Test Bank For Fundamental Nursing Care, 2nd Edition
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Exam Name___________________________________ MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) A graduate practical/vocational nurse has downloaded a copy of the NCLEX - PN® test plan from the National Council of State Boards of Nursing website. The nurse notes that information is included under a section entitled Integrated Processes. What is the most helpful understanding by the nurse of the relevance of these integrated processes into the licensing examination questions? 1) A) They are used as a guideline in every question that is included in the licensing examination. B) The include all of the steps in the nursing process. C) They are mainly important when the question is of a cultural nature. D) They test the licensure candidate's awareness of legal and ethical aspects of nursing. Answer: A Explanation: A) The Integrated Processes used in developing the current NCLEX - PN® test plan are those concepts identified as fundamental to the practice of practical/vocational nursing and are incorporated throughout the client needs categories and subcategories. These processes include the Clinical Problem - Solving Process (Nursing Process), Caring, Communication and Documentation, and Teaching and Learning. Including all of the steps of the nursing process addresses only one aspect of this. Legal and ethical aspects of nursing are tested in the client need category of Safe, Effective Care Environment. Cultural influence in nursing care is tested in the client need category of Psychosocial Integrity. Implementation Safe, Effective Care Environment - Coordinated Care Application B) The Integrated Processes used in developing the current NCLEX - PN® test plan are those concepts identified as fundamental to the practice of practical/vocational nursing and are incorporated throughout the client needs categories and subcategories. These processes include the Clinical Problem - Solving Process (Nursing Process), Caring, Communication and Documentation, and Teaching and Learning. Including all of the steps of the nursing process addresses only one aspect of this. Legal and ethical aspects of nursing are tested in the client need category of Safe, Effective Care Environment. Cultural influence in nursing care is tested in the client need category of Psychosocial Integrity. Implementation Safe, Effective Care Environment - Coordinated Care Application C) The Integrated Processes used in developing the current NCLEX - PN® test plan are those concepts identified as fundamental to the practice of practical/vocational nursing and are incorporated throughout the client needs categories and subcategories. These processes include the Clinical Problem - Solving Process (Nursing Process), Caring, Communication and Documentation, and Teaching and Learning. Including all of the steps of the nursing process addresses only one aspect of this. Legal and ethical aspects of nursing are tested in the client need category of Safe, Effective Care Environment. Cultural influence in nursing care is tested in the client need category of Psychosocial Integrity. Implementation Safe, Effective Care Environment - Coordinated Care Application 1
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D) The Integrated Processes used in developing the current NCLEX - PN® test plan are those concepts identified as fundamental to the practice of practical/vocational nursing and are incorporated throughout the client needs categories and subcategories. These processes include the Clinical Problem - Solving Process (Nursing Process), Caring, Communication and Documentation, and Teaching and Learning. Including all of the steps of the nursing process addresses only one aspect of this. Legal and ethical aspects of nursing are tested in the client need category of Safe, Effective Care Environment. Cultural influence in nursing care is tested in the client need category of Psychosocial Integrity. Implementation Safe, Effective Care Environment - Coordinated Care Application 2) A graduate nurse has been preparing for the NCLEX - PN® is and scheduled to take the examination in 3 weeks. As the licensure candidate reviews, she is aware of an increase in her self - confidence as well as in her accuracy in answering questions. She is beginning to think about rescheduling the examination for an earlier date if one is available. She decides to use the nursing process to help in reaching a decision. What is an appropriate initial action by this graduate nurse? 2) A) Keep the scheduled appointment time and continue to review as planned. B) Ask several nursing instructors what they would recommend. C) Answer a set of 205 questions within a 5 - hour time period with 90 percent accuracy. D) Call the testing center to see if an earlier appointment time is available. Answer: D Explanation: A) If an earlier appointment time is not available, then the reviewer does not need to keep thinking about it and can proceed to decide what and how she will continue to review. Another call can always be made to the testing site to see if the situation has changed. A test date can be changed once (earlier or later). Additional changes will incur a charge. Plan to gather objective information initially, then evaluate ongoing feelings about taking the exam earlier. Keeping the scheduled appointment time and continuing to review as planned is a do - nothing choice. Asking several nursing instructors what they would