NGN Style Question the Client Is a 38 - Year Old Female Who Was Brought to the Hospital Following a Workplace Accident. She Has a Deep Laceration to Her Left

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Sample questions from NGN Style Question the Client Is a 38 - Year Old Female Who Was Brought to the Hospital Following a Workplace Accident. She Has a Deep Laceration to Her Left

This material has 150 questions with answers and rationales. Here are the first 5.

1. 1.Refer to the client's chart. Which nursing actions are appropriate to implement or delegate? Select all that apply.

   • A.Delegate measuring vital signs and placing an NPO sign on the door to the unlicensed assistive personnel (UAP).
   • B.Instruct the UAP to perform and document the serial radial pulse and capillary refill checks.
   • C.Administer the prescribed Tdap vaccine intramuscularly in the right deltoid.
   • D.Provide a light oral carbohydrate snack because the client's vital signs and hematocrit are stable.
   • E.Verify that the surgeon discusses surgical risks and benefits before witnessing the client's signature on the operative consent.

   Rationale: Administering the Tdap vaccine in the unaffected extremity is indicated because the client has a contaminated wound and unknown/outdated (>10 years) immunization status. Delegating baseline vital signs and placing an NPO reminder sign are appropriate tasks for a UAP with a stable client. The nurse acts as an advocate and witness in informed consent, ensuring the surgeon provides necessary procedural disclosures prior to witnessing the signature. Instructing the UAP to conduct neurovascular assessments is incorrect because assessment and clinical evaluation cannot be delegated. Providing food is contraindicated because the client must remain NPO in anticipation of emergent surgical exploration.

2. 2.In the emergency department, the triage nurse evaluates four clients arriving simultaneously. Which client requires the most immediate assessment and intervention?

   • A.A 38-year-old client with a deep forearm laceration showing pulsating, bright red blood through a saturated bandage
   • B.A 19-year-old client with a linear scalp laceration from a fall, alert and oriented with a Glasgow Coma Scale (GCS) score of 15
   • C.A 51-year-old client with a puncture wound to the foot from a rusty nail 2 days ago, showing localized erythema and low-grade fever
   • D.A 62-year-old client with a closed wrist deformity following a fall, reporting pain rated 6/10 and capillary refill of 2 seconds

   Rationale: Pulsating, bright red bleeding indicates arterial hemorrhage, which is an immediate threat to circulation and airway/breathing/circulation (ABC) stability that can rapidly lead to hemorrhagic shock and exsanguination. The client with a scalp laceration is neurologically intact (GCS 15) and stable. The client with the closed wrist deformity has intact distal perfusion (capillary refill 2 seconds) and moderate pain, making them urgent but not emergent. The client with the puncture wound shows localized infection without hemodynamic instability and can be safely managed after life-threatening bleeding is controlled.

3. 3.An occupational health nurse is contacted by a company supervisor requesting the confidential medical records and drug screen results of an employee injured on the manufacturing line. Which action should the nurse take?

   • A.Verbally disclose the extent of the laceration and surgical prognosis without sending written documentation.
   • B.Inform the supervisor that employee health records cannot be released without the employee's explicit written authorization.
   • C.Provide only the post-incident drug screen results to the supervisor while withholding the nursing assessment notes.
   • D.Email the complete medical file directly to human resources and carbon-copy the supervisor.

   Rationale: Under the Health Insurance Portability and Accountability Act (HIPAA) and occupational health privacy standards, an employee's detailed medical records and diagnostic results are protected health information (PHI) and cannot be disclosed to supervisors or employers without signed written authorization, except for required workplace injury reporting forms that do not disclose confidential clinical charts. Providing partial results or emailing files violates federal privacy regulations and client confidentiality. Verbal disclosure of clinical details also breaches confidentiality.

4. 4.Following surgical repair of a deep forearm laceration, a client is admitted to the medical-surgical unit. Which task is appropriate for the registered nurse (RN) to delegate to an unlicensed assistive personnel (UAP)?

   • A.Assessing the client's radial pulse, motor function, and sensation in the operative extremity
   • B.Teaching the client signs and symptoms of wound infection and compartment syndrome to report
   • C.Elevating the operative extremity on a pillow and assisting the client with gown change and hygiene
   • D.Adjusting the rate of the continuous intravenous crystalloid infusion to maintain patency

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which action is the priority for the nurse to implement?

   • A.Request an urgent physical therapy consultation for passive range-of-motion exercises.
   • B.Elevate the extremity above heart level on two pillows and apply an ice pack to reduce local edema.
   • C.Administer an additional dose of intravenous opioid analgesia as ordered for breakthrough surgical pain.
   • D.Loosen the constrictive dressing, maintain the extremity at heart level, and immediately notify the surgeon.

   Answer and rationale are in the full material.