Nursing Management Styles (NCLEX 71-75)

Welcome to Nursing Management Styles. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


71. A student nurse is developing a plan of care for a paranoid client with a nursing diagnosis of Disturbed thought processes. The registered nurse reviews the interventions developed by the student and suggests revising the plan if the student has documented which intervention?

a) sit with the client and hold the client's hand
b) display a nonjudmental attitude
c) use simple and clear language when speaking to the client
d) diffuse angry and hostile verbal attacks with nondefensive stand

72. A benzodiazepine anxiolytic has been prescribed for a client for the management of anxiety, and a student nurse prepares to provide instructions to the client regarding the administration of the medication. The registered nurse who is supervising the student intervenes if the student plans to tell the client which of the following?

a) avoid driving or other activities requiring alertness until the response to the medication
b) do not skip medication doses and do not double up on missed doses
c) double a dose if a dose was missed
d) avoid the use of alcohol while taking the medication

73. A nurse is reviewing the critical paths of the clients on the nursing unit. In performing a variance analysis, which of the following would indicate the need for further action and analysis?

a) clear breath sounds in client with congestive heart failure
b) a postoperative client who develops a cough and a fever
c) the absence of a wound infection in a client who had a coronary artery bypass graft
d) a client with diabetes mellitus demonstrating accurate use of a glucometer following teaching

74. A nurse is told that the nursing model used in the nursing facility is a functional 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 methods is used to provide care to clients
b) a single registered nurse (RN) is responsible for providing nursing care to a group of clients
c) managed care concepts and tools are used in providing client care
d) nursing personnel are led by a RN in providing care to a group of clients

75. A nurse manager has implemented a change in the method of documenting nursing care. A licensed practical nurse (LPN) is resistant to the change and is not taking an active part in facilitating the process of change. Which of the following would be the best approach in dealing with the LPN?

a) ignore the resistance
b) tell the LPN that the registered nurse will do all of the documentation
c) confront the LPN, and encourage verbalization of feelings regarding the change
d) tell the LPN that she must comply with the change






Nursing Management Styles 
Answers and Rationale

71) A
- When caring for a paranoid client, the nurse must avoid any physical contact. The nurse should ask the client's permission if touch is necessary because touch may be interpreted as a physical or sexual assault. The nurse should use simple and clear language when speaking to the client to prevent misinterpretation and to clarify the nurse's intent and actions. A warm approach is avoided because it can be frightening to a person who needs emotional distance. Anger and hostile verbal attacks are diffused with a nondefensive stand. The anger a paranoid client expresses is often displaced, and when a staff member becomes defensive, anger of both the client and staff member escalates. A nondefensive and nonjudgmental attitude provides an environment in which feelings can be explored more easily.

72) C
- The client should be instructed to take the medication exactly as directed and not to skip or double up on the doses. The client should also be instructed not to increase doses or to abruptly withdraw the medication. Abrupt withdrawal may cause tremors, nausea, vomiting, and abdominal or muscle cramps. The client is also advised to avoid driving or other activities requiring alertness until response to the medication is known and to avoid taking alcohol or other central nervous system depressants concurrently with this medication.

73) B
- Variances are actual deviations or detours from the critical paths. Variances can be positive or negative, avoidable or unavoidable, and can be caused by a variety of things. Positive variance occurs when the client achieves maximum benefit and is discharged earlier than anticipated. Negative variance occurs when untoward events prevent a timely discharge. Variance analysis occurs continually in order to anticipate and recognize negative variance early so that appropriate action can be taken.

74) A
- In functional nursing, a task approach method is used to provide care to clients. Option B exemplifies primary nursing. Option C exemplifies a component of case management. Option D exemplifies team nursing.

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


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Management Styles (1-5)


Or proceed to the next set of questions:

Nursing Management Styles (76-80)

Read More

Nursing Management Styles (NCLEX 66-70)

Welcome to Nursing Management Styles. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.

66. A physician wrote an order for wrist restraints to be applied to a client. The nurse instructs the nursing assistant to apply the restraints. When checking the client, which observation would indicate that the nursing assistant performed unsafe care?

a) a safety (hitch) knot was used to secure the restraints
b) restraints were released every 2 hours
c) restraints were applied snugly and tightly
d) the call light was placed within reach of the client's hand

67. A registered nurse assigns a new nursing graduate to care for a client with a diagnosis of active tuberculosis, and the registered nurse explains the use of a particulate respirator to the graduate. Which observation indicates that the new nursing graduate understands how the particulate respirator operates?

a) the nosepiece is readjusted if air is detected escaping around the nose
b) another particulate respirator is obtained if air is escaping around the nose
c) the new nursing graduate states that a fit check is not needed
d) the new nursing graduate states that a fit check is necessary only when putting on the respirator for the first time

68. A registered nurse has instructed a new nursing graduate about the procedure for weaning a client from a ventilator by using a T-piece. The registered nurse determines that the new nursing graduate nurse states which of the following to be part of the procedure?

a) removing the client from the mechanical ventilator for a short period
b) connecting the T-piece to the client's artificial airway
c) providing supplemental oxygen through the T-piece at an Flo2 that is 10% higher than the ventilator setting
d) gradually decreasing the respiratory rate on the ventilator until the client takes over all of the work of breathing

69. A registered nurse is mentoring a new nurse hired to work in the nursing unit. The registered nurse determines that the new nurse is competent to provide safe effective care for a client on a ventilator when the registered nurse notes that the new nurse:

a) has the ventilator routinely assessed by the respiratory therapist
b) realizes that the ventilator readings provide information without human error
c) teaches family members how to reset controls during their visits if necessary
d) establishes a rest pattern before morning care

70. A nursing student develops a plan of care for a client who will be returning from the operating room after a mastoidectomy. The registered nurse reviews the plan of care and instructs the student to revise the plan if which intervention is listed?

a) assess client for pain, dizziness, or nausea
b) keep the head of the bed elevated to 30 degrees
c) instruct the client to lie on the affected side
d) assess for signs of injury to cranial nerve VII





Nursing Management Styles
Answers and Rationale

66) C
- Restraints should never be applied tightly because they could impair the circulation. A safety (hitch) knot may be used on the restraint because it can easily be released in an emergency. Restraints must be released at least every 2 hours (or per agency policy) to inspect the skin for abnormalities and to provide range-of-motion exercises. The call light must always be at the client's reach in case the client needs assistance.

67) A
- Personal protective equipment, called particulate respirators, is required for all health care workers entering a tuberculosis isolation room. When fitted and used properly, these respirators filter droplet nuclei. It is important that no air escapes around the nose while wearing the respirator. The strap needs to be adjusted if air is escaping. It is important to exhale forcefully while placing both hands over the apparatus. It is necessary to perform a fit check each time the nurse uses the mask.

