Question 1

A nurse is making client assignments for the shift. Which of the following clients is most appropriately assigned to the LPN?&#10;A)A client who is newly-diagnosed with diabetes and needs discharge teachings about dietary modifications&#10;B)A client who requires enemas and oral antibiotics&#10;C)A newly-admitted client with third degree burns on the chest area&#10;D)A client with severe anemia due to gastrointestinal bleeding

Accepted Answer

Administering enemas and oral antibiotics are within the LPN's scope of practice. Discharge teachings, client admissions, and blood administration require the skills of an RN.

Question 2

An 80-year old client is scheduled for a barium enema. The nurse appropriately assigns which task to the nursing assistant?&#10;A)Obtain informed consent.&#10;B)Provide post-procedure teachings.&#10;C)Assisting the client to the bathroom.&#10;D)Administer laxatives.

Accepted Answer

The nursing assistant can assist the client during ambulation. Informed consent is obtained by physicians. Providing post-procedure teaching requires the skills of a registered nurse. Administration of laxatives is done by licensed personnel.

Question 3

An RN delegates an LPN to teach a group of clients about managing pain. Which of the following topics should the nurse delegate to the LPN?&#10;A)Guided imagery&#10;B)Therapeutic touch&#10;C)Use of warm and cold compresses&#10;D)Transcutaneous electrical stimulation

Accepted Answer

The LPN can teach clients about using heat and cold applications to alleviate pain. This therapy is standardized, with predictable results. Guided imagery and therapeutic touch need additional training, whereas TENS is usually administered by a physical therapist.

Question 4

Nina the New Nurse is caring for a client who has just returned from gastric surgery. The client has a NG tube to low suction, is awake, and is not complaining of pain; however, he is complaining of severe nausea. While Nina the New Nurse is in the client's room to administer an anti-emetic, the client vomits. After administering the medication, Nina the New Nurse next irrigates the NG tube with 30cc of normal saline. Which one or more of the following, if any, did Nina the New Nurse do wrong?

A)Nina the New Nurse is correct
B)Nina the New Nurse should not irrigate a gastric surgery client, unless prescribed by the surgeon
C)Nina the New Nurse should have advanced the NG tube and then irrigated
D)Nina the New Nurse should have examined the NG tube for occlusions, and/or the suction apparatus for malfunctions

Accepted Answer

Generally, irrigation of NG tubes of post-op gastric surgery clients is not prescribed; therefore, the nurse must call the surgeon if this is needed. In this scenario, Nina the New Nurse skipped the first step in the nursing process: assessment. Assessing why the client is vomiting should include assessing the amount and contents of the suction container, the patency of the suction tubing, and the proper functioning of the suction equipment.

Question 5

A nurse is caring for a client who is completing her living will. The client asks the nurse to help her find witnesses for the will. The most appropriate nursing action is to:&#10;A)Call the nursing supervisor and inform her about the client's requests&#10;B)Tell the client that she must find witnesses on her own&#10;C)Suggest to the client that she can witness the will, if necessary&#10;D)Ask another nurse who is not giving direct care to the client to be a witness

Accepted Answer

The most appropriate action is to call the nursing supervisor for assistance.

Question 6

The nurse understands that as a nursing advocate, he or she can:&#10;A)Encourage a client to refuse the medical treatment prescribed by the physician&#10;B)Encourage a client to make decisions for himself&#10;C)Manage client assignment in the nursing unit&#10;D)Legally represent the client

Accepted Answer

A nurse advocate supports the client's right to self-determination by providing information and assistance during decision-making. The nurse must not make decisions for the client, nor represent the client legally.

Question 7

An RN delegates some tasks to the LPN. The RN's first consideration when delegating tasks is which of the following?&#10;A)Client ratio during the shift&#10;B)Stability of the client's status&#10;C)The LPN's familiarity with the skills required&#10;D)The LPN's skill level

Accepted Answer

The stability of the client's condition would be the nurse's priority when delegating tasks. RNs have to be directly involved in monitoring and giving care if the client is unstable.

Deck 2: Care Management