NSG 2510

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Sample questions from NSG 2510

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

1. 1.On a medical-surgical unit, a 68-year-old client is 2 days postoperative after a hip replacement. The client is alert, has stable vital signs, and needs assistance walking to the bathroom. Which task is appropriate for the registered nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assist the client to the bathroom using the prescribed walker and gait belt.
   • B.Teach the client how to use the incentive spirometer.
   • C.Evaluate the client's response to the first dose of an opioid analgesic.
   • D.Assess the client's pain before ambulation.

   Rationale: Assisting a stable client with an established mobility plan is an appropriate delegated task for a trained UAP. Pain assessment, teaching, and evaluation of medication response require nursing judgment and remain the registered nurse's responsibility. The nurse should communicate the client's mobility precautions and follow up on the delegated task.

2. 2.In a pediatric clinic, the parent of a 7-year-old asks the nurse to sign the consent form for a scheduled tonsillectomy because the surgeon is not yet available. The child is stable, with a temperature of 36.8 C and HR 92/min. What is the nurse's best response?

   • A.Have the child sign the consent form because the child is old enough to understand.
   • B.Ask the parent to sign now and document that the surgeon will provide teaching later.
   • C.Explain the procedure and sign the form as the witness.
   • D.Contact the surgeon to discuss the procedure and answer questions before the parent signs.

   Rationale: The surgeon or other provider performing the procedure is responsible for explaining its risks, benefits, and alternatives and answering questions so the parent can provide informed consent. The nurse may witness the parent's signature but should not provide the procedural explanation in the provider's place. A 7-year-old does not independently provide legal consent, although the child's assent may be sought.

3. 3.At change of shift on a medical unit, a 73-year-old client with heart failure has new confusion and a respiratory rate of 30/min; another client is requesting a routine dressing change, and two clients are waiting for discharge instructions. Which action should the nurse take first?

   • A.Complete the routine dressing change before beginning the shift assessments.
   • B.Assess the client with new confusion and tachypnea, including oxygenation and respiratory status.
   • C.Ask the UAP to assess the confused client's oxygen saturation and report back later.
   • D.Provide discharge instructions to the clients who are waiting.

   Rationale: New confusion with tachypnea in a client with heart failure may signal acute hypoxemia or worsening cardiopulmonary status and requires immediate registered nurse assessment. A routine dressing change and discharge teaching can wait until the unstable client is evaluated. A UAP can obtain vital signs, but the nurse should not delay the initial assessment by delegating clinical evaluation.

4. 4.Refer to the client's chart. Which actions should the nurse take now to coordinate care for this 56-year-old client with suspected sepsis? Select all that apply.

   • A.Communicate the client's current findings and trends to the rapid response team according to facility criteria.
   • B.Notify the provider promptly about the worsening blood pressure and mental status.
   • C.Wait for the next scheduled vital-sign check before escalating the change in condition.
   • D.Arrange for the prescribed isotonic fluid bolus to be started without delay.
   • E.Delegate interpretation of the lactate result and treatment decisions to the UAP.

   Answer and rationale are in the full material.

5. 5.During a school-based clinic visit, a 16-year-old asks to discuss contraception without a parent present. The adolescent is alert, has no acute symptoms, and says, "Please do not tell my parent." What should the nurse do first?

   • A.End the visit and require a parent to return before discussing contraception.
   • B.Promise that no information from the visit will ever be shared.
   • C.Explain the limits of confidentiality and assess the adolescent's immediate safety and applicable consent rights.
   • D.Call the parent to obtain permission before asking any further questions.

   Answer and rationale are in the full material.