Nursing Management NCLEX Quiz Questions

Nursing Management NCLEX Quiz Questions

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201 terms nursingstudent369 Preview NCLEX Review - Management of Ca...26 terms ish_jayme_penafiel Preview 75 Free 75 terms car Which of the following is the best guarantee that the patient's priority needs are met?Checking with the relative Preparing a nursing plan in collaboration with the patient Consulting the physician Coordinating with other members of the team Preparing a nursing plan in collaboration with the patient Rationale: The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.Mike is hopeful that his unit will make a big turnaround in the succeeding months. Which of the following actions demonstrates that he has reached the third stage of change?Wonders why things are not what it used to be Finds solutions to the problem Integrate the solutions to his day-to-day activities Selects the best change strategy Integrate the solutions to his day-to-day activities Rationale: Integrate the solution to his day to day activities is expected to happen during the third stage of change when the change agent incorporate the selected solutions to his system and begins to create a change.

A patient with a pulmonary embolus is receiving anticoagulation with IV heparin. What instructions would you give the nursing assistant (UAP) who will help the patient with activities of daily living? Select all that apply.Use a lift sheet when moving and positioning a patient in bed Use an electric razor when shaving the patient each day Use a rectal thermometer to obtain a more accurate body temperature Use a soft-bristle toothbrush or tooth sponge for oral care Yes!Be sure the patient's footwear has a firm sole or a "no- slip" guard when the patient ambulates Use a lift sheet when moving and positioning a patient in bed Use an electric razor when shaving the patient each day Use a soft-bristle toothbrush or tooth sponge for oral care Yes!Be sure the patient's footwear has a firm sole or a "no-slip" guard when the patient ambulates A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle.Which action should you delegate to the nursing assistant

(UAP)?

Discuss weight-loss strategies such as diet and exercise with the patient Teach the patient how to set up the BiPAP machine before sleeping Remind the patient to sleep on his side instead of on his back Administer Modafinil (Provigil) to promote daytime wakefulness Remind the patient to sleep on his side instead of on his back Rationale: The nursing assistant can remind patients about actions that they have already been taught by the nurse and are part of the patients care plan.Discussing and teaching require additional education and training. These actions are within the scope of practice of the RN. The RN can delegate administration of medication to an LPN, but not PCT.The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the nursing assistant (UAP) under your supervision?Observe how well the patient performs pursed-lip breathing Plan a nursing care regimen that gradually increases activity intolerance Assist the patient with basic activities of daily living Consult with the physical therapy department about reconditioning exercises Assist the patient with basic activities of daily living

Rationale: Experienced LPN's can use observation of patients to gather data

regarding how well patients preform interventions that have already been taught.Assisting patients with ADL's is more appropriate for a nursing assistant. Planning and consulting require additional education and skills, appropriate to an RN.

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 approach. The nurse determines that which scenario is characteristic of team-based model of nursing practice?Each staff member is assigned a specific task for a group of clients.A staff member is assigned to determine the clients needs at home and begin discharge planning.A single registered nurse (RN) is responsible for providing care to a group of 6 clients with the aid of an assistive personnel (AP).An RN leads 2 licensed practical nurses (LPNs) and 3 APs in providing care to a group of 12 clients.An RN leads 2 licensed practical nurses (LPNs) and 3 APs in providing care to a group of 12 clients.Rationale: In team nursing, nursing personnel are led by a registered nurse leader in providing care to a group of clients. Option A identifies functional nursing.Option B identifies a component of case management. Option C identifies primary nursing (relationship-based practice.The nurse employed in an emergency department is assigned to triage clients coming to the emergency department for treatment on an evening shift. The nurse should assign priority to which client?A client complaining of muscle aches, a headache, and history of seizures.A client with chest pain who states that he just ate pizza that was made with a very spicy sauce.A client who twisted her ankle when rollerblading and is requesting medication for pain.A client with a minor laceration on the index finger sustained while cutting an eggplant.A client with chest pain who states that he just ate pizza that was made with a very spicy sauce.Rationale: In an emergency department, triage involves brief client assessment to classify clients according to their need for care and includes establishing priorities of care. The type of illness or injury, the severity of the problem, and the resources available govern the process. Clients with trauma, chest pain, sever respiratory distress or cardiac arrest, limb amputation, and acute neurological deficits and those who have sustained chemical splashes to the eyes are classified as emergent and are the highest priority. Clients with conditions such as simple fracture, asthma without respiratory distress, fever, hypertension, abdominal pain, or a renal stone have urgent needs and are classified as a second priority. Clients with conditions such as a minor laceration, sprain, or cold symptoms are classified as nonurgent and are a third priority.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.Open doors to client rooms Move beds away from windows Close window shades and curtains Place blankets over clients who are confined to bed Relocate ambulatory clients from the hallways back into their rooms Move beds away from windows Close window shades and curtains Place blankets over clients who are confined to bed

