North Palm College Shadow Health

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Sample questions from North Palm College Shadow Health

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

1. 1.During a simulated medical-surgical assessment of a 72-year-old client, the nurse identifies a change in condition. Refer to the client's chart. Which action has priority?

   • A.Activate the rapid response team
   • B.Reassess urine output in 2 hours
   • C.Request a routine physical therapy evaluation
   • D.Administer the scheduled oral antihypertensive

   Rationale: The change from BP 118/68 to 84/48 mm Hg, new confusion, and increasing tachypnea indicate acute deterioration requiring rapid response activation. Physical therapy and delayed urine reassessment do not address the immediate threat to perfusion. Giving an antihypertensive could worsen hypotension; prioritize rescue before routine care.

2. 2.At morning rounds on a rehabilitation unit, an 81-year-old client recovering from hip surgery is stable, follows directions, and has an established mobility plan. Which tasks may the RN delegate to trained assistive personnel? Select all that apply.

   • A.Evaluate whether the analgesic relieved postoperative pain
   • B.Teach the client how to prevent hip dislocation
   • C.Measure and record oral fluid intake
   • D.Assist with ambulation using the prescribed walker and established plan
   • E.Obtain routine vital signs and report values outside specified parameters

   Rationale: Measuring intake and obtaining routine vital signs are predictable tasks that trained assistive personnel can perform with reporting parameters. Assisting with an established mobility plan is also appropriate for this stable client. Evaluating analgesic effectiveness and teaching hip precautions require nursing judgment and remain with the licensed nurse.

3. 3.Before elective surgery, a 46-year-old client tells the preoperative RN, 'I signed the consent, but I still do not understand why they might remove the whole organ.' The client has not received sedation. What should the RN do?

   • A.Explain the surgical alternatives and proceed with preparation
   • B.Document that the signed form establishes informed consent
   • C.Ask the spouse to confirm that the procedure was explained
   • D.Notify the surgeon that further explanation is needed before proceeding

   Rationale: The surgeon must clarify the procedure, risks, and alternatives when the client expresses uncertainty. The RN advocates for a pause but should not replace the proceduralist's consent discussion. Neither a spouse's reassurance nor a signed form establishes adequate understanding.

4. 4.At change of shift in a telemetry unit, the RN receives report on four clients. Which client should be assessed first?

   • A.A 55-year-old with atrial fibrillation and a stable heart rate of 88 beats/min
   • B.A 70-year-old with new chest pressure, diaphoresis, and BP 88/54 mm Hg
   • C.A 64-year-old with heart failure who gained 0.5 kg over 24 hours
   • D.A 39-year-old awaiting discharge who needs medication teaching

   Answer and rationale are in the full material.

5. 5.During discharge planning, a 58-year-old client with newly prescribed insulin says, 'I cannot afford the medicine or testing supplies.' The glucose level is 184 mg/dL, and discharge is planned for this afternoon. Which action best supports a safe transition?

   • A.Suggest using insulin only when symptoms occur
   • B.Ask a neighbor to share insulin supplies temporarily
   • C.Coordinate with the case manager and pharmacy to establish an affordable treatment plan before discharge
   • D.Provide a list of resources and discharge without further assessment

   Answer and rationale are in the full material.