recommend seeks evaluation from people other than the test - taker herself. Answering 205 questions in 5 hours with 90 percent accuracy may be something the test - taker decides to do as part of gathering information about readiness to test. Planning Safe, Effective Care Environment - Coordinated Care Application B) If an earlier appointment time is not available, then the reviewer does not need to keep thinking about it and can proceed to decide what and how she will continue to review. Another call can always be made to the testing site to see if the situation has changed. A test date can be changed once (earlier or later). Additional changes will incur a charge. Plan to gather objective information initially, then evaluate ongoing feelings about taking the exam earlier. Keeping the scheduled appointment time and continuing to review as planned is a do - nothing choice. Asking several nursing instructors what they would recommend seeks evaluation from people other than the test - taker herself. Answering 205 questions in 5 hours with 90 percent accuracy may be something the test - taker decides to do as part of gathering information about readiness to test. Planning Safe, Effective Care Environment - Coordinated Care Application 2
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C) If an earlier appointment time is not available, then the reviewer does not need to keep thinking about it and can proceed to decide what and how she will continue to review. Another call can always be made to the testing site to see if the situation has changed. A test date can be changed once (earlier or later). Additional changes will incur a charge. Plan to gather objective information initially, then evaluate ongoing feelings about taking the exam earlier. Keeping the scheduled appointment time and continuing to review as planned is a do - nothing choice. Asking several nursing instructors what they would recommend seeks evaluation from people other than the test - taker herself. Answering 205 questions in 5 hours with 90 percent accuracy may be something the test - taker decides to do as part of gathering information about readiness to test. Planning Safe, Effective Care Environment - Coordinated Care Application D) If an earlier appointment time is not available, then the reviewer does not need to keep thinking about it and can proceed to decide what and how she will continue to review. Another call can always be made to the testing site to see if the situation has changed. A test date can be changed once (earlier or later). Additional changes will incur a charge. Plan to gather objective information initially, then evaluate ongoing feelings about taking the exam earlier. Keeping the scheduled appointment time and continuing to review as planned is a do - nothing choice. Asking several nursing instructors what they would recommend seeks evaluation from people other than the test - taker herself. Answering 205 questions in 5 hours with 90 percent accuracy may be something the test - taker decides to do as part of gathering information about readiness to test. Planning Safe, Effective Care Environment - Coordinated Care Application 3) A student nurse who is doing a clinical practicum on a nursing unit approaches a staff licensed practical/vocational nurse and asks the nurse to read the PPD that the student received yesterday. What is the most appropriate response by the staff nurse at this time? 3) A) "The earliest the test can be read is after 48 hours." B) "What observations have you made about the results?" C) "Okay. Let me finish what I'm doing and I will meet you at the nurse's station." D) "It's not within my scope of practice to read PPD tests. A registered nurse has to do that." Answer: A Explanation: A) A tuberculin test is most correctly read between 48 and 72 hours after administration, by measuring the degree of induration (not redness). Saying that nurse will finish what she is doing and then meet the LPN at the nurse's station is not within the correct time limits. Although asking the LPN/LVN what observations have been made about the results may be interesting information to obtain, it is not the most appropriate response. LPN/LVNs can read tuberculin tests. Assessment Health Promotion and Maintenance Application 3
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B) A tuberculin test is most correctly read between 48 and 72 hours after administration, by measuring the degree of induration (not redness). Saying that nurse will finish what she is doing and then meet the LPN at the nurse's station is not within the correct time limits. Although asking the LPN/LVN what observations have been made about the results may be interesting information to obtain, it is not the most appropriate response. LPN/LVNs can read tuberculin tests. Assessment Health Promotion and Maintenance Application C) A tuberculin test is most correctly read between 48 and 72 hours after administration, by measuring the degree of induration (not redness). Saying that nurse will finish what she is doing and then meet the LPN at the nurse's station is not within the correct time limits. Although asking the LPN/LVN what observations have been made about the results may be interesting information to obtain, it is not the most appropriate response. LPN/LVNs can read tuberculin tests. Assessment Health Promotion and Maintenance Application D) A tuberculin test is most correctly read between 48 and 72 hours after administration, by measuring the degree of induration (not redness). Saying