LPN exams management of care practice questions, set 8
LPN exams · management of care
LPN exams management of care practice questionsset 8
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
The client on telemetry is showing ventricular tachycardia. Which action should the telemetry nurse delegate to the UAP?
A. Have the UAP call the operator and announce the code
B. Tell the UAP to answer the other call lights on the unit
C. Send the UAP to the room to start rescue breaths
D. Ask the family to step out of the room during the code
Show answer and rationale
Correct answer: A — Have the UAP call the operator and announce the code
The correct answer is A because in the scenario of a client experiencing ventricular tachycardia, immediate action is crucial. Having the UAP call the operator and announce the code ensures that the appropriate medical personnel are alerted promptly, initiating the necessary response team for the emergency. This action helps in expediting the arrival of the healthcare team to provide timely interventions such as defibrillation.
Choices B, C, and D are incorrect because they do not address the immediate need of responding to the cardiac emergency. Answer B distracts the UAP from the critical situation by focusing on non-urgent tasks. Answer C, sending the UAP to start rescue breaths, is a nursing intervention that requires specific training and should not be delegated to UAP. Answer D, asking the family to step out of the room, is important but not the most urgent action needed in a ventricular tachycardia scenario.
Question 2
A nurse in an ambulatory care setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth?
A. Developing client treatment protocols
B. Establishing communication between providers
C. Assessing client needs
D. Providing medication reconciliation
Show answer and rationale
Correct answer: C — Assessing client needs
The correct answer is C: Assessing client needs. In telehealth, one of the main objectives is to assess client needs remotely through virtual consultations. This allows healthcare providers to gather information, evaluate symptoms, and determine appropriate care without the need for an in-person visit. By assessing client needs, providers can make informed decisions about treatment plans and interventions.
The other choices are incorrect because:
A: Developing client treatment protocols is a part of the treatment planning process and not necessarily specific to the objective of telehealth.
B: Establishing communication between providers is important in healthcare coordination but not the primary objective of telehealth.
D: Providing medication reconciliation is a clinical task that can be done through telehealth, but it is not the main objective of telehealth, which is to assess and address client needs remotely.
Question 3
A staff development nurse is giving an in-service presentation about advocacy in nursing. Which of the following statements by a nurse indicates an understanding of the role of a client advocate?
A. As a client advocate, I will suggest the best course of action for clients who are indecisive
B. In the role of client advocate, I should take responsibility for coordinating each client's care
C. My role as a client advocate is to empower the clients to make informed health care decisions
D. As a client advocate, I will adhere to the provider's prescribed treatments
Show answer and rationale
Correct answer: C — My role as a client advocate is to empower the clients to make informed health care decisions
The correct answer is C: "My role as a client advocate is to empower the clients to make informed healthcare decisions."
Rationale:
1. Advocacy in nursing involves supporting and promoting the rights and best interests of clients.
2. Empowering clients to make informed decisions aligns with the ethical principle of autonomy.
3. By empowering clients, nurses help them make choices based on their values and preferences.
4. This approach respects the client's right to self-determination and promotes client-centered care.
Other Choices:
A: Suggesting the best course of action may not align with the client's wishes or values, limiting autonomy.
B: Coordinating care is important but not the primary role of a client advocate; it involves collaboration with the healthcare team.
D: Blindly adhering to prescribed treatments may not always be in the client's best interest and overlooks advocacy for informed decision-making.
Question 4
The nurse-manager delegates a task to a subordinate and says, 'This needs to be completed by noon today.' Which component of effective delegation has the manager addressed by making this statement?
A. Defining the limits of the subordinate's authority
B. Specifying the expected outcome
C. Establishing a timeline for completion
D. Determining the subordinate's legal accountability
Show answer and rationale
Correct answer: C — Establishing a timeline for completion
The correct answer is C: Establishing a timeline for completion. By setting a specific deadline of noon today, the nurse-manager is effectively addressing the component of establishing a timeline for completion when delegating a task. This ensures clarity on when the task needs to be finished, helps in prioritizing work, and enhances accountability.
A: Defining the limits of the subordinate's authority - This choice is incorrect because it pertains to specifying the boundaries and extent of decision-making power, not the timeframe for task completion.
B: Specifying the expected outcome - While important, this choice focuses on clarifying the end goal of the task, not the timing of its completion.
