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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Document preview page 1

2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 1

Document preview content for 2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions)

2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions)

Study smarter with 2023 NCLEX RN Medical Surgical Study Guide With Answers, a collection of carefully selected past exams.

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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 1 preview imageNCLEXRNQUESTIONS AND VERIFIED SOLUTIONS/ A+ GRADE 2023COMPLETE GUIDEWhileadministeringmedicationstoagroupofclientsonamedical-surgicalunit,aclientwho is postoperative from an accidental above-the-knee amputation indicates tothe nursethat he is ready to talk about his feelings. The nurse keeps her promise andreturns to talkwith the client as soon as she finishes administering medications. Whichof the followingethicalprinciples is thenursedemonstrating?VeracityJusticeNonmalecenceFidelityAnursehasassignedclientcareactivitiestoanassistivepersonnel(AP).Whichofthefollowingstatementsby theAPindicatesaneed forassistancewithtime management?"Iwillstartworkingwiththeclientinroom1,thenworkmywaytoroom10.""Iwillgivethisclienthismealtrayfirstbecauseheisgoingtophysicaltherapyearly.""Afterbreakfast,Iwillpackthebelongingsofclientswhowillbedischargedthismorning.""Iwillstartbyprovidingpartialbathsbeforebreakfast."A nurse is updating the plan of care for a client who has a new diagnosis of hypertension and aprescriptionforatenolol.Whichofthefollowingreferralsshouldthenurserequestfromtheproviderasthe priorityreferral?DietitianPhysicaltherapistPharmacistSocialworkerAnurseonapediatricunitisplanningcareforagroupofclients.Whichofthefollowingclientsshouldthe nurseplantoassess first?Aschool-agechildwhohasdiabetesmellitusandrequiresbloodglucosemonitoringAninfantwhohaspertussisandisreceivingoxygenvianasalcannulaAnadolescentwhois1daypostoperativefollowinganappendectomyAtoddlerwhoisscheduledforanuppergastrointestinalX-rayseries
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 2 preview image
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 3 preview imageAnurseiscaringforaclientwhohasterminallungcancer.Theclient'sproviderhasrecommendedhospiceservicesfortheclient.Whichofthefollowingstatementsbytheclientshouldindicatetothenursethattheclientunderstandshospice care?"Iwillhavetobeadmittedtoalong-termcarefacilityinordertoreceivehospicecare.""Ishouldexpectthehospiceteamtohelpmemanagemydifficultybreathing.""Hospicecareservicesareavailabletoanyonewhoisterminallyill,regardlessoflifeexpectancy.""MyoncologistwillcontinuetolookforacureformycancerwhileIamreceivinghospicecare."A nurse in a provider's office is reviewing the laboratory findings for a client who is receivingchemotherapy.Theclienthasaplateletcountof60,000/mm3.Whichofthefollowingactionsshouldthenursetakefirst?Providetheclientwithinformationaboutthetreatment.Discussthesefindingswiththeprovider.Asktheclienttoreturntotheclinicforfurtherlaboratorytests.Obtainareferraltoaspecializedprovider.Achargenurseisdelegatingtaskstonursingpersonnelonaten-beddementiacareunit.Whichofthefollowingassignmentsis anexampleofoverdelegation?Assigningtwoassistivepersonnel(AP)toambulateeachclientontheunitAssigninganewlylicensednursetoperformawet-to-drydressingchangeAssigningoneAPtofeedeachclientontheunitAssigninganexperiencedRNtoperformacentrallinedressingchangeAnurseonamedical-surgicalunitisdelegatingcareforagroupofclients.Whichofthefollowingspecimensshouldthenursedelegateanunlicensedassistivepersonnel(UAP)tocollect?WounddrainageforcultureUrinefromanindwellingcatheterBloodforanABGtestRandomstoolspecimenAnurseaccusesanewlylicensednurseofprovidinginadequatecareforaclientwhounderwenthiparthroplasty. Which of the following responses by the newly licensed nurse demonstratesassertiveness?"IfeelasthoughImetthestandardofcare.Wouldyoutellmemoreaboutyourconcerns?""Youshouldn'tmakeaccusations.Yournursingcaredoesn'talwayssetagoodexample."
