNs are trained to observe stable clients for changes indicating complications. One day after a tonsillectomy would be considered stable. D) This is a true statement. E) LPNs can provide medication instruction but only RNs can evaluate the effectiveness of teaching. F) LPNs are qualified to examine a surgical incision for problems as part of their overall monitoring of stable postsurgical clients The LPN is caring for clients in the acute medical-surgical unit. The LPN should question which assignment?

a) Monitor urine output of the client diagnosed with acute kidney injury

b) Perform nasotracheal suctioning for a client 4 days after a stroke

c) Provide tracheostomy care for the client with a cuffed tracheostomy tube

d) Receive hand off report for the client being transferred from the emergency department

d Explanation: Look for an incorrect action. A, B and C are all within the scope of practice of an LPN and performed on stable clients with predictable outcomes. Receiving hand off report is not within the LPN scope of practice. Client's coming from the ED are not stable and require assessment and evaluation by the RN.Which task is most appropriate for the assistive personnel (AP) to perform?

a) Reset a client's IV infusion pump when the alarm sounds

b) Change a peripheral IV catheter insertion site dressing

c) Observe pH of gastric secretions from enteral feeding tube

d) Assist with the insertion of a small-bore enteral tube

d Explanation: APs can assist clients with activities of daily living and perform standard, unchanging procedures. A, B and C are not within the scope of practice of an AP. APs may assist with procedures.The LPN is caring for a client in a pediatric urgent care clinic. The supervisor indicates that the LPN will float to an adult postoperative care unit.Which is the most appropriate statement the LPN should make?

• "I can't go to another unit. I don't have the proper skills to care for postoperative adult clients"
• "I will have to work under the supervision of another LPN while on the postoperative care unit"
• "I will need to inform the postoperative unit supervisor that my experience has been pediatric care"
• "I am only qualified to check vital signs and document intake and output on the postoperative care unit"

c Explanation: Skills are transferrable during the care of clients. Float nurses should know and be able to perform core competencies in the new unit to meet legal obligations as an LPN. The LPN should inform the supervisor of previous experience and request orientation.

The LPN is floating to several units in the community hospital. Which of the following client-care activities is best for the LPN?

a) Assisting a postsurgical client with ambulation to the bathroom

b) Checking with family members about the effectiveness of discharge teaching

c) Instructing newly admitted clients about diagnostic test preparation

d) Changing the purulent dressing of a client with stage 4 pressure injury

c Explanation: A) an AP would be appropriate to do this task. B) This is within the RN scope of practice. C) LPNs are trained to provide education and physical preparation for diagnostic tests. D) The LPNs are qualified to change dressings in stable clients. A stage 4 pressure injury is not considered stable.A rehabilitation unit is staffed by an RN, 2 LPNs, and an AP. The AP just called in sick. Which of the following client-care assignments would be appropriate for the LPNs? Select all that apply

a) Assess the newly admitted client with hip dysplasia

b) Bathe the client who is recovering from back surgery

c) Take vital signs of the client who is receiving IV antibiotics for a bone infection

d) Listen for breath sounds in a client who a history of chronic asthma

e) Show the postsurgical client how to use crutches

f) Teach the client recently diagnosed with arthritis how to self administer a weekly injection

b, c, d, e

Explanation:

• RNs do initial assessments
• Normally the AP would do this, but the LPN may do this task since there is no AP present.
• LPNs are trained to take accurate vital signs and report significant deviations from normal
• An LPN can listen for breath sounds and report the findings to the RN
• An AP would perform this task but LPNs can in the absence of the AP.
• An RN performs this type of teaching.

The LPN is caring for clients in the medical-surgical unit of the acute care facility. Which assignment is most appropriate for the LPN?

a) Observe a client who reports "tightness in the chest"; a 12 lead ECG is ordered

b) Teach a client newly diagnosed with type 2 diabetes; the client is prescribed glyburide

c) Change sterile dressing on the leg of a client 3 days after peripheral vascular surgery

d) Instruct a client diagnosed with heart failure about exercise and home medication

c Explanation: LPNs can perform activities concerning stable clients with predictable outcomes. LPNs can reinforce teaching after RNs have done the initial teaching.

• Client is not stable and requires assessment and evaluation by the RN
• The LPN can reinforce initial teaching done by the RN
• The LPN can administer prescribed therapies such as dressings
• LPN can reinforce initial teaching done by the RN