RN exams management of care practice questions, set 5
RN exams · management of care
RN exams management of care practice questionsset 5
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 RN exams exam guide or more RN 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 discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?
A. Have family members wear a gown and gloves when visiting.
B. Clean contaminated surfaces in the client's room with a bleach solution.
C. Use alcohol-based hand sanitizer when leaving the client's room.
D. Assign the client to a room with a private bathroom.
Show answer and rationale
Correct answer: A — Have family members wear a gown and gloves when visiting.
The correct answer is A because having family members wear a gown and gloves when visiting a client with C. difficile infection helps prevent the spread of the bacteria to others. This infection is highly contagious and can be transmitted through contact with contaminated surfaces or feces. By wearing protective gear, family members can reduce the risk of spreading the infection to themselves or others.
Choice B is incorrect because while cleaning contaminated surfaces with a bleach solution is important, it is not directly related to family members' responsibilities. Choice C is incorrect because alcohol-based hand sanitizers are not effective against C. difficile spores, so proper handwashing with soap and water is recommended. Choice D is incorrect because assigning the client to a room with a private bathroom is not directly related to the responsibility of family members visiting the client.
Question 2
Which of the following should be included in a discussion of advance directives with new nurse graduates?
A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
D. The advance directive designates a health-care surrogate who will make known the client’s wishes regarding medical treatment if the client is unable to do so.
Show answer and rationale
Correct answer: A — According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
Step 1: The Patient Self-Determination Act requires healthcare providers, including nurses, to inform clients of their right to create an advance directive.
Step 2: New nurse graduates need to understand this legal requirement to comply with ethical and legal standards.
Step 3: By discussing this requirement with new nurse graduates, they will be better equipped to provide information and support to clients regarding advance directives.
Step 4: This step is crucial in ensuring that clients' autonomy and right to self-determination are respected.
Step 5: Option A is the correct answer as it directly relates to the legal obligation of nurses in discussing advance directives with clients.
Summary: Options B, C, and D are incorrect as they do not address the specific legal requirement outlined in the Patient Self-Determination Act for informing clients about their right to create an advance directive.
Question 3
A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?
A. Suction the client's airway.
B. Instruct the client to perform incentive spirometry every hour.
C. Assist the client to an upright position.
D. Humidify the client's supplemental oxygen.
Show answer and rationale
Correct answer: C — Assist the client to an upright position.
The correct answer is C: Assist the client to an upright position. This is the priority intervention because placing the client in an upright position helps improve lung expansion and oxygenation by optimizing ventilation-perfusion matching. This position also reduces the risk of aspiration and improves overall respiratory function.
Choice A (Suction the client's airway) is not the first intervention because difficulty breathing in this scenario is more likely due to positioning rather than airway obstruction.
Choice B (Instruct the client to perform incentive spirometry every hour) is not the first intervention as it may not address the immediate issue of breathing difficulty related to supine positioning.
Choice D (Humidify the client's supplemental oxygen) is not the first intervention as lack of humidification is not likely the cause of the client's difficulty breathing in this situation.
Question 4
A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?
A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
B. Encourage the client to explore the reasons behind feeling useless.
C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'
Show answer and rationale
Correct answer: A — Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
The correct answer is A because it validates the client's feelings by acknowledging the common experience of middle adults feeling a sense of purpose through nurturing others. This response shows empathy and understanding, which can help the client feel heard and supported.
Choice B is incorrect because it immediately delves into exploring the reasons behind the feelings without first acknowledging or validating them. This approach may come off as dismissive or insensitive.
Choice C is incorrect because it brushes off the client's feelings by emphasizing the positive aspect of children becoming independent, without addressing the client's emotional distress.
Choice D is incorrect because it makes a generalization about happiness related to children leaving home without directly addressing the client's specific feelings of uselessness. It does not acknowledge or validate the client's emotions.
Question 5
A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
A. Lispro (Humalog)
B. Glargine (Lantus)
C. Detemir (Levemir)
D. NPH (Humulin N)
Show answer and rationale
Correct answer: A — Lispro (Humalog)
The correct answer is A: Lispro (Humalog). Lispro is a rapid-acting insulin that is ideal for mealtime coverage in intensive insulin therapy because it mimics the body's natural insulin response after a meal, providing quick and effective blood sugar control. Lispro has a rapid onset of action, peaks quickly, and has a shorter duration of action compared to other types of insulin. This makes it suitable for covering the rise in blood sugar levels that occurs after meals.
Summary of why other choices are incorrect:
B: Glargine (Lantus) is a long-acting insulin used for basal coverage, not for mealtime coverage.
C: Detemir (Levemir) is an intermediate-acting insulin used for basal coverage, not for mealtime coverage.