that nurse will finish what she is doing and then meet the LPN at the nurse's station is not within the correct time limits. Although asking the LPN/LVN what observations have been made about the results may be interesting information to obtain, it is not the most appropriate response. LPN/LVNs can read tuberculin tests. Assessment Health Promotion and Maintenance Application 4) Several graduate practical/vocational nurses are preparing for the licensing examination, which they plan to take in approximately 6 weeks. Each graduate shares one of his or her plans for reviewing. Which plan is the most realistic in relation to the task and time? 4) A) "I plan to answer sets of 85 questions, correct, and review the rationales at least three times a week. I will spend 2 hours doing this." B) "I'm starting at the beginning of the review book I bought and I'll go through it all and answer the questions. When I finish, I'll do the comprehensive examinations in the book." C) "I'm going to start with mental health because that's my weakest area. I plan to review some content and answer NCLEX - PN® style questions for at least 1 hour every day. It will take me about 2 weeks to review mental health." D) "The only time I have available is on the weekends, so I will review for at least 8 hours every weekend day. I'm starting with pharmacology." Answer: C 4
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Explanation: A) It is imperative to plan appropriate and realistic task and timeframes for reviewing for the NCLEX - PN®. Based on the comments, the graduate who is going to start with mental health has identified a weaker area and decided to begin with it, and has a plan to incorporate theory review and assessment (questions). Given the topic of mental health nursing and the potential of a minimum of 14 hours on the topic, the goal has a high possibility to be attained. Two hours (120 minutes) is not sufficient time to answer and correct and review rationales of 85 questions with any degree of thoroughness or effectiveness. Two hours is a reasonable time to answer the questions themselves, with no additional action. Planning to spend 8 hours a day focusing on NCLEX - PN® review is a goal that is difficult for many people to attain. Retaining information over this length of time is often decreased. Starting at the beginning of the review book and working through the entire book can potentially be an effective plan, once timeframes are attached to the activities. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis B) It is imperative to plan appropriate and realistic task and timeframes for reviewing for the NCLEX - PN®. Based on the comments, the graduate who is going to start with mental health has identified a weaker area and decided to begin with it, and has a plan to incorporate theory review and assessment (questions). Given the topic of mental health nursing and the potential of a minimum of 14 hours on the topic, the goal has a high possibility to be attained. Two hours (120 minutes) is not sufficient time to answer and correct and review rationales of 85 questions with any degree of thoroughness or effectiveness. Two hours is a reasonable time to answer the questions themselves, with no additional action. Planning to spend 8 hours a day focusing on NCLEX - PN® review is a goal that is difficult for many people to attain. Retaining information over this length of time is often decreased. Starting at the beginning of the review book and working through the entire book can potentially be an effective plan, once timeframes are attached to the activities. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis C) It is imperative to plan appropriate and realistic task and timeframes for reviewing for the NCLEX - PN®. Based on the comments, the graduate who is going to start with mental health has identified a weaker area and decided to begin with it, and has a plan to incorporate theory review and assessment (questions). Given the topic of mental health nursing and the potential of a minimum of 14 hours on the topic, the goal has a high possibility to be attained. Two hours (120 minutes) is not sufficient time to answer and correct and review rationales of 85 questions with any degree of thoroughness or effectiveness. Two hours is a reasonable time to answer the questions themselves, with no additional action. Planning to spend 8 hours a day focusing on NCLEX - PN® review is a goal that is difficult for many people to attain. Retaining information over this length of time is often decreased. Starting at the beginning of the review book and working through the entire book can potentially be an effective plan, once timeframes are attached to the activities. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 5
