Final Exam Mangemant

Free preview · Original latest version

Sample questions from Final Exam Mangemant

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, the charge nurse receives reports on four clients. Which client should the nurse assess first?

   • A.A 54-year-old 6 hours after abdominal surgery who is newly restless, has an oxygen saturation of 88% on room air, and is breathing 28 times/min
   • B.A 42-year-old with diabetes whose premeal glucose is 240 mg/dL and who is due for prescribed insulin
   • C.A 67-year-old with heart failure who has gained 1 kg in 24 hours and has bilateral ankle edema
   • D.A 76-year-old with a urinary tract infection who has a temperature of 38.1 C and is awaiting an oral antibiotic

   Rationale: The postoperative client has new restlessness, tachypnea, and hypoxemia, which may signal acute respiratory compromise and require immediate assessment and intervention. The heart failure client needs timely evaluation, but the reported edema and weight gain do not indicate the same immediate threat to airway or breathing. The elevated glucose and fever require follow-up, but neither is the first priority based on the cues provided. Use the ABC framework and prioritize acute changes over expected or less immediately dangerous findings.

2. 2.During an evening shift in a long-term care facility, an RN supervises a newly licensed practical nurse (LPN) and an experienced unlicensed assistive personnel (UAP). The residents are stable, and facility policy permits the LPN to administer routine medications. Which tasks are appropriate for the RN to delegate? Select all that apply.

   • A.Ask the LPN to reinforce previously taught instructions about a low-sodium diet with a resident
   • B.Ask the LPN to administer a scheduled oral antihypertensive to a stable resident and report the blood pressure response
   • C.Ask the UAP to assess a resident who reports new chest pressure and decide whether to activate emergency services
   • D.Ask the UAP to evaluate whether a newly prescribed pain medication relieved a resident's pain
   • E.Ask the UAP to obtain the morning weight of a stable resident with chronic heart failure and report the result

   Rationale: Obtaining and reporting a routine weight is an appropriate UAP task when the RN interprets the result and follows up on changes. Administering a routine oral medication and reinforcing established teaching are appropriate LPN tasks within the stated scope and policy; the RN remains responsible for oversight. Assessing new chest pressure and deciding on emergency action require nursing judgment and must not be delegated to the UAP. Evaluating medication effectiveness also requires nursing judgment, so the RN should perform that evaluation.

3. 3.In a pediatric clinic, the parent of a 9-year-old with a new prescription for an antibiotic says, "I do not understand how to give this medicine, but I need to leave now." The child is stable with a temperature of 37.2 C, HR 92/min, RR 20/min, and BP 104/66 mm Hg. What is the nurse's best action?

   • A.Ask the parent to sign the medication instruction form and provide a printed handout
   • B.Use teach-back to clarify the instructions and help arrange a safe plan for the first dose
   • C.Document that the parent declined teaching and send the prescription to the pharmacy
   • D.Request that another family member administer the first dose while the parent is away

   Rationale: The parent has identified a knowledge gap, so the nurse should clarify the instructions and use teach-back to verify understanding before relying on the caregiver to administer the medication. A signature or handout does not demonstrate comprehension. Asking an unassessed family member to give the medication does not ensure safe administration. Documenting a refusal is inaccurate because the parent has not refused; the nurse should address the barrier and coordinate a safe plan.

4. 4.A provider prescribes a medication for a 29-year-old client admitted to an inpatient unit. The dose is substantially higher than the usual dose listed in the medication reference, and the client has a BP of 118/72 mm Hg, HR 76/min, and no symptoms. What should the nurse do first?

   • A.Administer the medication because the provider entered the prescription
   • B.Reduce the dose to the usual range and document the change
   • C.Ask another nurse to administer the medication instead
   • D.Hold the medication and clarify the prescription with the provider

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which action should the nurse take first for the 6-year-old client?

   • A.Ask the parent to remain at the bedside while the nurse completes routine documentation
   • B.Administer the next scheduled antibiotic dose before contacting the provider
   • C.Notify the rapid response team and support oxygenation while reassessing the client
   • D.Encourage oral fluids and repeat the temperature in 1 hour

   Answer and rationale are in the full material.