D: Determining the subordinate's legal accountability - This choice is not directly related to the specific timeline set for task completion but deals with the responsibility and liability aspects of the delegated task.
Question 5
The manager has noted that employees are not following some recently implemented standards of practice and is unsure how to proceed. What approach should the manager attempt to resolve this problem?
A. Consult with the person who previously managed the clinic.
B. Make more of an effort to get to know each of the employees individually.
C. Reduce expectations on the employees in order to improve compliance.
D. Remind the nurse about their obligation to follow standards of practice.
Show answer and rationale
Correct answer: B — Make more of an effort to get to know each of the employees individually.
The correct approach for the manager to resolve the issue of employees not following standards of practice is to make more of an effort to get to know each of the employees individually (Option B). By building relationships and understanding the motivations and challenges of each employee, the manager can tailor their approach to address the specific reasons behind non-compliance. This approach fosters trust, open communication, and a supportive environment, leading to better engagement and adherence to standards.
Other choices are incorrect:
A: Consulting with the previous manager may not address the current employees' unique needs and may not provide relevant solutions.
C: Reducing expectations can send the wrong message and compromise the quality of care provided.
D: Simply reminding the nurse of their obligation does not address the root cause of non-compliance and may not lead to sustained behavior change.
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Question 6
A nurse is prioritizing care after receiving change-of-shift report on four clients. Which of the following clients should the nurse assess first?
A. A client who reports feeling lightheaded when he stands up from a lying position
B. A client who reports an urge to void but has not urinated during the prior shift
C. A client who reports a headache with sensitivity to light
D. A client who reports indigestion and pain in her jaw
Correct answer:
The correct answer is D because the client reporting indigestion and pain in her jaw could be experiencing symptoms of a heart attack, which is a life-threatening emergency. The nurse should assess this client first to rule out any cardiac issues. Indigestion and jaw pain are common signs of a heart attack in women.
A: Feeling lightheaded when standing up could indicate orthostatic hypotension, but it is not immediately life-threatening.
B: Having an urge to void without urinating may indicate a urinary retention issue, which is important to address but not as urgent as potential cardiac symptoms.
C: Headache with light sensitivity could be a sign of a migraine or tension headache, which are not immediate emergencies.
In summary, the correct answer is D because it addresses a potentially life-threatening condition, while the other choices are important but do not pose an immediate threat to the client's life.
A labor room nurse is caring for a client in labor with a known history of sickle cell anemia. Which priority action would the nurse implement to assist in preventing a sickle cell crisis from occurring during labor?
A. continually reassure and coach the client
B. administer the prescribed oxygen throughout labor
C. maintain strict asepsis throughout the labor process
D. increase the intravenous (IV) fluids if the client complains of feeling thirsty
Correct answer:
The correct answer is B: administer the prescribed oxygen throughout labor. Administering oxygen helps improve oxygenation and reduce the risk of sickling of red blood cells in clients with sickle cell anemia, thereby preventing a sickle cell crisis. Oxygen therapy is a crucial intervention to maintain adequate tissue oxygenation during labor.
Choice A: continually reassure and coach the client. While emotional support is important, it is not the priority action in preventing a sickle cell crisis.
Choice C: maintain strict asepsis throughout the labor process. Asepsis is important for infection prevention but is not directly related to preventing a sickle cell crisis.
Choice D: increase the intravenous (IV) fluids if the client complains of feeling thirsty. While hydration is important, increasing IV fluids based on thirst alone may not be the most effective way to prevent a sickle cell crisis during labor.
A nurse manager is preparing to institute a new system for scheduling staff. Several nurses have verbalized concern over the possible changes that will occur. Which of the following is an appropriate method to facilitate the adoption of the new scheduling system?
A. Introduce the new scheduling system by describing how it will save the institution money
B. Offer to reassign staff who do not support the change to another unit
C. Identify nurses who accept the change to help influence other staff nurses
D. Provide a brief overview of the new scheduling system immediately before its implementation
Correct answer:
The correct answer is C: Identify nurses who accept the change to help influence other staff nurses. This approach is effective as it leverages social influence within the team. By identifying nurses who are supportive of the new system, the nurse manager can empower them to positively influence their peers. This method creates a sense of peer support and encourages a more organic adoption of the new scheduling system. It fosters a collaborative environment and allows for a smoother transition.
