NCLEX for RN - Leadership and Management (1-5)

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1. A new nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. The nurse is told that the nursing model is a team nursing approach. The nurse understands that planning care delivery will be based on which characteristic of this type of nursing model of practice?
a) a task approach method is used to provide care to clients
b) managed care concepts and tools are used in providing client care
c) an RN leads nursing personnel in providing care to a group of clients
d) a single RN is responsible for providing nursing care to a group of clients

2. The nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. A nursing assistant is resistant to the change and is not taking an active part in facilitating the process of change. Which of the following is the best approach in dealing with the nursing assistant?

a) ignore the resistance
b) exert coercion with the nursing assistant
c) provide a positive reward system for the nursing assistant
d) confront the nursing assistant to encourage verbalization of feelings regarding the change

3. A nurse is giving a report to a nursing assistant who will be caring for a client who has hand restraints. The nurse instructs the nursing assistant to assess the skin integrity of the restrained hands every:

a) 2 hours
b) 3 hours
c) 4 hours
d) 30 minutes

4. Fibrinolysin and desoxyribonuclease (Elase) is prescribed to  treat a skin ulcer, and the nurse is observing a nursing student perform the treatment. The nurse intervenes if the nursing student is observed doing which of the following?

a) applies a thin layer of medication
b) cleans the wound with a sterile solution
c) places petrolatum gauze over the fibrinolysin and desoxyribonuclease
d) applies a thick layer of medication and covers with a dry sterile dressings

5. A nursing student is caring for a client with a brain attack (stroke) who is experiencing unilateral neglect. The nurse would intervene if the student plans to use which of the following strategies to help the client adapt to this deficit?

a) tells the client to scan the environment
b) approaches the client from the unaffected side
c) places the bedside articles on the affected side
d) moves the commode and cahir to the affected side



NCLEX for RN - Leadership and Management:
ANSWERS AND RATIONALE

1) C

- In team nursing, nursing personnel are led by a registered nurse leader in providing care to a group of clients. Option A identifies functional nursing. Option B identifies a component of case management. Option D identifies primary nursing.

2) D

- Confrontation is an important strategy to meet resistance head on. Face-to-face meetings to confront the issue at hand will allow verbalization of feelings, identification of problems and issues, and development of strategies to solve the problem. Option A will not address the problem. Option B may produce additional resistance. Option C may provide a temporary solution to the resistance but will not address the concern

3) D

- The nurse should instruct the nursing assistant to assess restraints and skin integrity every 30 minutes. Agency guidelines regarding the use of restraints should always be followed.

4) D

- The wound should be cleansed with a sterile solution and gently patted dry. A thin layer of fibrinolysin and desoxyribonuclease (Elase) is applied and covered with petrolatum gauze. If a dry powder preparation is used, for best effects, the solution should be prepared just before use.

5) B

- Unilateral neglect is an unawareness of the paralyzed side of the body, which increases the client’s risk for injury. The nurse’s role is to refocus the client’s attention to the affected side. The nurse moves personal care items and belongings to the affected side, as well as the bedside chair and commode. The nurse teaches the client to scan the environment to become aware of that half of the body and approaches the client from the affected side to increase awareness further.


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NCLEX for RN - Leadership and Management (6-10)

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