Here are the Answers to NCLEX Preparation Course - Critical Thinking VI (31-40) -->
31. A nurse (RN) on a medical-surgical unit receives a new client admitted with abdominal pain. Which of the following activities should be performed by the RN rather than delegated to the LPN/LVN or nursing assistant?
a) preparing the client's chart
b) administering bedtime medications to the clients on the unit
c) completing the admission assessment for the new client
d) obtaining a clean-catch urine specimen from the client
32. A nurse is working with an LPN/LVN and a nursing assistant on a long-term care unit. The nurse observes the LPN/LVN and the nursing assistant moving a client up in bed to. The nurse will intervene if which of the following is observed?
a) the LPN/LVN and the nursing assistant grasp the client under the arms to pull up the bed
b) the client is asked to flex his knees and dig his heels in to help push up in bed
c) the bed is put in the high position prior to lifting the client
d) the side rails are lowered prior to lifting the client up in bed
33. A nurse working on a surgical unit is approached by a physician who asks if a client's consent form for surgery has been signed yet. The most appropriate response for the nurse is:
a) the LPN/LVN is caring for that client. I will check on whether the form is signed yet
b) I asked the other nurse on the floor to get that while I was at lunch. Please see that nurse about this
c) I have not had time to do that yet. I have been so busy today
d) I asked another nurse to get consent. I will check on whether it was done yet
34. An enema is ordered for a client as part of a bowel preparation for surgery. The nurse delegates the task to the LPN/LVN. Which of the following actions by the nurse is best?
a) write the task on the assignment sheet
b) explain the task and expected results to the LPN/LVN
c) explain to the client why the LPN/LVN will administer enema
d) if the LPN/LVN is too busy to give the enema, the nurse should give it
35. A new nurse is interested in learning more about how to appropriately delegate tasks to the LPN/LVNs and nursing assistants on the unit. The best source of information the nurse can refer to regarding which tasks are appropriate for which level of personnel is:
a) the American Nurses Association Code for Nurses
b) the hospital's Nursing Procedure Manual
c) The Nurse Practice Act in the State the nurse is practicing
d) a nursing management textbook
36. A nurse delegates medication administration for a group of clients to a LPN/LVN prepares to administer a subcutaneous (SQ) injection of heparin to a client. The nurse should intervene if the LPN/LVN:
a) rubs the injection site with alcohol before and after the injection
b) administer the heparin SQ injection in the left lower quadrant of the abdomen
c) does not aspirate after inserting the needle
d) gently withdraws the needle at the same angle it was inserted
37. A registered nurse on a medical surgical unit is preparing the assignment for the day shift. The RN is working with a licensed practical (vocational) nurse (LPN/LVN) and a nursing assistant. The RN most appropriately assigns which client to the LPN/LVN?
a) a newly admitted client with syncope
b) a client with tracheostomy needing suctioning
c) a client with cerebral palsy who needs assistance with feeding
d) a client with a below the knee amputation
38. A nurse on telemetry unit receives a new client admitted with atrial fibrillation. Which of the following activities should be performed by the RN rather than delegated to the LPN/LVN or nursing assistant?
a) attaching the leads of the cardiac monitor
b) obtaining an infusion pump for the client
c) completing the admission assessment for the client
d) obtaining a urinalysis specimen from the client
39. A nurse is working with a team consisting of an LPN/LVN and nursing assistant. The nurse delegates medication administration to the LPN/LVN. According to the principles of delegation, the nurse knows that in delegating this task to the LPN/LVN, the nurse retains:
a) accountability
b) authority
c) responsibility
d) credibility
40. A nurse delegates application of anti-embolism stockings to an LPN/LVN. Which of the following actions, if observed by the nurse, would not require intervention?
a) rubs lotion on legs before applying stockings
b) applies stockings after client is assisted out of bed to a chair
c) turns the stocking inside out before applying
d) folds top of stockings over
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NCLEX Preparation Course - Critical Thinking Exercises VI (Questions 31-40)
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