68) D
- The T-piece or Briggs device requires that the client is removed from the mechanical ventilation for a short time, usually beginning with a 5-minute period. The ventilator is disconnected and the T-piece is connected to the client's artificial airway. Supplemental oxygen is provided through the device, often at a FIo2 that is 10% higher than the ventilator setting. Option 4 describes the process of weaning via synchronized intermittent mandatory ventilation.

69) A
- Ventilators need to be assessed routinely by the respiratory therapist. Ventilators are machines, and machines can fail. Therefore, option B is not a reasonable option. Family members should not reset ventilator controls. Although option D is considered good nursing practice for the comfort of the client, it is not the priority option.

70) C
- Following mastoidectomy, the nurse should monitor vital signs and inspect the dressing for drainage or bleeding. The nurse should assess for signs of facial nerve injury to cranial nerve VII and assess the client for pain, dizziness, or nausea. The head of the bed should be elevated at least 30 degrees, and the client is instructed to lie on the unaffected side. The client would probably have sutures and an outer ear packing and a bulky dressing, which is removed on approximately the sixth postoperative day.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Management Styles (1-5)


Or proceed to the next set of questions:

Nursing Management Styles (71-75)

Read More

Leadership NCLEX Questions (61-65)

Welcome to Leadership NCLEX Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


61. A client is scheduled for bronchoscopy, and the registered nurse reviews the plan of care written by a nursing student. The registered nurse discusses revision of the plan with the nursing student if which incorrect intervention was documented?

a) removing any dentures
b) removing contact lenses
c) letting the client eat or drink
d) obtaining a signed informed consent

62. A physician prescribes a chemotherapeutic medication dose that the nurse believes is too high. The nurse calls the physician, but the physician has left the office for the weekend. The nurse appropriately:

a) reschedules the client's chemotherapy until the following week
b) telephones the answering service and confers with the on-call physician
c)  withholds giving the medication until the physician's partner makes rounds the following day
d) checks with the pharmacist, who agrees the dose is too high, and then reduces the dose accordingly

63. A medication nurse is supervising a newly hired nurse who is administering pyridostigmine (Mestinon) orally to a client with myasthenia gravis. Which observation by the medication nurse indicates safe practice by the newly hired nurse before administering this medication?

a) asking the client to take a sips of water
b) asking the client to lie down on her right side
c) asking the client to look up at the ceiling for 30 seconds
d) instructing the client to void before taking the medication

64. A registered nurse (RN) is supervising a licensed practical nurse (LPN) providing care to a client with end-stage heart failure. The client is withdrawn, reluctant to talk, and shows little interest in participating in hygienic care or activities. Which statement by the LPN to the client indicates that the LPN needs instructions in the use of therapeutic communication skills?

a) you are very quiet today
b) what are your feelings right now?
c) why don't you feel like getting up?
d) tell me more about your difficulty with sleeping at night

65. A nurse is observing a nursing assistant care for an older client who had a hip pinned following a fracture 4 days ago. To prevent client injury, the nurse intervenes in the care if the nursing assistant:

a) leave the side rails down
b) ensures that the nightlight is working
c) answers the nurse call signal promptly
d) places the nurse call signal within reach




Leadership NCLEX Questions
Answers and Rationale

 61) C
- The client is not allowed to eat or drink for usually 6 to 8 hours (or as specified by the physician) before the procedure. The client must sign an informed consent, because the procedure is invasive. If the client has any contact lenses, dentures, or other prostheses, they are removed before sedation is administered to the client.

62) B
- If the nurse believes a physician's order to be in error, the nurse must clarify the dosage with the client's physician or the physician's substitute before administering the medication. Checking with the pharmacist can assist the nurse in determining whether the dose ordered is incorrect, but the nurse or pharmacist cannot alter the dose without a revised prescription from a licensed health care provider with prescriptive authority. Withholding the medication until the following day is incorrect. Chemotherapy agents must be administered in the proper combinations or sequence in order to be effective. Rescheduling the client's chemotherapy is also incorrect. Chemotherapy must be administered on a specific schedule for maximum effect with minimum adverse effects. Additionally, only a prescriber can withhold or reschedule chemotherapy.

63) A
- Myasthenia gravis can affect the client's ability to swallow. The primary assessment is to determine the client's ability to swallow. Options B and C are not appropriate. In this situation, there is no reason for the client to lie down to swallow medication or to look up at the ceiling. Additionally, lying down could place the client at risk for aspiration. There is no specific reason for the client to void before taking medication.

64) C
- When a "why" question is made to the client, an explanation for feelings and behaviors is requested, and the client may not know the reason. Requesting an explanation is a nontherapeutic communication technique. In option A, the LPN is using the therapeutic communication technique of acknowledging the client's behavior. In option B, the LPN is encouraging identification of emotions or feelings. In option D, the LPN is using the therapeutic communication technique of exploring, which is asking the client to describe something in more detail or to discuss it more fully.

65) A
- Safe nursing actions intended to prevent injury to the client include keeping the side rails up, bed in low position, and providing a call bell that is within the client's reach. Responding promptly to the client's use of the call bell minimizes the chance that the client will try to get up alone, which could result in a fall. Nightlights are built into the lighting systems of most facilities, and these bulbs should be routinely checked to see that they are functional.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Leadership NCLEX Questions (1-5)


Or proceed to the next set of questions:

Leadership NCLEX Questions (66-70)

Read More

Leadership NCLEX Questions (56-60)

Welcome to Leadership NCLEX Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


56. A nurse receives a telephone calls from emergency department and is told that a client in leg traction will be admitted to the nursing unit. The nurse prepares for the arrival of the client and asks the nursing assistant to obtain which item that will be essential for helping the client move in bed while in leg traction?

a) a foot board
b) extra pillows
c) a bed trapeze
d) an electric bed

57. A registered nurse is observing a nursing student auscultate the breath sounds of a client. The registered nurse intervenes if the nursing student performs which incorrect action?

a) use the bell of the stethoscope
b) asks the client to sit straight up
c) places the stethoscope directly on the client's skin
d) has the client breathe slowly and deeply through the mouth

58. A nurse has oriented a new employee to basic procedures for continuous electrocardiogram (ECG) monitoring. The nurse would intervene of the new employee did which of the following while initiating cardiac monitoring on a client?

a)  clipped small areas of hair under the area planned for electrode placement
b) stated the need to change the electrodes and inspect the skin every 24 hours
c) stated the need to use hypoallergenic electrodes for clients who are sensitive
d) cleansed the skin with Betadine (povidone-iodine) before applying the electrodes