A: Introducing the system based on cost-saving benefits may not address the nurses' concerns and could lead to resistance.
B: Threatening to reassign staff who do not support the change creates a negative environment and may not address the underlying issues.
D: Providing a brief overview before implementation does not address the concerns of the nurses or involve them in the process, potentially leading to resistance.
A nurse assumes the leading role on the hazardous materials team immediately following a chemical mass casualty incident in the community. As clients arrive at the designated triage area outside the hospital, which of the following actions should the nurse take?
A. Admit the injured clients to positive-pressure rooms
B. Place shower caps over the clients' hair
C. Scrub the clients' skin with betadine solution
D. Remove contaminated clothing
Correct answer:
The correct answer is D: Remove contaminated clothing. This action is crucial to prevent further exposure to hazardous materials. By removing contaminated clothing, the nurse can limit the spread of toxins and reduce the risk of secondary contamination to both the clients and healthcare providers. This initial step helps to decontaminate the affected individuals and should be followed by thorough cleansing of the skin with soap and water.
Choice A is incorrect because admitting clients to positive-pressure rooms would not address the immediate need for decontamination. Choice B is incorrect as placing shower caps over the clients' hair is a minor concern compared to the urgency of removing contaminated clothing. Choice C is incorrect because scrubbing the clients' skin with betadine solution may not effectively remove the hazardous material and could potentially worsen the situation by spreading the toxins.
Which model suggests that behaviour change is influenced by personal factors, environmental factors, and the interaction between them?
A. Health Belief Model
B. Theory of Planned Behaviour
C. Social Cognitive Theory
D. Transtheoretical Model
Correct answer:
The correct answer is C: Social Cognitive Theory. This model suggests that behavior change is influenced by personal factors (beliefs, attitudes), environmental factors (social influences, physical surroundings), and the interaction between them (reciprocal determinism). Personal factors shape behavior through self-efficacy, outcome expectations, and goals. Environmental factors provide external stimuli and reinforcement. The interaction between personal and environmental factors explains how individuals adapt and learn new behaviors. The other choices are incorrect because:
A: Health Belief Model focuses on individual perceptions of health threats and benefits of actions.
B: Theory of Planned Behaviour emphasizes the role of attitudes, subjective norms, and perceived behavioral control.
D: Transtheoretical Model focuses on stages of behavior change and processes individuals go through to adopt new behaviors.
A charge nurse on a pediatric unit is delegating tasks to an assistive personnel (AP) who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP?
A. A 2-year-old child who has impetigo contagiosa
B. A 3-year-old with chickenpox
C. A 1-year-old with cytomegalovirus
D. A 4-year-old with rubella
Correct answer:
When delegating tasks, the charge nurse must consider the safety of both the client and the assistive personnel, especially given the AP's pregnancy and uncertain immune status. Impetigo, a bacterial skin infection caused by Staphylococcus or Streptococcus, is contagious but poses minimal risk to the AP if universal precautions (e.g., gloves, hand hygiene) are followed, as it's not airborne or teratogenic. In contrast, chickenpox, cytomegalovirus, and rubella are viral infections with significant risks during pregnancy chickenpox and rubella can cause fetal anomalies, and cytomegalovirus is a leading cause of congenital defects. Assigning the AP to the child with impetigo ensures her safety and that of her fetus, as the condition is manageable with standard precautions, unlike the other options, which involve greater exposure risks and potential complications for an immunocompromised or pregnant individual.
The nurse is caring for Mr. A.B., a client on a telemetry unit. At 0830 the client complains of chest pain. Which medication should the nurse administer? --Morphine sulfate 2 mg IVP QH PRN chest pain --Oxycodone 7.5/acetaminophen 325mg PO Q4H PRN pain --Maalox 30ml PO PRN indigestion --Nitroglycerin 0.4 mg SL Q5min up to 3 tablets PRN chest pain --Nitroglycerin transdermal cream 1/2 inch
A. Administer 1/2 inch of nitroglycerin transdermally now
B. Morphine sulfate 2 mg IVP STAT
C. Oxycodone 7.5 mg/acetaminophen 325 mg PO now
D. Nitroglycerin 0.4 mg SL STAT
Correct answer:
The correct answer is D: Administer Nitroglycerin 0.4 mg sublingually stat. This is the appropriate choice because nitroglycerin is the medication of choice for chest pain related to potential cardiac issues like myocardial infarction. Sublingual administration ensures rapid absorption, providing quick relief. The dose of 0.4 mg is standard for acute angina or chest pain. The frequency of up to 3 tablets every 5 minutes ensures that the nurse can titrate the medication to achieve pain relief while monitoring for adverse effects like hypotension.