D: NPH (Humulin N) is an intermediate-acting insulin with a slower onset and longer duration of action, making it less suitable for mealtime coverage in intensive insulin therapy.
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Question 6
Which of the following laboratory values should the nurse monitor in a client with Cushing's syndrome?
A. Blood glucose levels
B. Serum calcium levels
C. Serum potassium levels
D. Serum sodium levels
Correct answer:
The correct answer is A: Blood glucose levels. In Cushing's syndrome, there is excess cortisol in the body which leads to increased blood glucose levels due to its effect on glucose metabolism. Elevated blood glucose levels are a common finding in individuals with Cushing's syndrome. Monitoring blood glucose levels is crucial as it helps in assessing and managing hyperglycemia in these patients.
Choice B, serum calcium levels, is not typically a priority in monitoring for Cushing's syndrome. While abnormalities in calcium levels can occur in some endocrine disorders, hypercalcemia is not a hallmark of Cushing's syndrome.
Choice C, serum potassium levels, and Choice D, serum sodium levels, are not directly associated with Cushing's syndrome. While electrolyte imbalances can occur in various conditions, they are not specifically linked to Cushing's syndrome as blood glucose levels are.
Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)
A. Notify the nursing supervisor.
B. Notify security.
C. Have them check patients to verify safety.
D. Ask construction workers to be responsible.
Correct answer:
The correct answer is D because asking construction workers to be responsible for the equipment and sharp items used is not within the charge nurse's role or authority. The responsibility for ensuring safety and security in the Emergency Department lies with the healthcare staff (including the charge nurse) and security personnel. Construction workers may not have the training or expertise to handle agitated patients or prevent potential incidents.
A: Notifying the nursing supervisor (A) can help escalate the issue and involve higher authority in addressing the safety concern.
B: Notifying security (B) is essential to ensure that trained professionals are present to handle security-related issues.
C: Having staff check patients (C) is important to verify their safety, but it does not address the primary concern of preventing patients from accessing construction equipment as weapons.
Although technology has seen many advances, which two ethical principles may be in conflict because of technology?
A. Beneficence and justice
B. Beneficence and nonmaleficence
C. Beneficence and veracity
D. Beneficence and confidentiality
Correct answer:
The correct answer is B: Beneficence and nonmaleficence. Beneficence refers to doing good and promoting well-being, while nonmaleficence means to do no harm. Technology can sometimes create a conflict between these two principles when the benefits of a technology may come with potential risks or harm. In such cases, healthcare professionals must carefully balance the benefits and risks to ensure they are not causing harm while trying to do good.
Choice A: Beneficence and justice do not inherently conflict because promoting well-being and ensuring fairness can work together.
Choice C: Beneficence and veracity (truthfulness) are not directly in conflict; being honest and promoting well-being can align.
Choice D: Beneficence and confidentiality can be in conflict in certain situations, but the conflict between beneficence and nonmaleficence is more common in the context of technology.
Effective leaders must communicate a vision for the future. Which of the following is the best method for communicating a vision for the future?
A. Involve others in creating the vision and connect daily work tasks to the vision.
B. Encourage staff nurses to openly discuss practice and possible improvements.
C. Critically analyze and discuss advances in practice with other nurses on staff.
D. Actively listen to the recommendations of others.
Correct answer:
The best method for communicating a vision for the future is to involve others in creating the vision and connect daily work tasks to the vision. This approach fosters ownership and commitment among team members, as they feel part of the vision-building process and understand how their daily tasks contribute to achieving that vision. Choice B, encouraging staff nurses to openly discuss practice and possible improvements, is important for fostering communication but doesn't directly address creating and communicating a vision. Choice C, critically analyzing and discussing advances in practice with other nurses, focuses on professional development and knowledge sharing rather than specifically communicating a future vision. Choice D, actively listening to recommendations, is valuable for gathering input but may not be sufficient on its own for effectively communicating a future vision.
The nurse manager has two employees with a longstanding conflict that is affecting the group's productivity and cohesiveness. She decides to meet with the employees in private, bring the conflict out into the open, and attempt to resolve it through knowledge and reason. Which conflict management strategy did she employ?
A. Confrontation
B. Suppression
C. Collaboration
D. Intervention
Correct answer:
The correct answer is A: Confrontation. In this scenario, the nurse manager directly addresses the conflict by meeting with the employees in private. Confrontation involves facing the conflict head-on, bringing it out into the open, and attempting to resolve it through open communication and discussion. By addressing the conflict directly, the nurse manager is using a proactive approach to resolve the issue.
Summary of other choices:
B: Suppression - This involves ignoring or avoiding the conflict, which is not what the nurse manager is doing in this scenario.
