LPN exams management of care practice questions, set 6
LPN exams · management of care
LPN exams management of care practice questionsset 6
You decide who to see first, what to delegate, and which order cannot wait. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five management of care questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A nurse is preparing to transfer an older adult client to a long-term care facility. To promote continuity of care, which of the following actions should the nurse plan to take?
A. Give a verbal report to the facility staff
B. Give a written summary of the client's nursing plan of care to the long-term care facility
C. Instruct the client to request their records
D. Rely on the provider's discharge summary
Show answer and rationale
Correct answer: B — Give a written summary of the client's nursing plan of care to the long-term care facility
Continuity of care ensures seamless transitions between healthcare settings, especially for older adults with complex needs. Providing a written summary of the client's nursing plan of care to the long-term care facility is the most effective action, as it communicates detailed, specific information about the client's needs, medications, and care preferences in a permanent, referenceable format. This reduces miscommunication risks and supports the receiving staff in maintaining consistent care. A verbal report, while helpful, lacks permanence and may omit details if not recorded. Instructing the client to request records shifts responsibility inappropriately, and relying solely on the provider's discharge summary may exclude nursing-specific insights critical for daily management. The written summary bridges the gap between acute and long-term care, enhancing safety and quality by ensuring all relevant care aspects are conveyed comprehensively.
Question 2
A nurse walks into the room of a client diagnosed with congestive heart failure (CHF). The client is lying supine and is diaphoretic, anxious, and dyspneic. What is the nurse's priority action?
A. Administer 0.5 mg of lorazepam
B. Administer oxygen at 4 L/min
C. Raise the head of the bed to 45°
D. Draw arterial blood gases
Show answer and rationale
Correct answer: C — Raise the head of the bed to 45°
In a client with congestive heart failure (CHF) presenting with diaphoresis, anxiety, and dyspnea while lying supine, the priority is to improve oxygenation and reduce respiratory distress. Raising the head of the bed to 45° facilitates better lung expansion and eases breathing by reducing pressure on the diaphragm, addressing the immediate issue of dyspnea. Administering lorazepam may reduce anxiety but does not directly address the respiratory compromise. Administering oxygen is important but is a secondary action to positioning, as it requires setup and does not immediately alleviate the mechanical difficulty of breathing. Drawing arterial blood gases is diagnostic and time-consuming, delaying intervention for an acute situation. The nurse must act swiftly to stabilize the client, and positioning is the most effective initial step to improve comfort and oxygenation, aligning with the ABCs (airway, breathing, circulation) of emergency care.
Question 3
The clinic leader tends to make decisions independently and closely supervises and controls the practice of the nurses at the clinic. What type of leadership is being exemplified?
A. Authoritarian
B. Democratic
C. Laissez-faire
D. A contingency approach
Show answer and rationale
Correct answer: A — Authoritarian
The correct answer is A: Authoritarian. In this scenario, the clinic leader is exhibiting an authoritarian leadership style by making decisions independently and closely supervising and controlling the nurses. Authoritarian leaders typically make decisions on their own without much input from others and have strict control over their subordinates. This style can be effective in certain situations where quick decision-making and clear direction are needed.
Summary of other choices:
B: Democratic leadership involves involving others in decision-making and promoting collaboration, which is not demonstrated in this scenario.
C: Laissez-faire leadership is characterized by a hands-off approach, where leaders provide minimal guidance and supervision, which is opposite to the behavior described in the scenario.
D: A contingency approach considers different leadership styles based on the situation, which is not explicitly mentioned in the scenario.
Question 4
A nurse in a rehabilitation facility is administering medications to a client who was admitted earlier that day. The client refuses two of the medications, stating 'I've never taken these before.' Which of the following actions should the nurse take first?
A. Consult the pharmacist about the client's prescribed medications
B. Review the intended purpose of the prescribed medications with the client
C. Compare the client's medication administration record with the prescriptions on the transfer orders
D. Call the provider to clarify the client's prescribed medications
Show answer and rationale
Correct answer: C — Compare the client's medication administration record with the prescriptions on the transfer orders
The correct answer is C: Compare the client's medication administration record with the prescriptions on the transfer orders. This is the first action the nurse should take because it ensures that the medications the client is refusing are indeed prescribed for them. By cross-referencing the client's current medications with the transfer orders, the nurse can verify the accuracy of the prescriptions and identify any discrepancies or errors. This step is crucial in ensuring patient safety and preventing medication administration mistakes.