A: Administer 1/2 inch of nitroglycerin transdermally now - This is not the best choice for acute chest pain as transdermal administration is slower and less effective in providing immediate relief.
B: Morphine sulfate 2 mg IVP STAT - While morphine can help with pain relief, it is not the first-line medication for acute chest pain, especially in cardiac patients
A nurse manager is planning to assign care for four clients on a medical-surgical unit. Which of the following clients should the nurse assign to a licensed practical nurse?
A. An adolescent client who is newly diagnosed with diabetes and requires teaching regarding insulin administration
B. A middle adult client who had a below-the-knee amputation and requires a dressing change
C. An older adult client who has lung cancer and has periodic episodes of severe dyspnea
D. A young adult client who is postoperative, receiving morphine via epidural, and reports pruritus
Correct answer:
The correct answer is B because a licensed practical nurse (LPN) is qualified to perform dressing changes. LPNs are trained to provide basic nursing care, including wound care and dressing changes. Clients with amputations may require frequent dressing changes to prevent infection and promote healing.
Choice A is incorrect because teaching regarding insulin administration requires a higher level of nursing knowledge and assessment skills, typically provided by a registered nurse.
Choice C is incorrect because managing a client with lung cancer and severe dyspnea may involve complex assessment and interventions that are beyond the scope of practice for an LPN.
Choice D is incorrect because managing a client postoperative with epidural morphine and pruritus may involve assessing for complications, adjusting pain management, and monitoring for side effects, which require the skills of a registered nurse.
Which intervention demonstrates Florence Nightingale's theory of nursing?
A. Respecting the patient's culture and incorporating cultural needs
B. Promoting good health and treating those who are ill in a holistic manner
C. Understanding how to motivate people to practice a healthy lifestyle and reduce risks
D. Teaching other nurses how to deliver the highest quality of care
Correct answer:
The correct answer is B because promoting good health and treating those who are ill in a holistic manner aligns with Florence Nightingale's theory of nursing. Nightingale emphasized the importance of considering the physical, emotional, and social aspects of patients' well-being. This approach focuses on addressing the whole person rather than just the illness.
Respecting the patient's culture and incorporating cultural needs (A) is important in providing patient-centered care, but it does not directly align with Nightingale's theory. Understanding how to motivate people to practice a healthy lifestyle and reduce risks (C) is relevant to health promotion but does not fully capture the holistic approach of Nightingale. Teaching other nurses how to deliver the highest quality of care (D) is essential for professional development but does not specifically reflect Nightingale's holistic nursing philosophy.
A nurse is evaluating care for a group of clients. The nurse should consult the provider for which of the following clients?
A. A client who requires an IV intermittent bolus dose of vancomycin and has a creatinine level of 1.5 mg/dL
B. A client who is ready for discharge after coronary artery stent placement and has a prescription for clopidogrel
C. A client who has a pacemaker and whose cardiac monitor shows sinus rhythm with intermittent periods of a wide QRS complex after each pacer spike
D. A client who has atrial fibrillation and a rapid ventricular rate of 105/min and is receiving diltiazem IV and weight-based heparin
Correct answer:
The correct answer is A because the client has a creatinine level of 1.5 mg/dL, which may indicate impaired kidney function. Vancomycin is known to be nephrotoxic and can further worsen kidney function. Consulting the provider is necessary to assess the risk versus benefit of administering vancomycin to this client.
Choice B is incorrect because a client ready for discharge after coronary stent placement and on clopidogrel would not necessarily require immediate provider consultation.
Choice C is incorrect because a pacemaker with intermittent periods of a wide QRS complex may indicate a malfunction or lead dislodgement, requiring immediate intervention rather than consultation.
Choice D is incorrect because a client with atrial fibrillation and a rapid ventricular rate receiving diltiazem and heparin is already on appropriate treatment and does not necessarily require immediate provider consultation.
About these LPN exams management of care questions
LPN exams management of care practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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