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 4 preview image"Iamsorryyouaredispleased.Ialwaysdomybesttogivegoodcaretomyclients.""Yes,youmightberight.Ihaven'thadthebestrolemodelssinceIstartedthisposition.A nurse is caring for a client who is participating in a research study for an experimentalchemotherapymedication.Afterthreetreatments,theexperimentalmedicationisdiscontinueddueto evidence of rapidly advancing kidney failure. The nurse should recognize that discontinuingthismedicationdemonstrateswhichofthefollowingethical principles?JusticeAutonomyFidelityNonmalecenceAnurseonaqualityassuranceteamisreviewingunitincidentreportsthatwereledwithinthelastsixmonths.Whichofthefollowingincidentsmeetsthecriteriaforasentinelevent?Aclientwhowaspostoperativefromsurgeryreportedavaluablepieceofjewelrywasstolenfromhisroom.Aclientwhowasexperiencingacutealcoholwithdrawalhitsanurse,causingthenursetofalltothefloor and breaktheirwrist.Aclientwhowashavingananaphylacticreactionwasadministeredepinephrine0.75mgintramuscularly.Theclientexperiencedacardiaceventanddied.AnAPleftaclientonfallprecautionsunattendedintherestroom,wheretheclientfellandsustainedascrapetothe knee.Anursemanagerisreviewingtheadmissionhistoryoffouradultclients.Thenurseisrequiredtoreport whichofthefollowingsituations toanoutside agency?AnolderadultclientwhoisdependentoncaregiversandwasadmittedforthetreatmentofburnsonthebuttocksAyoungadultclientwhowasadmittedforasthmaandhastrackmarksthatmightindicateIVsubstanceuseAyoungadultclientwhowasadmittedforacuteglomerulonephritisfollowingaviralinfectionAnemancipatedminorwhohasacuteappendicitisandwantstoleavethefacilitywithouttreatmentAnurseisplanninganin-servicefornursingstaffaboutmanagingcareforclientswhodevelopdisequilibrium syndrome. Which of the following interventions should the nurseinclude in theteaching?Administeranopioidmedication.Monitorforthedevelopmentofchestpain.
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 5 preview imageAssesslevelofconsciousness.Startanintravenousinfusionofdextrose50%AnurseispreparingtodelegatetaskstoanLPNandanassistivepersonnel(AP).Whichofthefollowing tasks shouldthenurseassigntotheLPN?Transportingaclientwhoexperiencedastroke72hragototheradiologydepartmentProvidingabackrubtoaclientwhohasright-sidedparalysisRemovingandcleaningthecannulaofaclientwhohasastable,exisitingtracheostomyEmptyingthedrainagefromtheostomybagofaclientwhohasanewcolostomyAnurseisplanninganeducationprogramabouthearthealthforadultsinthecommunity.Whichofthefollowingprinciplesshouldthenurseusewhen planningtheprogram?Theprogramshouldbeteacher-directed.Thecontentoftheprogramshouldbeproblem-centered.Thegoalsoftheprogramshouldbesetbytheteacher.Theprogramshouldbeconductedinaformalatmosphere.Anurseisteachingaclientaboutchoosingahealthcaresurrogate.Whichofthefollowingstatementsby theclientindicatesanunderstanding oftheteaching?A."IcanchangewhoIdesignateasmyhealthcaresurrogateaslongasIhavemyprovider'sapproval."B."IfIbecomeincapacitated,end-of-lifechoiceswillbemadebymyhealthcaresurrogate."C."Ihavetochooseafamilymemberasmyhealthcaresurrogate."D."IcanverballyindicatetomynursewhoIwanttoassignasmyhealthcaresurrogate."Anursemanagerisplanningstrategiestoovercomeresistanceamongunitnursesforaproactivepolicychange.Whichofthefollowinginterventionsshouldthenurse include?Emphasizethatfuturerevisionstothepolicychangearenotanoption.Openlydiscussthereasonforthechange.Avoidredirectingtheresistanceofthenursingstaffuntiloppositionisresolved.EmphasizethereasonforthechangeratherthanthebenefitsofthechangeA nurse in a preoperative unit is caring for a client who is scheduled for surgery. The nurse is awitnessontheclient'sconsentform.Thenurseprovidesasignatureontheconsentformforwhichofthefollowingpurposes?EnsuringtheclientisofagetosigntheformConfirmingtheclientappearscompetenttoprovideconsent