Choice A is incorrect because consulting the pharmacist should come after verifying the client's current medications and transfer orders. Choice B is not the first priority as the nurse needs to first confirm the prescribed medications before discussing their intended purpose with the client. Choice D is not the immediate action, as calling the provider should be done after confirming the medication orders.
Question 5
A member of the team has been delegated some tasks and reports, 'I've been given too much to do and I'm not going to be able to complete the work on time.' What is the RN's best initial action?
A. Assign the work to another team member.
B. Take on the responsibility of the tasks.
C. Have the team member perform only the most necessary tasks.
D. Examine the workload and assist the individual in reprioritizing
Show answer and rationale
Correct answer: D — Examine the workload and assist the individual in reprioritizing
The correct answer is D: Examine the workload and assist the individual in reprioritizing. This is the best initial action as it involves identifying the root cause of the issue and working collaboratively to find a solution. By examining the workload together, the RN can help the team member prioritize tasks effectively, ensure essential tasks are completed, and provide support where needed.
Option A: Assign the work to another team member is not the best initial action as it does not address the underlying problem of the team member feeling overwhelmed. It may also create resentment among team members.
Option B: Take on the responsibility of the tasks does not encourage accountability and growth within the team. It may lead to dependency on the RN to solve all issues.
Option C: Have the team member perform only the most necessary tasks does not address the issue of workload management and may result in important tasks being neglected.
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Question 6
Which information best describes quantum theory in regard to nursing leadership?
A. A mixture of maturation and learning
B. Linear movement with controlled chaos
C. Interfacing among all group members
D. A scientific way of thinking
Correct answer:
The correct answer is C: Interfacing among all group members. Quantum theory in nursing leadership emphasizes the interconnectedness and interactions among all group members. It focuses on collaborative relationships, shared decision-making, and mutual influence. This approach recognizes the dynamic and complex nature of leadership within a healthcare team.
A: A mixture of maturation and learning - This choice does not capture the essence of quantum theory in nursing leadership, which is more about relationships and interactions rather than individual development.
B: Linear movement with controlled chaos - This choice does not align with the principles of quantum theory, which emphasize non-linear and unpredictable patterns of behavior within a group.
D: A scientific way of thinking - While scientific thinking is important in nursing leadership, it does not fully encompass the relational and dynamic aspects emphasized by quantum theory.
A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduating soon. A nurse asks the UAP if he has performed a urinary catheterization on clients while in school. When the UAP says yes, the nurses asks him to help her by doing a urinary catheterization on a post-surgical client. What is the best response by the UAP?
A. Let me get permission from the client first
B. I can't do it, is there something else I can help you with?
C. I can't do it unless you supervise me
D. Sure, which client is it?
Correct answer:
As an unlicensed assistive personnel (UAP), the nursing student's role is limited to tasks within the UAP scope, regardless of skills learned in school. Urinary catheterization is an invasive procedure requiring sterile technique and clinical judgment, typically reserved for licensed nurses, not UAPs. Responding, 'I can't do it, is there something else I can help you with?' is the best choice, as it acknowledges the UAP's limitations and offers alternative assistance, maintaining patient safety and legal boundaries. Seeking client permission is irrelevant, as the task is outside the UAP's scope. Requesting supervision doesn't change the fact that it's an inappropriate delegation. Agreeing to perform it risks patient harm and violates regulations. The UAP must prioritize their current role over future qualifications, ensuring care remains within their authorized duties and protecting both the patient and themselves from potential liability.
Rather than focus on production, situations, or technology, the neoclassical theory was concerned with the
A. Employer
B. Manager
C. Follower
D. Employee
Correct answer:
The correct answer is D: Employee. Neoclassical theory focuses on individuals within an organization, particularly the employees. This theory emphasizes the importance of understanding human behavior, motivation, and relationships in the workplace to improve productivity and organizational effectiveness. It highlights the significance of employee satisfaction, engagement, and well-being in achieving organizational goals.