Rationale: In this weather event, the appropriate nursing actions focus on

protecting clients from flying debris or glass. The nurse should close doors to each client's room and move beds away from the windows, and close window shades and curtains to protect clients, visitors, and staff from shattering glass and flying debris. Blankets should be placed over clients confined to bed. Ambulatory clients should be moved into the hallways from their rooms, away from windows.

You are the Nurse Manager for the trauma unit. Which of these staff incident reports indicate the need for you to provide an educational activity relating to confidentiality and information security?"A computer in the hallway was left unattended and a client's medical record was visible to me." "I just saw a nursing student looking at the medical record for a client that they are NOT caring for during this clinical experience." "As I was walking past the nursing station, I saw a dietician reading the progress notes written by members of the laboratory department in addition to other dieticians' progress notes." "I refused the nursing supervisor's request to share my electronic password for the new nurse on the unit." "As I was walking past the nursing station, I saw a dietician reading the progress notes written by members of the laboratory department in addition to other dieticians' progress notes." Rationale: A staff members comment, "As I was walking past the nursing station, I saw a dietician reading the progress notes written by members of the laboratory department in addition to other dieticians' progress notes" "indicates the need for the Nurse Manager to provide an educational activity relating to confidentiality and information security because dieticians often have the "need to know" about laboratory data so that they can, for example, assess the client's nutritional status in terms of their creatinine levels.The report that the nursing student was "looking at the medical record for a client that they are NOT caring for during this clinical experience" indicates that the reporting staff member is correctly applying the principles for maintaining confidentiality and privacy of information; the report that a "computer in the hallway was left unattended and a client's medical record was visible to me" indicates that the reporting staff member is correctly applying the principles for maintaining confidentiality and privacy of information; and lastly, "I refused the nursing supervisor's request to share my electronic password for the new nurse on the unit" also indicates that the staff member is knowledgeable about privacy and confidentiality.You are a registered nurse who is performing the role of a Case Manager in your hospital. You have been asked to present a class to the newly employed nurses about your role, your responsibilities and how they can collaborate with you as the Case Manager. Which of the following is a primary case management responsibility associated with reimbursement that you should you include in this class?The case manager's role in terms of organization wide performance improvement activities The case manager's role in terms complete, timely and accurate documentation The case manager's role in terms of the clients' being at the appropriate level of care The case manager's role in terms of contesting denied reimbursements The case manager's role in terms of the clients' being at the appropriate level of care

Rationale: Registered nurse case managers have a primary case management

responsibility associated with reimbursement because they are responsible for ensuring that the client is being cared for at the appropriate level of care along the continuum of care that is consistent with medical necessity and the client's current needs. A failure to ensure the appropriate level of care jeopardizes reimbursement. For example, care in an acute care facility will not be reimbursed when the client's current needs can be met in a subacute or long-term care setting.Nurse case managers do not have organization wide performance improvement activities, the supervision of complete, timely and accurate documentation or challenging denied reimbursements in their role. These roles and responsibilities are typically assumed by quality assurance/performance improvement, supervisory staff and medical billers, respectively.The nurse has received the assignment for the day shift.After making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first?A client who is ambulatory demonstrating steady gait A post-operative client who has just received an opioid pain medication A client scheduled for physical therapy for the first crutch-walking session A client with a white blood cell count of 14,000mm^3 (14x10^9/L) and a temperature of 38.4 degrees Celsius A client with a white blood cell count of 14,000mm^3 (14x10^9/L) and a temperature of 38.4 degrees Celsius Rationale: The nurse should plan to care for the client who has an elevated white blood cell could and a fever first, because the client's needs are the priority. The client who is ambulatory with steady gait and the client scheduled for physical therapy for a crutch-walking session do not have priority needs. Waiting for pain medication to take effect before providing care to the post-operative client is best