C: Collaboration - While collaboration involves working together to find a mutually beneficial solution, the nurse manager is taking a more direct approach by confronting the conflict.
D: Intervention - This typically involves a third party stepping in to mediate the conflict, which is not what is happening in this scenario.
Which of the following best describes the concept of shared decision-making in healthcare?
A. The process by which patients make healthcare decisions on their own
B. A collaborative process that allows patients and providers to make healthcare decisions together
C. A method for providers to dictate treatment plans to patients
D. The use of evidence-based guidelines to make healthcare decisions
Correct answer:
The correct answer is B because shared decision-making in healthcare involves both patients and providers actively participating in the decision-making process together. This collaborative approach allows for a discussion of treatment options, considering patient preferences, values, and medical evidence. It promotes patient autonomy and enhances the quality of care by incorporating both the patient's perspective and the provider's expertise.
Choice A is incorrect because shared decision-making is not solely about patients making healthcare decisions independently. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients, which is not in line with the principles of shared decision-making. Choice D is incorrect as it refers to evidence-based guidelines, which are important but not the sole focus of shared decision-making.
After change-of-shift report, which patient should the nurse assess first?
A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain
Correct answer:
The correct answer is C because the patient with hyperosmolar hyperglycemic syndrome showing signs of poor skin turgor and dry oral mucosa is at risk for severe dehydration and potential complications. Assessing this patient first is crucial to address their immediate needs.
Choice A is incorrect as the 19-year-old with possible dawn phenomenon can be assessed after the patient with hyperosmolar hyperglycemic syndrome who is at higher risk.
Choice B is incorrect as a blood glucose reading of 230 mg/dL in a 35-year-old with type 1 diabetes is high but not indicative of an immediate life-threatening situation compared to severe dehydration.
Choice D is incorrect as the 68-year-old with peripheral neuropathy and foot pain, while in discomfort, does not present an immediate threat to their life like severe dehydration does in a patient with hyperosmolar hyperglycemic syndrome.
Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?
A. Measure the ankle-brachial index.
B. Check for changes in skin pigmentation.
C. Assess for unilateral or bilateral foot drop.
D. Ask the patient about symptoms of depression.
Correct answer:
The correct answer is A, "Measure the ankle-brachial index." This task involves using a blood pressure cuff and Doppler ultrasound to assess blood flow in the lower extremities, which is within the scope of practice for UAPs. It is a non-invasive procedure that does not require specialized training.
Choice B, "Check for changes in skin pigmentation," involves assessing for potential skin changes related to circulation issues, which requires more in-depth knowledge and interpretation than what UAPs are trained for.
Choice C, "Assess for unilateral or bilateral foot drop," involves evaluating muscle strength and nerve function, which requires clinical judgment and knowledge beyond the scope of UAP practice.
Choice D, "Ask the patient about symptoms of depression," involves assessing mental health and requires communication skills and training that UAPs do not typically have.
A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?
A. Integrative decision-making
B. Win-win
C. Competing
D. Confrontation
Correct answer:
The correct answer is A: Integrative decision-making. This strategy involves allowing the group to explore multiple solutions and reach a consensus, fostering collaboration and mutual benefit. This approach promotes a win-win outcome and encourages open communication and respect among team members. It is effective for resolving conflicts as it focuses on finding a solution that satisfies the interests of all parties involved.
Choice B: Win-win is a similar concept to integrative decision-making but lacks the emphasis on exploring multiple solutions and reaching a consensus.
Choice C: Competing involves one party winning at the expense of the other, contrary to the collaborative nature of integrative decision-making.
Choice D: Confrontation is a direct and aggressive approach that does not promote collaboration or consensus-building like integrative decision-making does.
When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?
A. Position the client in a side-lying position.
B. Perform the irrigation using a 20-mL syringe.
C. Instill 15 mL of irrigation fluid into the catheter with each flush.
D. Measure and record the amount of irrigant used.
Correct answer:
The correct answer is B: Perform the irrigation using a 20-mL syringe. This is the correct action because using a 20-mL syringe allows for precise and controlled instillation of the irrigation fluid into the catheter. Using a smaller syringe helps prevent excessive pressure within the catheter, reducing the risk of trauma or damage to the client's urinary system.
A: Positioning the client in a side-lying position is not essential for open irrigation technique, as long as the client is comfortable and the procedure can be safely performed.
C: Instilling 15 mL of irrigation fluid with each flush may not be appropriate as the volume needed may vary based on the client's condition.
D: Although measuring and recording the amount of irrigant used is important for documentation purposes, it is not the immediate action to ensure the safe and effective irrigation of the catheter.
RN exams management of care practice questions, set 5 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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