NRSG3000 Exam 1 — Original Latest Version Study Set

Free preview · Original latest version

Sample questions from NRSG3000 Exam 1 — Original Latest Version Study Set

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

1. 1.During morning rounds on a medical unit, a 72-year-old client's condition changes. Refer to the client's chart. Which action should the RN take first?

   • A.Repeat the blood pressure in 30 minutes.
   • B.Request a routine physical therapy consultation.
   • C.Activate the rapid response team.
   • D.Administer the prescribed oral antihypertensive.

   Rationale: The fall in BP to 86/48 mm Hg, new confusion, tachypnea, and SpO2 of 89% indicate acute deterioration requiring immediate escalation. Physical therapy is inappropriate during instability, and the antihypertensive could worsen hypotension. Waiting 30 minutes delays treatment of possible shock. Prioritize rescue resources when several indicators of perfusion and oxygenation worsen together.

2. 2.At change of shift on a surgical unit, four clients need care. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Evaluate pain relief in a 32-year-old after IV morphine.
   • B.Measure urine output for a stable 55-year-old with an indwelling catheter.
   • C.Assess new dizziness in a 68-year-old receiving an antihypertensive.
   • D.Teach a 40-year-old how to use an incentive spirometer.

   Rationale: Measuring and reporting urine output is a routine task appropriate for trained UAP when the client is stable. Assessing new dizziness requires nursing judgment. Initial teaching and evaluation of medication effectiveness are RN responsibilities. Delegate predictable tasks, not assessment, teaching, or evaluation.

3. 3.On a rehabilitation unit, an RN coordinates care for a stable 70-year-old recovering from a stroke. The client has established swallowing precautions and requires assistance with hygiene. Which assignments are appropriate for a trained UAP? Select all that apply.

   • A.Obtain routine vital signs and report values outside specified parameters.
   • B.Assist with bathing using the established care plan.
   • C.Determine whether swallowing precautions can be discontinued.
   • D.Develop a new transfer plan after the client becomes weaker.
   • E.Record intake and output.

   Rationale: Bathing assistance and recording intake and output are predictable tasks for a trained UAP. Routine vital signs may also be delegated with clear reporting parameters. Discontinuing swallowing precautions and developing a transfer plan after a change require licensed nursing assessment. The RN remains accountable for supervision and follow-up.

4. 4.Before surgery in an ambulatory center, a 46-year-old says, 'I signed the form, but I still do not understand why I need this procedure.' Sedation has not been given. What is the RN's best action?

   • A.Ask the surgeon to clarify the procedure before proceeding.
   • B.Proceed because the signed consent establishes understanding.
   • C.Explain the surgical risks in place of the surgeon.
   • D.Ask the spouse to authorize the procedure instead.

   Answer and rationale are in the full material.

5. 5.In the emergency department, a 58-year-old with chest pain refuses recommended admission after accurately explaining the risk of myocardial infarction and death. The client is alert, not intoxicated, and has decision-making capacity. Which response is best?

   • A.Ask security to prevent the client from leaving.
   • B.Tell the client that insurance will not cover today's care.
   • C.Remove the IV and leave without further discussion.
   • D.Explore the refusal, notify the provider, and offer a safer follow-up plan.

   Answer and rationale are in the full material.