Nrg 200 Mid Term and Final Exam

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Sample questions from Nrg 200 Mid Term and Final Exam

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

1. 1.A nurse on a medical-surgical unit receives reports on four clients. Which client should the nurse assess first?

   • A.A 68-year-old with heart failure who has bilateral ankle edema and gained 0.5 kg in 24 hours
   • B.A 45-year-old who is 8 hours postoperative and reports incisional pain of 7/10
   • C.A 29-year-old with gastroenteritis who requests an antiemetic after one episode of vomiting
   • D.A 72-year-old with pneumonia whose oxygen saturation decreased from 94% to 86% on 2 L/min oxygen and who is newly confused

   Rationale: New confusion with worsening hypoxemia indicates an immediate threat to oxygenation and requires assessment first. Incisional pain requires treatment but is less urgent than respiratory deterioration. Mild weight gain with ankle edema warrants follow-up, while isolated vomiting without instability is not the highest priority. Prioritize acute changes affecting airway, breathing, or circulation over stable symptoms.

2. 2.A registered nurse is working with an experienced unlicensed assistive personnel (UAP) on a rehabilitation unit. A 76-year-old client recovering from a stroke has stable vital signs and an established transfer plan requiring a gait belt and one-person assistance. Which task is appropriate to delegate to the UAP?

   • A.Assist the client from the bed to the chair using the established plan
   • B.Teach the client how to use a new walker
   • C.Evaluate whether the client's transfer plan should be changed
   • D.Assess the cause of dizziness reported during transfer

   Rationale: Assisting a stable client with a routine transfer using an established plan is appropriate for trained UAP. Evaluating the plan and assessing new dizziness require nursing judgment. Initial teaching about a new walker also remains the nurse's responsibility. Delegate predictable tasks, not assessment, teaching, or evaluation.

3. 3.A charge nurse on a medical unit is assigning care to an RN, an LPN/VN, and a UAP. Facility policy permits the LPN/VN to administer routine oral medications and perform established wound care. Which assignments are appropriate? Select all that apply.

   • A.Assign the LPN/VN to complete the initial comprehensive assessment of a newly admitted 81-year-old client
   • B.Assign the UAP to obtain routine vital signs for a stable 38-year-old client
   • C.Assign the LPN/VN to administer scheduled oral antihypertensives to a stable 64-year-old client
   • D.Assign the LPN/VN to change an established dressing for a stable 70-year-old client
   • E.Assign the UAP to teach a 59-year-old client how to self-administer insulin

   Rationale: Routine oral medication administration and established wound care for stable clients are appropriate LPN/VN assignments under the stated policy. Obtaining routine vital signs is appropriate for a trained UAP, with the RN responsible for interpreting findings. The initial comprehensive assessment requires an RN. Initial insulin teaching cannot be delegated to UAP; assignments must match client stability, legal scope, and demonstrated competence.

4. 4.A 52-year-old client in the preoperative area is scheduled for a colectomy. The consent form is unsigned, and the client says, "I do not understand why I might need a colostomy." The surgeon asks the nurse to obtain the signature. What should the nurse do?

   • A.Have the client sign and document that questions remain
   • B.Explain all surgical risks and then obtain the signature
   • C.Notify the surgeon that the client needs additional explanation before signing
   • D.Ask the client's spouse to sign because the client is anxious

   Answer and rationale are in the full material.

5. 5.A 67-year-old client admitted for atrial fibrillation has prescriptions for apixaban and newly prescribed enoxaparin at a therapeutic dose. No transition plan is documented, and the client's platelet count is 210,000/mm3. What is the nurse's best action before the next anticoagulant doses?

   • A.Administer both medications because the platelet count is normal
   • B.Clarify the potentially duplicate anticoagulant prescriptions with the prescriber and pharmacist
   • C.Discontinue apixaban independently and administer enoxaparin
   • D.Administer the medications 2 hours apart to prevent an interaction

   Answer and rationale are in the full material.