59. A client has an order for seizure precautions, and a nursing student develops a plan of care for the client. The registered nurse reviews the plan of care with the student and will instruct the student to remove which of hte following interventions?

a)  keep all the lights on in the room at night
b) assist the client to ambulate in the hallway
c) monitor the client closely while the client is showering
d) push the lock-out button on the electric bed to keep the bed in the lowest position

60. A client with active tuberculosis (TB) is to be admitted to a medical-surgical unit. When planning a bed assignment, the nurse:

 a) plans to transfer the client to the intensive care unit
b) places the client in a private, well-ventilated room
c) assigns the client to a double room because intravenous antibiotics will be administered
d) assigns the client to a double room and places a "strict handwashing" sign outside the door






Leadership NCLEX Questions
Answers and Rationale

56) C
- A trapeze is essential to allow the client to lift straight up while being moved so that the amount of pull exerted on the limb in traction is not altered. A foot board and extra pillows do not facilitate moving. Either an electric bed or a manual bed can be used for traction, but this does not specifically assist the client with moving in bed.

57) A
- The bell of the stethoscope is not used to auscultate breath sounds. The client ideally should sit up and breathe slowly and deeply through the mouth. The diaphragm of the stethoscope, which is warmed before use, is placed directly on the client's skin, not over a gown or clothing.

58) D
- The skin is cleansed with soap and water (not Betadine), denatured with alcohol, and allowed to air-dry before electrodes are applied. The other three options are correct.

59) A
- A quiet, restful environment is provided as part of seizure precautions. This includes undisturbed times for sleep, while using a nightlight for safety. The client should be accompanied during activities such as bathing and walking, so that assistance is readily available and injury is minimized if a seizure begins. The bed is maintained in low position for safety.

60) B
- According to category-specific (respiratory) isolation precautions, a client with TB requires a private room. The room needs to be well-ventilated and should have at least six exchanges of fresh air per hour and should be ventilated to the outside if possible. Therefore, option 2 is the only correct option.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Leadership NCLEX Questions (1-5)


Or proceed to the next set of questions:

Leadership NCLEX Questions (61-65)

Read More

Leadership NCLEX Questions (51-55)

Welcome to Leadership NCLEX Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


51. A cooling blanket is prescribed for a child with a fever. A nurse caring for the child has never used this type of equipment, and the charge nurse provides instructions and observes the nurse using the cooling blanket. The charge nurse intervenes if the nurse:

a) keeps the child uncovered to assist in reducing the fever
b) places the cooling blanket on the bed and covers the blanket with a sheet
c) keeps the child dry while on the cooling blanket to reduce the risk of frostbite
d) checks the skin condition of the child before, during, and after the use of the cooling blanket

52. A nursing instructor asks a nursing student to identify situations that indicate a secondary level of prevention in health care. Which situation, if identified by the student, would indicate the need for further study of the levels of prevention?

a)  teaching s stroke client how to use a walker
b) screening for hypertension in a community group
c) screening for hyperlipidemia in a community group
d) encouraging a woman who is more than 40 years old to obtain periodic mammograms

53. A charge nurse is supervising a new registered nurse (RN) who is providing care to a client with end-stage heart failure. The client is withdrawn and reluctant to talk, and she shows little interest in participating in hygienic care or activities. Which statement, if made by the new RN to the client, indicates that the new RN requires further teaching regarding the use of therapeutic communication techniques?

a) what are your feelings right now?
b) why don't you feel like getting up for your bath?
c) these dreams you mentioned, what are they like?
d) many clients with end-stage heart failure fear death

54. A nurse is observing a nursing assistant talking to a client who is hearing impaired. The nurse would intervene if which of the following is performed by the nursing assistant during communication with the client?

a)  the nursing assistant is speaking in a normal tone
b) the nursing assistant is speaking clearly to the client
c) the nursing assistant is facing the client when speaking
d) the nursing assistant is speaking directly into the impaired ear

55. A charge nurse reviews the plan of care formulated by a new nursing graduate for a child returning from the operating room after a tonsillectomy. The charge nurse assists the new nursing graduate with changing the plan if which incorrect intervention is documented?

a) suction whenever necessary
b) offer clear, cool liquids when awake
c) monitor for bleeding from the surgical site
d) eliminate milk or milk products from the diet






Leadership NCLEX Questions
Answers and Rationale

51) A
- While on a cooling blanket, the child should be covered lightly to maintain privacy and reduce shivering. Options B, C, and D are important interventions to prevent shivering, frostbite, and skin breakdown.

52) A
- Secondary prevention focuses on the early diagnosis and prompt treatment of disease. Tertiary prevention is represented by rehabilitation services. Options B, C, and D identify screening procedures. Option A identifies a rehabilitative service.

53) B
- When the nurse asks a "why" question of the client, the nurse is requesting an explanation for feelings and behaviors when the client may not know the reason. Requesting an explanation is a nontherapeutic communication technique. In option A, the nurse is encouraging the verbalization of emotions or feelings, which is a therapeutic communication technique. In option C, the nurse is using the therapeutic communication technique of exploring, which involves asking the client to describe something in more detail or to discuss it more fully. In option D, the nurse is using the therapeutic communication technique of giving information. Identifying the common fear of death among clients with end-stage heart failure may encourage the client to voice concerns.

54) D
- When communicating with a hearing-impaired client, the nurse should speak in a normal tone to the client and should not shout. The nurse should talk directly to the client while facing the client, and he or she should speak clearly. If the client does not seem to understand what is being said, the nurse should express the statement differently. Moving closer to the client and toward the better ear may facilitate communication, but the nurse needs to avoid talking directly into the impaired ear.

55) A
- After tonsillectomy, suction equipment should be available, but suctioning is not performed unless there is an airway obstruction. Clear, cool liquids are encouraged. Milk and milk products are avoided initially because they coat the throat; this causes the child to clear the throat, thereby increasing the risk of bleeding. Option C is an important intervention after any type of surgery.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Leadership NCLEX Questions (1-5)



Or proceed to the next set of questions:

Leadership NCLEX Questions (56-60)

Read More

Nursing Leadership Programs (46-50)

Welcome to Nursing Leadership Programs. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


46. A nurse is working in the emergency department of a small local hospital when a client with multiple gunshot wounds arrives by ambulance. Which of the following actions by the nurse is contraindicated in the handling legal evidence?

a) initiate a chain of custody log
b) give clothing and wallet to the family
c) cut clothing along seams, avoiding bullet holes
d) place personal belongings in a labeled, sealed paper bag

47. A registered nurse (RN) is orienting a nursing assistant to the clinical nursing unit. The RN would intervene if the nursing assistant did which of the following during a routine handwashing procedure?