Explanation for why the other choices are incorrect:
A: Employer - Neoclassical theory does not solely focus on the employer but rather on all individuals within the organization.
B: Manager - While managers play a role in neoclassical theory, the primary focus is on employees as they are considered the key drivers of productivity and success.
C: Follower - Neoclassical theory does not specifically address followers, but rather emphasizes the importance of individual employees and their contributions to the organization.
The nurse-manager is preparing to use the PERT tool when making a staffing decision. This tool will primarily address what component of the decision-making process?
A. Values
B. Consequences
C. Timing
D. Ethics
Correct answer:
The correct answer is C: Timing. PERT (Program Evaluation and Review Technique) is a tool used for project management to analyze and represent the tasks involved in completing a project, along with their respective timelines. In the context of staffing decisions, PERT helps in determining the optimal sequencing of activities and estimating the time required for each task. This tool focuses on the timing aspect of decision-making, ensuring that the staffing process is efficient and well-organized.
Incorrect choices:
A: Values - Values refer to beliefs and principles that guide decision-making, which is not the primary focus of PERT.
B: Consequences - While consequences are important in decision-making, PERT does not primarily address the outcomes or results of staffing decisions.
D: Ethics - Ethics relate to moral principles and standards of conduct, which are essential but not the main focus of PERT in the context of staffing decisions.
A community health nurse is working with older residents who were involved in a recent flood. Many of the residents are emotionally despondent, and they refused to leave their homes for days. When planning forth rescue and relocation of these older residents, what is the first item that the nurse needs to consider?
A. contacting the older resident's families
B. attending to the emotional needs of the older residents
C. arranging for ambulance transportation for the oldest residents
D. attending to the nutritional status and basic needs of the older residents
Correct answer:
The correct answer is D, attending to the nutritional status and basic needs of the older residents. In a crisis situation like a flood, ensuring the basic needs such as food, water, and shelter are met is crucial for survival. By attending to the nutritional status and basic needs first, the nurse can address immediate health concerns and provide support for the residents. This action also lays the foundation for addressing emotional and psychological needs later on.
Summary of other choices:
A: contacting the older resident's families - While important for support, addressing immediate physical needs takes priority.
B: attending to the emotional needs of the older residents - Important, but ensuring basic needs like nutrition comes first for survival.
C: arranging for ambulance transportation for the oldest residents - Transportation is important but not the first priority; addressing basic needs is critical for health and survival.
Which activity is currently one of the most challenging opportunities for nurses in acute care institutions to become involved with to produce change?
A. Participating in patient management just prior to discharge
B. Developing creative staffing mixes to provide optimum care
C. Using standardized critical paths without any individual variation
D. Training of unlicensed assistive personnel to do patient assessment
Correct answer:
The correct answer is B, developing creative staffing mixes to provide optimum care. This is because staffing is a crucial factor that directly impacts patient outcomes in acute care settings. Nurses need to strategically plan and create staffing mixes that ensure proper care delivery, resource utilization, and patient safety. By innovatively designing staffing solutions, nurses can optimize care quality and efficiency.
A: Participating in patient management just prior to discharge, although important, may not necessarily be the most challenging opportunity for nurses in producing change.
C: Using standardized critical paths without any individual variation can be helpful for consistency but may not necessarily lead to significant change in the institution.
D: Training unlicensed assistive personnel to do patient assessment is important for delegation, but it may not be the most challenging opportunity for nurses in producing change.
A patient with diabetes has hot, dry skin, rapid and deep respirations, and a fruity odor to his breath. The charge nurse observes a newly graduated RN performing all of the following patient tasks. Which action requires that the charge nurse intervene immediately?
A. Checking the patient's fingerstick glucose level
B. Encouraging the patient to drink orange juice
C. Checking the patient's order for sliding-scale insulin dosing
D. Assessing the patient's vital signs every 15 minutes
Correct answer:
Correct Answer: B - Encouraging the patient to drink orange juice
Rationale:
1. The patient is showing signs of diabetic ketoacidosis (DKA) - hot, dry skin, rapid deep respirations, fruity breath.
2. Orange juice is high in sugar and can worsen the patient's condition by increasing blood glucose levels.
3. In DKA, insulin is needed to lower blood glucose levels, not sugar intake.
4. Checking glucose levels, insulin dosing, and vital signs are important but not as urgent as addressing the patient's high blood sugar levels.
