BSN 366

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Sample questions from BSN 366

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

1. 1.At change of shift on a medical-surgical unit, a 76-year-old client with heart failure, BP 148/82 mm Hg, HR 88/min, and SpO2 95% on room air is scheduled for discharge. Which task is appropriate for the RN to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Obtain the client's daily weight and report it to the RN.
   • B.Evaluate the client's understanding of discharge instructions.
   • C.Assess the client's response to the morning dose of furosemide.
   • D.Teach the client how to follow a low-sodium diet.

   Rationale: Obtaining and reporting a routine weight is within the role of a trained UAP; the RN interprets the result and acts on it. Teaching, assessment, and evaluation require RN judgment and cannot be delegated. The exam takeaway is to delegate routine, predictable tasks while retaining nursing judgment.

2. 2.In a long-term care facility, an 82-year-old resident with dementia is newly prescribed an antipsychotic for unsafe agitation; BP is 128/74 mm Hg and the resident has had two falls this month. Which action should the nurse take first?

   • A.Ask the UAP to document the resident's behavior each shift.
   • B.Administer the medication as prescribed and reassess next month.
   • C.Apply a vest restraint while awaiting the medication's effect.
   • D.Clarify the indication and review nonpharmacologic approaches with the prescriber.

   Rationale: Antipsychotics in older adults with dementia carry significant risks and require a clear indication, evaluation of alternatives, and monitoring. Routine administration without clarification, delegating behavioral assessment, or applying a restraint without an appropriate indication does not address safety and least-restrictive care. The exam takeaway is to advocate for safe, individualized treatment.

3. 3.During a clinic visit, a 54-year-old client with type 2 diabetes has a glucose of 286 mg/dL and reports missing insulin because of its cost. Which response by the nurse best supports continuity of care?

   • A.Tell the client to use half the prescribed dose until the next visit.
   • B.Document nonadherence and continue with the scheduled appointment.
   • C.Refer the client to a social worker or medication-assistance resource and notify the prescriber.
   • D.Advise the client to purchase insulin from an unverified online seller.

   Rationale: Connecting the client with assistance and informing the prescriber addresses the barrier while avoiding unsafe medication changes. Halving the dose is not a prescribed plan, documentation alone does not resolve the access problem, and unverified medication sources are unsafe. The exam takeaway is to identify barriers and coordinate practical resources.

4. 4.Refer to the client's chart. A 68-year-old client is hospitalized with pneumonia. Which action should the nurse take first?

   • A.Obtain a sputum specimen before any further treatment.
   • B.Apply oxygen and rapidly assess respiratory status.
   • C.Administer the next scheduled oral antibiotic dose.
   • D.Teach the client how to use an incentive spirometer.

   Answer and rationale are in the full material.

5. 5.In an outpatient surgical center, a 45-year-old client scheduled for elective surgery says, "I took my apixaban this morning, but I forgot to tell anyone." Which action should the nurse take?

   • A.Give vitamin K and continue with the scheduled procedure.
   • B.Notify the surgeon and anesthesia professional and clarify the plan before surgery.
   • C.Ask the client to sign a waiver acknowledging the bleeding risk.
   • D.Proceed because the client has no active bleeding.

   Answer and rationale are in the full material.