a) kept hands lower than elbows
b) dried from forearm down to fingers
c) washed continuously for 10 to 15 seconds
d) used 3 to 5 ml of soap from the dispenser

48. A registered nurse (RN) on the night shift assists a staff member in completing an incident report for a client who was found sitting on the floor. Following completion of the report, the RN intervenes if the staff member prepares to:

a) notify the nursing supervisor
b) ask the secretary to telephone the physician
c) document in the nurse's notes that an incident report was filed
d) forward incident report to the Continuous Quality Improvement Department

49. A physician visiting a client on the nursing unit is paged and notified that the monthly physician's breakfast meeting is about to start. The physician states to the nurse : "I'm in a hurry. Can you write an order t decrease the atenolol (Tenormin) to 25mg daily?" Which of the following is the appropriate nursing action?

a) write the order
b) call the nursing supervisor to write the order
c) inform the client of the change of medication
d) ask the physician to return to the nursing unit to write the order

50. A registered nurse suspects that a colleague is substance impaired and notes signs of alcohol intoxication in the colleague. The Nurse Practice Act requires the registered nurse do which of the following?

a) talk with the colleague
b) call the impaired nurse organization
c) report the information to a nursing supervisor
d) ask the colleague to go to the nurse's lounge to sleep for a while






Nursing Leadership Programs
Answers and Rationale

46) D

- Basic rules for handling evidence include limiting the number of people with access to the evidence, initiating a chain of custody log to track handling and movement of evidence, and carefully removing of clothing to avoid destroying evidence. This usually includes cutting clothes along seams, while avoiding areas where there are obvious holes or tears. Potential evidence is never released to the family to take home.

47) B

- Proper handwashing procedure involves wetting the hands and wrists and keeping the hands lower than the forearms so that water flows toward the fingertips. The nurse uses 3 to 5 mL of soap and scrubs for 10 to 15 seconds, using rubbing and circular motions. The hands are rinsed and then dried, moving from the fingers to the forearms. The paper towel is then discarded, and a second one is used to turn off the faucet to avoid hand contamination.

48) C

- Nurses are advised not to document the filing of an incident report in the nurses' notes for legal reasons. Incident reports inform the facility's administration of the incident so that risk management personnel can consider changes that might prevent similar occurrences in the future. Incident reports also alert the facility's insurance company to a potential claim and the need for further investigation. Options A, B, and D are accurate interventions.

49) D

- Nurses are encouraged not to accept verbal orders from the physician because of the risks of error. The only exception to this may be in an emergency situation, and then the nurse must follow agency policy and procedure. Although the client will be informed of the change in the treatment plan, this is not the appropriate action at this time. The physician needs to write the new order. It is inappropriate to ask another individual other than the physician to write the order.

50) C

- Nurse Practice Acts require reporting the suspicion of impaired nurses. The Board of Nursing has jurisdiction over the practice of nursing and may develop plans for treatment and supervision. This suspicion needs to be reported to the nursing supervisor, who will then report to the Board of Nursing. Confronting the colleague may cause conflict. Asking the colleague to go to the nurses' lounge to sleep for awhile does not safeguard clients.




After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Leadership Programs (1-5)


Or proceed to the next set of questions:

Nursing Leadership Programs (51-55)

Read More

Nursing Leadership NCLEX Questions (41-45)

Welcome to Nursing Leadership NCLEX Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


41. When assessing the client with the vest restraint (security device) at the beginning of day shift, which observation by the charge nurse would indicate that the nurse who placed the vest restraint on the client failed to follow safety guidelines?

a) a hitch was used to secure the restraint
b) the call light was placed within reach of the client
c) the restraint was applied tightly across the client's chest
d) the client's record indicates that the restraint will be released every 2 hours

42. A male client who is admitted to the hospital for an unrelated medical problem is diagnosed with urethritis caused by chlamydial infection. The nursing assistant assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care. The nurse tells the nursing assistant that:

a) enteric precautions should be instituted for the client
b) gloves and mask should be used when the in client's room
c) contact isolation should be initiated, because the diseases is highly contagious
d) standard precautions are sufficient, because the disease is transmitted sexually

43. A nursing assistant is caring for an older male client with cystits who has an indwelling urinary catheter. The registered nurse provides directions regarding urinary catheter care and ensures that the nursing assistant:

a) loops the tubing under the client's leg
b) places the tubing below the client's knee
c) uses soap and water to cleanse the perineal area
d) keeps the drainage bag above the level of the bladder

44. A nurse is planning care for a client with acute glomerulonephritis. The nurse instructs the nursing assistant to do which of the following in the care of the client?

a) ambulate the client frequently
b) monitor the temperature every 2 hours
c) encourage a diet that is high in protein
d) remove the water pitcher from the bedside

45. A nurse watches a second nurse perform hemodialysis on a client. The second nurse is drinking coffee and eating doughnut next to the hemodialysis machine while talking with the client about the client's week. The first nurse should:

a) get a cup of coffee and join in on the conversation
b) determine whether or not the client would like a cup of coffee
c) admire the therapeutic relationship the second nurse has with the client
d) ask the second nurse to refrain from eating and drinking in the client area





Nursing Leadership NCLEX Questions:
Answers and Rationale

41) C

- A vest restraint should never be applied tightly because it could impair respirations. A hitch knot may be used on the client because it can easily be released in an emergency. The call light must always be within the client's reach in case the client needs assistance. The restraint needs to be released every 2 hours (or per agency policy) to provide movement.

42) D

- Chlamydia is a sexually transmitted disease. Caregivers cannot acquire the disease during administration of care, and standard precautions are the only measure that needs to be used.

43) C

- Proper care of an indwelling urinary catheter is especially important to prevent prolonged infection or reinfection in the client with cystitis. The perineal area is cleansed thoroughly using mild soap and water at least twice a day and following a bowel movement. The drainage bag is kept below the level of the bladder to prevent urine from being trapped in the bladder, and, for the same reason, the drainage tubing is not placed or looped under the client's leg. The tubing must drain freely at all times.

44) D

- A client with acute glomerulonephritis commonly experiences fluid volume excess and fatigue. Interventions include fluid restriction as well as monitoring weight and intake and output. The client may be placed on bed rest or at least encouraged to rest, because a direct correlation exists between proteinuria, hematuria, edema, and increased activity levels. The diet is high in calories but low in protein. It is unnecessary to monitor the temperature as frequently as every 2 hours.