Summary:
A: Checking the patient's fingerstick glucose level is important, but not urgent compared to addressing the patient's high blood sugar levels in DKA.
C: Checking the patient's order for sliding-scale insulin dosing is relevant, but immediate intervention is required to address the high blood sugar levels.
D: Assessing the patient's vital signs every 15 minutes is important for monitoring, but addressing the
A nurse-manager has recently been accused of assigning work unequally. The manager has recognized the need to revise the process for assigning work to nurses. How can the manager best apply the principles of Theory Z?
A. Making a decision independently and imposing it on the nurses
B. Gathering input from employees in order to reach a consensus
C. Making a decision based on the pros and cons of each option
D. Identifying as many different alternatives as possible
Correct answer:
The correct answer is B: Gathering input from employees in order to reach a consensus. Theory Z emphasizes participative management and employee involvement in decision-making. By involving nurses in the process of revising work assignments, the nurse-manager can benefit from their insights and perspectives, leading to a more effective and fair system. This approach promotes employee engagement, ownership, and commitment to the new process.
Incorrect Choices:
A: Making a decision independently and imposing it on the nurses goes against Theory Z principles of employee involvement and collaboration.
C: Making a decision based on the pros and cons of each option is a rational approach but does not fully utilize the benefits of employee input and consensus-building.
D: Identifying as many different alternatives as possible is a good practice, but without employee involvement, it may not result in the most suitable solution for the team.
A client is brought to the emergency department following a motor-vehicle crash. Drug use is suspected in the crash, and a voided urine specimen is ordered. The client repeatedly refuses to provide the specimen. Which of the following is the appropriate action by the nurse?
A. Tell the client that a catheter will be inserted
B. Assess the client for urinary retention
C. Obtain a provider's prescription for a blood alcohol level
D. Document the client's refusal in the chart
Correct answer:
The correct answer is D: Document the client's refusal in the chart. The rationale for this is that documenting the client's refusal is important for legal and ethical reasons. It ensures that there is a record of the client's refusal to provide a urine specimen, which can be used for future reference and to protect both the client and the healthcare provider.
Choice A (Tell the client that a catheter will be inserted) is incorrect because it is not appropriate to threaten or coerce the client into providing a urine specimen.
Choice B (Assess the client for urinary retention) is also incorrect because the client's refusal to provide a urine specimen is the primary issue that needs to be addressed.
Choice C (Obtain a provider's prescription for a blood alcohol level) is incorrect because the initial request was for a urine specimen, and switching to a blood alcohol level without addressing the client's refusal is not appropriate.
The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first?
A. A 21-year-old patient with diabetes insipidus whose urine output overnight was 2000 mL
B. A 55-year-old patient with SIADH who is demanding that the assistive personnel refill his water pitcher
C. A 65-year-old patient with Addison's disease whose morning potassium level is 6.2 mEq/L
D. A 48-year-old patient with Cushing's disease with a weight gain of 1.5 lb (0.7 kg) over the past 4 days
Correct answer:
The correct answer is C. The nurse must assess the 65-year-old patient with Addison's disease whose morning potassium level is 6.2 mEq/L first because hyperkalemia is a critical condition that can lead to life-threatening cardiac arrhythmias. High potassium levels can result from adrenal insufficiency (Addison's disease) due to decreased aldosterone levels. The priority is to address the immediate risk to the patient's life by monitoring and managing the potassium levels.
Choice A is incorrect because while diabetes insipidus can lead to significant urine output, it is not immediately life-threatening. Choice B is incorrect as the patient with SIADH is not in immediate danger, and the demand for water may be managed by setting limits and educating the patient. Choice D is incorrect as a weight gain of 1.5 lb over 4 days in a patient with Cushing's disease is concerning but does not pose an immediate threat to the patient's life.
About these LPN exams management of care questions
LPN exams management of care practice questions, set 6 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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