Management of Care 2

Note: These questions include ones similar to alternative format questions as seen on the NCLEX-RN exam.

A widowed woman is being admitted for emergency cardiac surgery by the nurse. She is asking the nurse questions about who will make decisions for her if something goes wrong during her surgery. Which of these is the correct course of action for the nurse?

A terminally ill male patient who is mentally competent declines palliative radiation for his inoperable brain tumor. The nurse knows that this patient is refusing treatment based on which of these legal standards?

Which of these examples is most illustrative of a nurse acting as an advocate for the patient?

A nurse is assigned five patients on a medical surgery floor. There are two LPNs and one nursing assistant also working the shift. Which of the following interventions are appropriate to delegate to the supportive nursing staff? Select all that apply.

A. auscultating breath sounds on a 70-year-old client with emphysema
B. changing bed linens on a 44-year-old client while he is in radiology for an MRI
C. assisting a 83-year-old client with history of unstable gait to the restroom
D. administering IV Toradol (Ketorolac tromenthamine) to a 56-year-old recovering from a stroke
E. taking vital signs on a 65-year-old client whose blood pressure was last 80/46

Which of these scenarios correctly describes proper delegation by a nurse?

The nurse is planning to delegate tasks for her patients at the nursing home. The nurse knows that she does not need which of these to ensure successful supervision of the delegated tasks?

A 75-year-old female recovering from a broken hip is being discharged from a healthcare facility. After completing her care plan after discharge, the nurse learns that her patient has a 78-year-old husband with dementia that she cares for at home. He has been staying with other family members during her convalescence. Which of these is the correct course of action for the nurse?

A nurse is taking care of a previously healthy adult patient with a newly diagnosed serious medical condition. The patient is apprehensive and confused by all of the information, tests, test results, and the number of medical practitioners involved in the care plan. The nurse knows that it is her job to inform and educate this patient on the rights and responsibilities of those receiving healthcare as specified in the Patients’ Bill of Rights. According to this document, which of the following is not included in this discussion?

A nurse has a 75-year-old patient with COPD and diabetes that requires care from a pulmonologist, endocrinologist, respiratory therapist, physical therapist, occupational therapist, as well as services from a social worker and registered dietician. The nurse knows that this interdisciplinary action across the various areas of medicine is known as ____.

The nurse working in the ICU takes a phone call from an unknown person inquiring about the status of one of the patients under her care. Which of the following is the best course of action for the nurse?

In which of these situations is a nurse in violation of HIPAA guidelines?

A nurse is preparing discharge arrangements for an elderly client with a right ankle fracture. The client is scheduled to go to a skilled nursing and rehabilitation facility. Which of the following interventions are appropriate for providing continuity of care during the facility transition? Select all that apply.

A. secures a client bed at the new facility
B. transfers the complete medical record
C. discards the current medication schedule as it will change at the new facility
D. discusses the transport and transfer information with the client and family
E. schedules follow-up appointment with the surgeon in six weeks

A nurse has just received report on all four of his patients for his upcoming shift on a medical/surgical floor. Which of the patients should the nurse attend to first?

Prior to surgery, a surgeon requests that the nurse review the surgical procedure, risks, benefits, and alternative therapies with a client. Which response by the nurse is most appropriate?

A nurse has just received report and taken over care of a new patient admitted to the floor for pneumonia. The patient is febrile and has been started on IV antibiotics. Based on this information, which of these statements from this patient should concern the nurse the most?

When considering the principles of ethics of the nursing profession, acting in a manner that avoids harm refers to the principle of ____.

Which of these examples correctly identifies a nurse demonstrating the ethical principle of justice?

A nurse is present when a physician speaks with a patient about an upcoming invasive diagnostic procedure. The physician describes the procedure in detail and discusses all possible alternative procedures and treatments and what the potential ramifications are if the patient decides not to have the procedure. The nurse knows that the patient cannot give informed consent based on this discussion because the physician forgot to include which of these?

A nurse caring for an insulin-dependent diabetic patient forgets to give him his dose of insulin. This action precipitates an episode of diabetic ketoacidosis which requires care in the ICU. In a court of law, the nurse may be found guilty of ____.

A nurse begins working in a rehabilitation facility and notes that many patients suffer falls. She identifies the appropriate cases and brings them to the attention of her nurse manager. Together, they begin to identify the factors contributing to the increased number of falls and work on ways to improve this. The nurse knows that she is participating in which of these processes?