45) D

- A potential complication of hemodialysis is the acquisition of dialysis-associated hepatitis B. This is a concern for clients (who may carry the virus), client families (at risk from contact with the client and with environmental surfaces), and staff (who may acquire the virus from contact with the client's blood). This risk is minimized by the use of standard precautions, appropriate handwashing and sterilization procedures, and the prohibition of eating, drinking, or other hand-to-mouth activity in the hemodialysis unit. The first nurse should ask the second nurse to stop eating and drinking in the client area.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Leadership NCLEX Questions (1-5)


Or proceed to the next set of questions:

Nursing Leadership NCLEX Questions (46-50)

Read More

Nursing Leadership NCLEX Questions (36-40)

Welcome to Nursing Leadership NCLEX Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


36. A registered nurse is a preceptor for a new nursing graduate an is describing critical paths and variance analysis to the new nursing graduate. The registered nurse instructs the new nursing graduate that a variance analysis is performed on all clients:

a) continuously
b) daily during hospitalization
c) every third day of hospitalization
d) every other day of hospitalization

37. When a nurse manager makes a decisions regarding the management of the nursing unit without input from the staff, the type of leadership style that the nurse manager is demonstrating is:

a) autocratic
b) situational
c) democratic
d) laissez-faire

38. A charge nurse knows that drug and alcohol use by nurses is a reason for the increasing numbers of disciplinary cares by the Board of Nursing. The charge nurse understands that when dealing with a nurse with such an illness, it is most important to assess the impaired nurse to determine:

a) the magnitude of drug diversion over time
b) if falsification of clients records occurred
c) the types of illegal activities related to the abuse
d) the physiological impact of the illness on practice

39. A nurse manager is planning to implement a change in the method of the documentation system for the nursing unit. Many problems have occurred as a result of the present documentation system, and the nurse manager determines that a change is required. The initial step in the process of change for the nurse manager is which of the following?

a) plan strategies to implement the change
b) set goals and priorities regarding the change process
c) identify the inefficiency that needs improvement or correction
d) identify potential solutions and strategies for the change process

40. A nurse receives a telephone call from the emergency department and is told that a child with a diagnosis of tonic-clonic seizures will be admitted to the pediatric unit. The nurse prepares for the admission of the child and instructs assistant to place which items at the bedside?

a) a tracheostomy set and oxygen
b) suction apparatus and an airway
c) an endotracheal tube and an airway
d) an emergency cart and laryngoscope








Nursing Leadership NCLEX Questions
Answers and Rationale

36) A

- Variance analysis occurs continually as the case manager and other caregivers monitor client outcomes against critical paths. The goal of critical paths is to anticipate and recognize negative variance early so that appropriate action can be taken. A negative variance occurs when untoward events preclude a timely discharge and the length of stay is longer than planned for a client on a specific critical path. Options B, C and D are incorrect.

37) A

- The autocratic style of leadership is task oriented and directive. The leader uses his or her power and position in an authoritarian manner to set and implement organizational goals. Decisions are made without input from the staff. Democratic styles best empower staff toward excellence because this style of leadership allows nurses to provide input regarding the decision-making process and an opportunity to grow professionally. The situational leadership style utilizes a style depending on the situation and events. The laissez-faire style allows staff to work without assistance, direction, or supervision.

38) D

- A nurse must be able to function at a level that does not affect the ability to provide safe, quality care. The highest priority is to determine how the illness affects the nurse's ability to practice. The other options will be addressed if an investigation is carried out.

39) C

- When beginning the change process, the nurse should identify and define the problem that needs improvement or correction. This important first step can prevent many future problems, because, if the problem is not correctly identified, a plan for change may be aimed at the wrong problem. This is followed by goal setting, prioritizing, and identifying potential solutions and strategies to implement the change.

40) B

- Tonic-clonic seizures cause tightening of all body muscles followed by tremors. Obstructed airway and increased oral secretions are the major complications during and following a seizure. Suction is helpful to prevent choking and cyanosis. Options A and C are incorrect because inserting an endotracheal tube or a tracheostomy is not done. It is not necessary to have an emergency cart (which contains a laryngoscope) at the bedside, but a cart should be available in the treatment room or on the nursing unit.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Leadership NCLEX Questions (1-5)


Or proceed to the next set of questions:

Nursing Leadership NCLEX Questions (41-45)

Read More

Nursing Leadership NCLEX Questions (31-35)

Welcome to Nursing Leadership NCLEX Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


31. Based upon a request made by the client's spouse and children, a physician asks a nurse to discontinue the feeding tube in a client who is in chronic debilitated and comatose state. The nurse understands the legal basis for carrying out the order and first checks the client's record for documentation of:

a) a court approval to discontinue the treatment
b) approval by the institutional Ethics Committee
c) a written order by the physician to remove the tube
d) authorization by the family to discontinue the treatment

32. A nurse plans to carry out a multidisciplinary research project on the effects of immobility on client's stress levels. Of the following statements, which principle is most important when planning this project?

a)  any client has the right to refuse to participate in research studies
b) collaboration with other disciplines is essential to the successful practice of nursing
c) the cooperation of the physicians on staff must be ensured in order for the project to succeed
d) the corporate nurse executive should be consulted, because the project will take nursing time

33. A nurse manager has identified a problem on the nursing unit and holds unit meetings for all shifts. The nurse manager presents an analysis of the problem and proposals for actions to team members and invites the team members to comment and provide input. Which style of leadership is the nurse manager specifically employing?

a)  situational
b) laissez-faire
c) participative
d) authoritarian

34. A charge nurse observes that a staff nurse is not able to meet client needs in a reasonable time frame, does not problem-solve situations, and does not prioritize nursing care. The charge nurse has the responsibility to:

a)  supervise the staff nurse more closely so that tasks are completed
b) ask other staff members to help the staff nurse get the work done
c) provide support and identify the underlying cause of the staff nurse's problem
d) report the staff nurse to the supervisor so that something is done to resolve the problem


35. A registered nurse is preceptor for a new nursing graduate and is observing the new nursing graduate organize the client assignment and daily tasks. The registered nurse intervenes if the new nursing graduate does which of the following?

a) provide time for unexpected tasks
b) lists the supplies needed for a task
c) prioritizes client needs and daily tasks
d) plans to document task completion at the end of the day





Nursing Leadership NCLEX Questions
Answers and Rationale

31) D

- The family or a legal guardian can make treatment decisions for the client who is unable to do so. Once the decision is made, the physician writes the order. Generally, the family makes decisions in collaboration with physicians, other health care workers, and other trusted advisors. Although a written order by the physician is necessary, the nurse first checks for documentation of the family's request. Unless special circumstances exist, a court order is not necessary. Although some health care agencies may require reviewing such requests via the Ethics Committee, this is not the nurse's first action.

32) A

- The proposed project is research and includes human subjects. Although options B, C, and D need to be considered, they are all secondary to the overriding principle of the legal and ethical practice of nursing that any client has the right to refuse to participate in research using human subjects.

