NCLEX Review - Management of Care Latest

NCLEX Review - Management of Care Latest Update - 400 Questions and 100% Verified Correct Answers Guaranteed A+

A 90 year-old is readmitted to the hospital, less than 2 weeks after being discharged, for the same health concern. What factors contribute to hospital readmissions among older adults? (Select all that apply.)

1) Reconciliation of medications

2) Poor communication among providers

3) Client health status

4) Family preferences

5) Excellent primary care - CORRECT ANSWER: 2, 3, 4

Rationale:

Avoidable hospitalization, especially among older adults living in skilled nursing facilities, usually results from multiple system failures. The reasons most often cited include inadequate primary care (including inadequate discharge planning and lack of reconciliation of medications), poor care coordination, poor skilled nursing facility quality of care, poor communication among providers and even family preferences. Not all illnesses can be anticipated and clients with more complex health issues are readmitted more often, regardless of quality or coordination of care.

A Bosnian Muslim woman who does not speak English seeks care at a community clinic. Through physical gestures, the woman indicates that she has pain originating in either the pelvic or genital region. Assuming several people are available to interpret, who would be the most appropriate choice?

1) A female neighbor of the client who is also from Bosnia

2) A female interpreter who does not know the client

3) The client's adult daughter

4) A Bosnian male, who is a certified medical interpreter - CORRECT ANSWER: 2

Rationale:

When the nurse and the client do not speak the same language, or have limited fluency, the services of an interpreter is needed. But, it may be inappropriate to have a male 1 / 4

interpreter for a female client because the client may not be as forthcoming. The client may also feel it is inappropriate to have private matters interpreted by her daughter (especially if they are of a sexual nature or involve infidelity). To avoid a breach of confidentiality, the nurse should avoid using an interpreter from the same community as the client. The best response is to have a female interpreter who does not know the client.

A client is admitted with a diagnosis of schizophrenia. The client refuses to take any medication and states, "I don't think I need those medications. They make me too sleepy and drowsy. I want you to explain their use and side effects of these medications." The nurse should respond with an understanding of which statement?

1) A referral is needed to the psychiatrist who should provide the client with answers to the request

2) Such education is an independent decision of the individual nurse whether or not to teach clients about their medications

3) Clients with schizophrenia are at a higher risk of psychosocial complications when they know about their medication's uses and side effects

4) The client has a right to know about the use and side effects of the prescribed

medications - CORRECT ANSWER: 4

Rationale:

Clients have a right to informed consent, which includes detailed information about medications, treatments and diagnostic studies. The other options are incorrect approaches.

A client is being prepped for a surgical procedure and the nurse is reviewing the informed consent with the client. The client asks, "Is there any other way to take care of

this without having surgery?" The nurse has a duty to first:

1) Reassure the client that the surgery is the best treatment option

2) Tell the client if they don't want the surgery, they don't have to have it

3) Notify the surgeon that the client has additional questions about alternatives to surgery

4) Call the surgeon and cancel the surgery until the consent form is signed - CORRECT

ANSWER: 3

Rationale:

The client has a right to an explanation of the treatment and its expected results, anticipated risks and benefits, possible alternative treatment options and all questions 2 / 4

answered before a consent form is signed. Remember, the client is not asking you for your opinion. The client is asking about alternative treatments for the condition. Notify the appropriate health care provider if the client needs additional information that you cannot answer. Once the client has all the necessary information then they can decide not to sign the informed content and cancel the surgery.

A newly graduated nurse, who has recently completed orientation, voices concern about her assignment: "I have never taken care of anyone with a lumbar drain before." Which action would be most appropriate for the charge nurse?

1) Check with the nurse and the client often during the shift

2) Provide an immediate one-on-one, personal in-service about the drain

3) Assign the graduated staff nurse to be transferred to another floor for the shift

4) Change the assignment; reassign the client with the lumbar drain to a different nurse

- CORRECT ANSWER: 4

Rationale:

One of the first principles of safe assignments is to match skills with the task. New nurses should not be assigned tasks for which they are not competent. The assignment needs to be changed. The other options simply help support the nurse but may be dangerous for the client. And, of course, the new nurse will need training about caring for a client with a lumbar drain.

A nurse has unintentionally given an incorrect dose of medication to their client. No harm was done to the client. What is the next action, if any, required by the nurse?

1) The nurse is not required to report the mistake because the client was not harmed

2) The nurse is not responsible for the mistake because they have not been provided current education by their employer

3) The nurse will immediately be suspended and their license will be revoked

4) The nurse will report the incident to their nurse manager and follow their

organizational procedures for reporting - CORRECT ANSWER: 4

Rationale:

Although the client was not harmed as a result of the mistake, the incident still needs to be reported. Nurses are responsible for their practice and for staying current and competent by becoming lifelong learners. In this case, neither an immediate suspension nor revoking a license are warranted.

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A nurse is named in a lawsuit. Which of these factors will offer the best protection for that nurse in a court of law?

1) Clinical specialty certification by an accredited organization

2) Complete and accurate documentation of assessments and interventions

3) Above-average performance reviews prepared by nurse manager

4) Sworn statement that health care provider orders were followed - CORRECT

ANSWER: 2

Rationale:

The medical record is a legal document. Documentation should include all steps of the nursing process; it must be complete, accurate, concise and in chronological order.Inaccurate or incomplete documentation will raise red flags and may indicate the nurse failed to meet the standards of care. The attorney will review the medical record with the nurse before giving a deposition (sworn pretrial testimony). Above-average performance reviews could be considered supporting information. Certification is an "extra" based on the nurse's initiative; it is, however, unrelated to accurate charting.

A nurse receives an illegible hand-written medication order. Which statement to the health care provider reflects appropriate assertive communication?

1) "Would you please clarify what you have written so I am sure I am reading it correctly?"

2) "Please print in the future so I do not have to spend extra time attempting to read your writing."

3) "I am having difficulty reading your handwriting. It would save me time if you would be more careful."

4) "I cannot give this medication as it is written. I have no idea of what you mean." -

CORRECT ANSWER: 1

Rationale:

Assertive communication respects the rights and responsibilities of both parties. This statement is an honest expression of concern for safe practice and a request for clarification without self-depreciation. It reflects the right of the professional to give and receive information.

A registered nurse (RN) is working on the medical/surgical unit of a large medical center and needs to contact the health care provider regarding a change in a client's status.

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