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 6 preview imageAssertingthenursehasexplainedtherisksandbenefitsoftheprocedureRecordingthattheclient'spartneragreestheprocedureisnecessaryAnurseiscompletingamedicationreconciliationwithanewlylicensednurseonaclientadmittedtotheunitfromtheemergencydepartment.Whichofthefollowingstatementsbythenewlylicensednurseindicates anunderstandingofthe process?"TheAmericanHospitalAssociationrequiresaccreditedfacilitiestohaveprotocolsinplacerequiringmedicationreconciliation.""Thepurposeofmedicationreconciliationistocomparethemedicationsaclientistakingwithnewlyprescribedmedication.""WhenIperformmedicationreconciliation,Iamdemonstratingtheethicalprincipalofveracity.""Ishouldperformamedicationreconciliationonceeachshift."A client who has liver cancer informs the nurse that the provider has recommended that sheconsiderreceivingalivertransplant.Theclienttellsthenurseshedoesnotwanttopursuethisoptionbecause she "has already been through enough suffering." Which of the followingresponses shouldthenursemake?"Itisyourrighttomakedecisionsregardingyourcare.""Yourdoctormadethisrecommendationbecauseshefeelsyouareagoodcandidateforatransplant;perhapsyou should reconsider yourdecision.""Yourfamilyissupportive;maybeyoushouldallowthemtomakethedecision.""Livertransplantsareacommonprocedureatthishospital,soyoushouldn'thavetoworryabouthavingcomplications."Anurseispresentinganin-serviceaboutdelegationtoagroupofnewlylicensednurses.Whichofthefollowingstatementsbyanewlylicensednurseindicatesanunderstandingoftheteaching?"Delegationensurestheclientreceivesappropriateresources.""Delegationpermitsadesignatedindividualtomeetagoalonyourbehalf.""Delegationpromotesclientdischargeteachingbyunlicensedpersonnel.""Delegationshiftsaccountabilitytotheindividualperformingthetask."Anurseisprovidingdietaryteachingtoaclientwhohasdysphagiafollowingastroke.Whichofthefollowing instructionsshouldthenurseincludeintheteaching?"Restfor15minutespriortomeals.""Placefoodintheweakersideofyourmouthtochew.""Situpinachairfor20minutesaftereating."
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 7 preview image"Flexyourheadwithyourchintuckeddowntoassistwithswallowing."Anurseinanurgentcareclinicistriagingclients.Whichofthefollowingclientsshouldthenurseidentifyas thepriorityfor theprovidertoexamine?AnadolescentclientwhoisconfrontationalhasdecreasedreasoningandhasslurredspeechAtoddlerwhohasalacerationontheforeheadandisscreamingAmiddleadultclientwhoisdiaphoreticandreportsepigastricpainAyoungadultwhohasapainfulsunburnoverthefaceandarmsAnurseiscompletinganincidentreportforaclientwhohasfallen.Whichofthefollowingactionsshouldthe nursetake?Makeacopyoftheincidentreportfortheprovider.Submittheincidentreporttotheriskmanager.Placetheincidentreportintheclient'smedicalrecord.DocumentinthemedicalrecordthatanincidentreporthasbeenledAnurseiscaringforaclientwhohadastroke3daysagoandhasdevelopeddysphagia.Thenurseshould identify that a referral to which of the following members of the interdisciplinaryteam is thepriority?PharmacistOccupationaltherapistDietitianSpeechtherapistAchargenursehearsaprovideryellingatastaffnurseaboutthelackofsuppliesavailabletoperformaprocedure.Whichofthefollowingstatementsbythechargenurseisappropriate?"Youshouldthinkabouthowyoumakeothersfeelwhenyouloseyourtemper.""Iwillhelpyouwiththisprocedureinsteadofthestaffnurse.""Itmustbeveryfrustratingwhenyoudon'thavewhatyouneedtoperformtheprocedure.""Nooneknewyouwereplanningtoperformaprocedure.Wecannotbeblamedfornothavingthesuppliesneeded."Achargenurseassignsanobstetrical(OB)nursetooattotheacutemedical-surgical(AMS)unitdue to a staffing shortage. The nurse does not feel comfortable with the assignment. Whichof thefollowing actions shouldthe nursetake?RefusetheassignmentandremainontheOBunit.