33) C

- Participative leadership demonstrates an "in-between" style, neither authoritarian nor democratic style. In participative leadership, the manager presents an analysis of problems and proposals for actions to team members, inviting critique and comments. The participative leader then analyzes the comments and makes the final decision. A laissez-faire leader abdicates leadership and responsibilities, allowing staff to work without assistance, direction, or supervision. The autocratic style of leadership is task oriented and directive. The situational leadership style utilizes a style depending on the situation and events.

34) C

Option C empowers the charge nurse to assist the staff nurse while trying to identify and reduce the behaviors that make it difficult for the staff nurse to function. Options A, B, and D are punitive actions, shift the burden to other workers, and do not solve the problem.

35) D

- The nurse should document task completion continuously throughout the day. Options A, B, and C identify accurate components of time management.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Nursing Leadership NCLEX Questions (1-5)


Or proceed to the next set of questions:

Nursing Leadership NCLEX Questions (36-40)

Read More

Nursing Questions about Leadership and Management (26-30)

Welcome to Nursing Questions about Leadership and Management. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


26. A nurse notes that a postoperative client has not been obtaining relief from pain with the prescribed opioid analgesics when a particular licensed practical nurse (LPN) is assigned to the client. The appropriate action for the nurse to take is to:

a) reassign  the LPN to the care of clients not receiving opioids
b) notify the physician that the client needs an increase in opioid dosage
c) review the client's medication administration record immediately and discuss the observations with the nursing supervisor
d) confront the LPN with the information about the client having pain control problems and ask if the LPN is using the opioids personally

27. A medication nurse is supervising a newly hired licensed practical nurse (LPN) during the administration of oral pyridostigmine bromide (Mestinon) to a client with myasthenia gravis. Which observation by the medication nurse would indicate safe practice by the LPN?

a) asking the client to take sips of water
b) asking the client to lie down on his right side
c) asking the client to look up at the ceiling for  30 seconds
d) instructing the client to void before taking the medication

28. During orientation, a graduate nurse learns that the nursing model of practice implemented in the facility is a primary nursing approach. When the nurse attends report on the medical unit, the nurse will verify with the staff which of the following characteristics of primary nursing?

a)  critical paths are used when providing client care
b) the nurse manager assigns tasks to the staff members
c) a registered nurse (RN) leads nursing staff in providing care to a group of clients
d) a single RN is responsible for planning and providing individualized nursing care to clients

29. A clinical nurse manager conducts an inservice educational session for the staff nurses about case management. The clinical nurse manager determines that a review of the material needs to be done if a staff nurse stated that case management:

a)  manages client care by managing the client care environment
b) maximizes hospital revenues while providing for optimal client care
c) is designed to promote appropriate use of hospital personnel and material resources
d) represents a primary health prevention focus managed by a single case manager

30. A nurse manager is reviewing the critical paths of the clients on the nursing unit. The nurse manager collaborates with each nurse assigned to the clients and performs a variance analysis. Which of the following would indicate the need for further action and analysis?

a)  a client is performing his own colostomy care
b) purulent drainage is noted from a postoperative wound incision
c) a 1-day postoperative client has a temperature of 98.8F
d) a client newly diagnosed with diabetes mellitus is preparing his own insulin for injection





Nursing Questions about Leadership and Management
Answers and Rationale

26) C

- In this situation, the nurse has noted an unusual occurrence, but before deciding what action to take next, the nurse needs more data than just suspicion. This can be obtained by reviewing the client's record. State and federal labor and opioid regulations, as well as institutional policies and procedures, must be followed. It is therefore most appropriate that the nurse discuss the situation with the nursing supervisor before taking further action. The client does not need an increase in opioids. To reassign the LPN to clients not receiving opioids ignores the issue. A confrontation is not the most advisable action because it could result in an argumentative situation.

27) A

- Myasthenia gravis can affect the client's ability to swallow. The primary assessment is to determine the client's ability to handle oral medications or any oral substance. Options B and C are not appropriate. Option B could result in aspiration and option C has no useful purpose. There is no specific reason for the client to void before taking this medication.

28) D

- Primary nursing is concerned with keeping the nurse at the bedside actively involved in direct care while planning goal-directed, individualized client care. Option A identifies a component of case management. Option B identifies functional nursing. Option C identifies team nursing.

29) D

- Case management represents an interdisciplinary health care delivery system to promote appropriate use of hospital personnel and material resources to maximize hospital revenues while providing for optimal client care. It manages client care by managing the client care environment.

30) C 

- Variances are actual deviations or detours from the critical paths. Variances can be either positive or negative, or avoidable or unavoidable and can be caused by a variety of things. Positive variance occurs when the client achieves maximum benefit and is discharged earlier than anticipated. Negative variance occurs when untoward events prevent a timely discharge. Variance analysis occurs continually in order to anticipate and recognize negative variance early so that appropriate action can be taken. Option B is the only option that identifies the need for further action.




After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning: 

Nursing Questions about Leadership and Management (1-5)


Or proceed to the next set of questions:

Nursing Questions about Leadership and Management (31-35)

Read More

Nursing Questions about Leadership and Management (21-25)

Welcome to Nursing Questions about Leadership and Management. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


21. A nursing student prepares a postoperative plan of care for a client scheduled for hypophysectomy. The registered nurse reviews the plan and informs the nursing student that the plan needs to be corrected if which of the following was noted?

a) obtain daily weights
b) administer mouth care
c) monitor intake and output
d) encourage coughing and deep breathing

22. A nurse manager is reviewing with the nursing staff the purposes for applying  wrist and ankle restraints (security devices) to a client. The nurse manager determines that further review is necessary when a nursing staff member states that an indication for the use of a restraint is to:

a) limit movement of a limb
b) keep the client in bed at night
c) prevent the violent client from injuring self and others
d) prevent the client from pulling out intravenous lines and catheters

23. A hospitalized client with a diagnosis of anorexia nervosa and in a state of starvation is in two-bed hospital room. A newly admitted client will be assigned to this client's room. Which client would be inappropriate to assign to this two-bed room?

a)  a client with pneumonia
b) a client who can perform self-care
c) a client with a fractured leg that is casted
d) a client who is scheduled for a diagnostic test

24. A multidisciplinary health care team is planning care for a client with hyperparathyroidism. The nurse identifies which client outcome to the health care team?

a) describes how to take antacids
b) restricts fluids to 1000 ml per day
c) describes how to take antidiarrheal medications
d) walks down the hall for 15 minutes, three times a day

25. A clinic nurse wants to develop a diabetic teaching program. In order to meet the client's needs, the nurse must first:

a)  assess the client's functional abilities
b) ensure that insurance will pay for participation in the program
c) discuss the focus of the program with the multidisciplinary team
d) include everyone who comes into the clinic in the teaching sessions






Nursing Questions about Leadership and Management
Answers and Rationale

21) D

- Toothbrushing, sneezing, coughing, nose blowing, and bending are activities that should be avoided postoperatively in the client who underwent a hypophysectomy. These activities interfere with the healing of the incision and can disrupt the graft. Options A, B, and C are appropriate postoperative interventions.

