Professional Nursing Practice: the Foundation of Clinical Excellence

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Sample questions from Professional Nursing Practice: the Foundation of Clinical Excellence

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.The RN is caring for a group of clients on a medical-surgical unit. Which client should the nurse assess first?

   • A.A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
   • B.A client who underwent a laparoscopic cholecystectomy 4 hours ago and is complaining of shoulder pain.
   • C.A client with chronic obstructive pulmonary disease (COPD) who has an oxygen saturation of 91% on room air.
   • D.A client who had a femoral-popliteal bypass graft 2 hours ago and now has a cool, pale foot with an absent pedal pulse.

   Rationale: The client with a cool, pale foot and absent pulse after a bypass graft is showing signs of acute arterial occlusion, which is a surgical emergency (Circulation). Edema in heart failure and 91% saturation in COPD are expected findings. Shoulder pain after laparoscopic surgery is an expected finding due to the CO2 used during the procedure.

2. 2.Which task is most appropriate for the RN to delegate to a UAP?

   • A.Assisting a client who is 1-day post-operative following a total hip replacement to ambulate for the first time.
   • B.Recording the intake and output for a client who is receiving continuous bladder irrigation.
   • C.Providing discharge instructions to a client who was treated for a simple skin infection.
   • D.Performing a focused physical assessment on a client who just returned from a cardiac catheterization.

   Rationale: Recording intake and output is a routine task within the UAP's scope. First-time ambulation after surgery requires an RN assessment for stability. Discharge teaching and physical assessments are the responsibility of the RN and cannot be delegated.

3. 3.A client is scheduled for an elective surgery. During the pre-operative assessment, the client tells the nurse, 'I'm not really sure why I need this surgery or what they are going to do.' Which action should the nurse take first?

   • A.Explain the risks and benefits of the surgery to the client.
   • B.Provide the client with a pamphlet explaining the surgical procedure.
   • C.Notify the surgeon that the client does not understand the procedure.
   • D.Ask the client to sign the consent form and then call the surgeon.

   Rationale: The nurse's role in informed consent is to ensure the client understands the procedure. If the client states they do not understand, the nurse must notify the surgeon, who is legally responsible for obtaining the consent. The nurse should not explain the risks/benefits and should never have the client sign the form if they are confused.

4. 4.The RN is supervising a PN who is caring for a client with a new diagnosis of diabetes mellitus. Which action by the PN requires the RN to intervene?

   • A.The PN reinforces the RN's teaching on how to perform a finger-stick glucose check.
   • B.The PN administers the client's scheduled dose of subcutaneous insulin glargine.
   • C.The PN provides the initial education on the signs and symptoms of hypoglycemia.
   • D.The PN collects data on the client's dietary preferences for the care plan.

   Answer and rationale are in the full material.

5. 5.Following a mass casualty incident, which client should be assigned a 'red tag' by the triage nurse?

   • A.A client with a large laceration on the forehead who is walking and talking.
   • B.A client with an open fracture of the tibia and a palpable pedal pulse.
   • C.A client with a sucking chest wound and a respiratory rate of 34 breaths per minute.
   • D.A client with fixed, dilated pupils and no spontaneous respirations.

   Answer and rationale are in the full material.