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 8 preview imageAskthechargenursetoappointaresourcenurseontheAMSunit.Reportthechargenurseforunsafeclientcarepractices.FloattotheAMSunitandperformcertifiednursingassistant(CNA)duties.A nurse is preparing to administer a bisacodyl enema to a client who has constipation. Theclientstates,“Thedoctordidn'ttellmeIwassupposedtoreceiveanenema."Whichofthefollowingactionsshouldthe nursetakefirst?Checktheclient'smedicationadministrationrecordfortheprovider'sprescription.Explaintheproceduretotheclient.Assuretheclientthatenemasareoftenprescribedforconstipation.Assisttheclienttotheleftlateralposition.Anurseisprovidingteachingabouthometracheostomycaretothepartnerofaclientwhoistobedischarged.Whenconsideringcost-effectivecare,whichofthefollowinginstructionsshouldthenursegive tothepartner?Wearcleangloveswhensuctioningtheclient'stracheostomy.Rinseanddrysuctioncathetersandreuseforupto24hr.Emptyandrinsethesuctioncontainerinasinkevery24hr.Discardoralsuctiontubes(Yankauer)aftereachuse.Anurseiscaringforaclientwhohasaterminalillnessandisusingaventilator.Theclientisalertand oriented and tells the nurse he wants to discontinue the use of the ventilator. The nurseshouldidentify that continued treatment against the client's wishes is a violation of which of thefollowingethical principles?VeracityAutonomyUtilityJusticeAnurseonanoncologyunitaccidentlyadministereddoxorubicintothewrongclient,resultinginharmtotheclient.Thisactionisanexampleofwhichofthefollowingtorts?BatteryInvasionofprivacyMalpracticeAssault
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2023 NCLEX RN Medical Surgical Study Guide With Answers (131 Solved Questions) - Page 9 preview imageAnurseisprovidingchange-of-shiftreportaboutagroupofclientstotheoncomingnurse.Whichofthefollowinginformation shouldthenurseincludeinthereport?"Mr.Rodriguezinroom200needsanotherIVbagat0700.""Mrs.Smithinroom201hadavisitoryesterdayevening.""Mr.Jonesinroom202hadroutinevitalsobtainedthismorning.""Mrs.Hasslerinroom203isgrumpyafterwakingup."Anurseisplanningdischargeforaclientwhohascirrhosisandexperiencedascitesandesophagealvarices during hospitalization. The nurse should collaborate with which of the followingmembers oftheinterdisciplinaryteamtoperformspecializedcareforthisclientAphysicaltherapisttoteachtheclienthowtolivewithparalysisofthelowerextremitiesAdietitiantoteachaboutalow-sodiumdietAsocialworkertoattendtothespiritualneedsoftheclientApharmacisttoteachabouthomewarfarintherapyA charge nurse assigns a client's dressing change to a licensed practical nurse (LPN). Severalhourslater,theclientreportsthatthedressinghasnotbeenchanged.Whichofthefollowingactionsshouldthechargenursetake?Informtheclientthatthetaskhadbeendelegatedhoursago.Reassignthetasktoanothernurse.AsktheLPNtodiscusswhythedressingchangehasnotbeencompleted.Reporttheissuetotheunitmanager.A nurse is obtaining informed consent for treatment from a 16-year-old adolescent who hasasexuallytransmittedinfection.Thenurseshouldidentifythatwhichofthefollowingindividualscanprovideconsentfortheadolescent?ClientPhysicianClient'soldersiblingAvisiblyintoxicatedparentAstaffnurseasksanassistivepersonnel(AP)toambulateaclientandtheAPrefuses.Whichofthefollowing actions shouldthe nursetake?Ambulatetheclient.DismisstheAP.
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