22) B

- Wrist and ankle restraints are devices used to limit the client's movement in situations when it is necessary to immobilize a limb. They are applied to prevent the client from injuring self or others; from pulling out intravenous lines, catheters, or tubes; or from removing dressings. Restraints also may be used to keep children still and from injuring themselves during treatments and diagnostic procedures. Restraints are not applied to keep a client in bed at night and should never be used as a form of punishment.

23) A

- The client in a state of starvation has a compromised immune system. Having a roommate with pneumonia would place the client at risk for infection. Options B, C, and D are appropriate roommates.

24) D

- Mobility of the client with hyperparathyroidism should be encouraged as much as possible because of the calcium imbalance that occurs in this disorder and the predisposition to the formation of renal calculi. Fluids should not be restricted. Options A and C are not specifically associated with this disorder.

25) A

- Nurse-managed clinics focus on individualized disease prevention and health promotion and maintenance. Therefore the nurse must first assess the clients and their needs in order to effectively plan the program. Options B, C, and D do not address the clients' needs.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning: 

Nursing Questions about Leadership and Management (1-5)


Or proceed to the next set of questions:

Nursing Questions about Leadership and Management (26-30)

Read More

Nursing Questions about Leadership and Management (16-20)

Nursing Questions about Leadership and Management

16. A client who is mouth breathing is receiving oxygen by face mask. The nursing assistant asks the registered nurse (RN) why a water bottle is attached to the oxygen tubing near the wall oxygen outlet. The RN responds that the primary purpose of this feature is to:

a) prevent fluid loss from the lungs during mouth breathing
b) give the client added fluid via the respiratory rate
c) humidify the oxygen that is bypassing the client's nose
d) prevent the client from getting nosebleed

17. A nurse and a nursing assistant are assisting the respiratory therapist to position a client for postural drainage. The nursing assistant asks the nurse how the respiratory therapists selects the position used for the procedure. The nurse responds that a position is chosen that will use gravity to help drain secretions from which of the following areas?

a) trachea
b) main bronchi
c) lobes
d) alveoli

18. A registered nurse (RN) is observing a licensed practical nurse (LPN) caring for a deceased client whose eyes will be donated. The RN intervenes if the LPN performs which action?

a) elevates the head of the bed
b) closes the client's eyes
c) places wet saline gauze pads and ice pack on the eyes
d) closes the client's eyes and places a dry sterile dressing over the eyes

19. The nurse has recently been assigned to manage a pulmonary progressive unit at a large urban hospital. The nurse's leadership style is participative, with the belief that all staff members assist in decision making and the development of the unit's goals. The nurse is implementing which leadership style?

a) democratic
b) laissez faire
c) auticratic
d) situational

20. A physician has written an order for a vest restraint to be applied on a client from 10:00 pm to 7:00 am because the client becomes disoriented during the night and is at risk for falls. At 11:00 pm, the charge nurse makes rounds on all of the clients with the vest restraint, which observation by the charge nurse would indicate that the nurse who cared for this client performed an unsafe action in the use of the restraint?

a) a safety knot was used to secure the restraint
b) the client's record indicates that the restraint will be released every 2 hours
c) the restraint was applied tightly
d) the call light was placed within reach of the client





Nursing Questions about Leadership and Management:
Answers and Rationale

16) C

- The purpose of the water bottle is to humidify the oxygen that is bypassing the nose during mouth breathing. The humidified oxygen may help keep mucous membranes moist but will not substantially alter fluid balance (options A and B). A client who is breathing through the mouth is not at risk for nosebleeds.

17) C

- Postural drainage uses specific client positions that vary depending on the affected lobe(s). The positions usually involve having the head lower than the affected lung segment(s) to facilitate drainage of secretions. Postural drainage often is done in conjunction with chest percussion for maximum effectiveness. The other options are incorrect.

18) D
- When a corneal donor dies, the eyes are closed and gauze pads wet with saline are placed over them with a small ice pack. Within 2 to 4 hours, the eyes are enucleated. The cornea is usually transplanted with 24 to 48 hours. The head of the bed should also be elevated. Placing dry sterile dressings over the eyes serves no useful purpose.

19) A

- Democratic leadership is defined as participative with a focus on the belief that all members of the group have input into the decision making process. This leader acts as a resource person and facilitator. Laissez faire leaders assume a passive approach, with the decision making left to the group. Autocratic leadership dominates the group, with maintenance of strong control over the group. Situational leadership is based on the current events of the day.

20) C

- Restraints should never be applied tightly because that could impair circulation. The restraint should be applied securely (not tightly) to prevent the client from slipping through the restraint and endangering himself or herself. A safety knot should be used because it can easily be released in an emergency. Restraints, especially limb restraints, must be released every 2 hours (or per agency policy) to inspect the skin for abnormalities. The call light must always be within the client’s reach in case the client needs assistance.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning: 

Nursing Questions about Leadership and Management (1-5)


Or proceed to the next set of questions:

Nursing Questions about Leadership and Management (21-25)

Read More

NCLEX for RN - Leadership and Management (11-15)

11. A nursing student is developing a plan of care for a client with a chest tube that is attached to a Pleur-Evac drainage system. The nurse intervenes if the student writes which incorrect intervention in the plan?

a) position the client in semi-fowler's position
b) add water to the suction chamber as it evaporates
c) tape the connection sites between the chest tube and the drainage system
d) instruct the client to avoid coughing and deep breathing


12. A nurse is caring for a client who has just had a plaster leg cast applied. The nurse would plan to prevent the development of compartment syndrome is instructing the licensed practical nurse assigned to care for the client to:

a) elevate the limb and apply ice to the affected leg
b) elevate the limb and cover the limb with bath blankets
c) place the leg in a slightly dependent  position and apply ice to the affected leg
d) keep the leg horizontal and apply ice to the affected leg

13. A registered nurse (RN) is supervising a licensed practical nurse (LPN) administering an intramuscular (IM) injection of iron to an assigned client. The RN would intervene if the LPN is observed to perform which of the following?

a) changing the needle after drawing up the dose and before injection
b) preparing an air lock when drawing up the medication
c) using a Z-track method for injection
d) massaging the injection site after injection

14. A nursing student develops a plan of care for a client with paraplegia who has a risk for injury related to spasticity of the leg muscles. On reviewing the plan, the co-assigned nurse identifies which of the following as an incorrect intervention.

a) use of padded restraints to immobilize the limb
b) performing range of motion to the affected limbs
c) removing potentially harmful objects near the spastic limbs
d) use of prescribed muscle relaxants as needed

15. A registered nurse (RN) is observing a licensed practical nurse (LPN) preparing a client for treatment with a continuous passive motion (CPM) machine. Which observation by the RN would indicate that the LPN is performing an incorrect action?

a) places the client's knee in a slightly externally rotated position
b) keeps the client's knee at the hinged joint of the machine
c) assesses the client for pressure areas at the knee and the groin
d) checks the degree of extension and flexion and the speed of the CPM machine per the physician's orders




NCLEX for RN - Leadership and Management:
ANSWERS AND RATIONALE

11) D

- It is important to encourage the client to cough and deep breathe when a chest tube drainage system is in place. This will assist in facilitating appropriate lung re-expansion. Water is added to the suction chamber as it evaporates to maintain the full suction level prescribed. Connections between the chest tube and the drainage system are taped to prevent accidental disconnection. The client is positioned in semi-Fowler’s to facilitate ease in breathing.

12) A

- Compartment syndrome is prevented by controlling edema. This is achieved most optimally with the use of elevation and application of ice. Options B, C, and D are incorrect.

13) D

- The site should not be massaged after injection because massaging could cause staining of the skin. Proper technique for administering iron by the IM route includes changing the needle after drawing up the medication and before giving it. An air lock and Z-track technique both should be used. The medication should be given in the upper outer quadrant of the buttock, not in an exposed area such as the arms or thighs.

14) A

- Range-of-motion exercises are beneficial in stretching muscles, which may diminish spasticity. Removing potentially harmful objects is a good safety measure. Use of muscle relaxants also is indicated if the spasms cause discomfort to the client or pose a risk to the client’s safety. Use of limb restraints will not alleviate spasticity and could harm the client.

15) A

- In the use of a CPM machine, the leg should be kept in a neutral position and not rotated either internally or externally. The knee should be positioned at the hinge joint of the machine. The nurse should monitor for pressure areas at the knee and the groin and should follow the physician’s orders and institutional protocol regarding extension and flexion and speed of the CPM machine.



Go to the next page ---> NCLEX for RN - Leadership and Management (16-20)

Or go back to NCLEX for RN - Leadership and Management (1-5)


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

Read More

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

NCLEX for RN about Leadership and Management

6. A nursing instructor asks the nursing student to describe the definition of a critical path. Which of the following statements, if made by the student, indicates a need for further understanding regarding critical paths?

a) they are developed through the collaborative efforts of all members of the health care team
b) they provide an effective way of monitoring care and for reducing or controlling the length of hospital stay for the client
c) they are developed based on appropriate standards of care
d) they are nursing care plans and use the steps of the nursing process

7. A community health nurse is working with a disaster relief following a tornado. The nurse's goal for the community is to prevent as much injury and death as possible from the uncontrollable event. Finding safe housing for survivors, providing support to families, organizing counseling, and securing physical care when needed all examples of which type of prevention?

a) primary level of prevention
b) secondary level of prevention
c) tertiary level of prevention
d) aggregate care prevention

8. The nurse manager is planning to implement a change in the nursing unit from team nursing to primary nursing. The nurse anticipates that there will be resistance to the change during the change process. The primary technique that the nurse would use in implementing this change is which of the following?

a) introduce the change gradually
b) confront the individuals involved in the change process
c) use coercion to implement the change
d) manipulate the participants in the change process

9. A nurse manager is providing an educational session to nursing staff members about the phases of viral hepatitis. The nurse manager tells the staff that which clinical manifestation(s) are primarily characteristic of preicteric phase?

a) right upper quadrant pain
b) fatigue, anorexia and nausea
c) jaundice, dark-colored urine, and clay-colored stools
d) pruritus

10. A nurse is preparing a plan of care for a client who will be hospitalized for insertion of an internal cervical radiation implant. Which nursing intervention should the nurse implement in preparation for the arrival of the client?

a) prepare a private room at the end of the hallway
b) place a sign on the door that indicates that visitors are limited to 60-minute visits
c) assign one primary nurse to care for the client during the hospital stay
d) place a linen bag outside of the client's room for discarding linens after morning care





NCLEX for RN - Leadership and Management:
ANSWERS AND RATIONALE

6) D

- Use the process of elimination and knowledge regarding the definition and purpose of critical paths to direct you to option D. Note the strategic words in the question, a need for further understanding. These words indicate a negative event query and ask you to select an option that is incorrect.  If you had difficulty with this question, review critical paths.

7) C

- Tertiary prevention involves the reduction of the amount and degree of disability, injury, and damage following a crisis. Primary prevention means keeping the crisis from occurring, and secondary prevention focuses on reducing the intensity and duration of a crisis during the crisis itself. There is no known aggregate care prevention level.

8) A

- The primary technique that can used to handle resistance to change during the change process is to introduce the change gradually. Confrontation is an important strategy used to meet resistance when it occurs. Coercion is another strategy that can be used to decrease resistance to change but is not always a successful technique for managing resistance. Manipulation usually involves a covert action, such as leaving out pieces of vital information that the participants might receive negatively. It is not the best method of implementing a change.

9) B

- In the preicteric phase, the client has nonspecific complaints of fatigue, anorexia, nausea, cough, and joint pain. Options A, C, and D are clinical manifestations that occur in the icteric phase. In the posticteric phase, jaundice decreases, the color of urine and stool return to normal, and the client’s appetite improves.

10) A

- The client with an internal cervical radiation implant should be placed in a private room at the end of the hall because this location provides less of a chance of exposure of radiation to others. The client’s room should be marked with appropriate signs that indicate the presence of radiation. Visitors should be limited to 30-minute visits. Nurses assigned to this client should be rotated so that one nurse is not consistently caring for the client and exposing him or herself to excess amounts of radiation. All linens should be kept in the client’s room until the implant is removed in case the implant has dislodged and needs to be located.


Go to the next page ---> NCLEX for RN - Leadership and Management (11-15)

Or go back to NCLEX for RN - Leadership and Management (1-5)


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

Read More

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

If you want to master the art of taking NCLEX exam on Fundamentals of Nursing... Try our Fundamentals Test Bank... It is for FREE!!!
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.


After you reviewed your answers through its rationale, you can now proceed to the next set of questions: 

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

You can also check our main page for the different Compilation of NCLEX Practice Questions

Read More