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D) It is imperative to plan appropriate and realistic task and timeframes for reviewing for the NCLEX - PN®. Based on the comments, the graduate who is going to start with mental health has identified a weaker area and decided to begin with it, and has a plan to incorporate theory review and assessment (questions). Given the topic of mental health nursing and the potential of a minimum of 14 hours on the topic, the goal has a high possibility to be attained. Two hours (120 minutes) is not sufficient time to answer and correct and review rationales of 85 questions with any degree of thoroughness or effectiveness. Two hours is a reasonable time to answer the questions themselves, with no additional action. Planning to spend 8 hours a day focusing on NCLEX - PN® review is a goal that is difficult for many people to attain. Retaining information over this length of time is often decreased. Starting at the beginning of the review book and working through the entire book can potentially be an effective plan, once timeframes are attached to the activities. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 5) Several nursing students are discussing what they have heard about the NCLEX - PN® examination from graduates of their nursing program and nurses who work in the facilities where they have been doing clinical practice. They are concerned because they have heard that the licensing examination does not test what really happens in hospitals and what nurses really do. They have also heard that the questions on the test are nothing like the ones in review books. What information will be of most value for the student nurses in preparing for the licensing examination? (Select all that apply.) 5) A) "A lot of the questions are about setting priorities. And you can't just use the ABCDs." B) "The questions are about what LPN/LVNs do in the first 3 years they work after graduating from a nursing school." C) "Some people had ten drug questions and some didn't have any." D) "Two people said their whole exam was about maternity and they didn't have any med - surg at all." E) "Twenty - five of the questions don't count, so you will really only answer 60 questions." F) "They have other kinds of questions on the exam besides multiple choice. For some of them you have to fill in things like IV drip rates." Answer: A, C, F Explanation: A) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 6
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B) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis C) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis D) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 7
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E) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis F) The NCLEX - PN® was developed and is updated every 3 years by the National Council of State Boards of Nursing (NCSBN), when a vocational nursing job analysis study is done. The exam tests the skills and knowledge required for entry - level practice in practical/vocational nursing. The NCLEX - PN® tests knowledge of client needs and the use of the nursing process in all areas in which the LPN/LVN is employed. To be successful on the examination, the test - taker must be able to think critically, set priorities, determine initial actions, and identify appropriate and inappropriate responses to a question. Some test - takers may have what appears to be more or less focus on one area of practice in their questions; the questions, regardless of area of practice, are all examples of one area of client need and one step in the nursing process. The test contains alternate - format questions, including more than one correct response (multiple - multiple response), fill - in - the - blank, identifying an area on a picture or graph, and sequence ordering of actions. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 8
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6) An assigned client of a nurse experiences a cardiopulmonary arrest, is resuscitated, and transferred to the intensive care unit. The client's room needs to be cleared of the equipment that was used during the code blue, and the client's belongings need to be gathered and sent to the intensive care unit. It is essential that this nurse first: 6) A) Dispose of all used syringes, needles, and medication vials used during the code blue in a sharps container. B) Call for a new emergency cart to be delivered to the unit. C) Itemize, document, and transfer the client's belongings. D) Wash his or her hands. Answer: B Explanation: A) Before doing anything with the room or the client's belongings, it is essential that the nurse arrange for a replacement of the emergency cart. A nursing unit should never be without a fully stocked cart. All of the other choices will be done at various times during the process. They should not be the nurse's initial action. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis B) Before doing anything with the room or the client's belongings, it is essential that the nurse arrange for a replacement of the emergency cart. A nursing unit should never be without a fully stocked cart. All of the other choices will be done at various times during the process. They should not be the nurse's initial action. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis C) Before doing anything with the room or the client's belongings, it is essential that the nurse arrange for a replacement of the emergency cart. A nursing unit should never be without a fully stocked cart. All of the other choices will be done at various times during the process. They should not be the nurse's initial action. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis D) Before doing anything with the room or the client's belongings, it is essential that the nurse arrange for a replacement of the emergency cart. A nursing unit should never be without a fully stocked cart. All of the other choices will be done at various times during the process. They should not be the nurse's initial action. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis 7) A candidate for licensure in practical/vocational nursing will take the NCLEX - PN® tomorrow. In the 24 hours before arriving at the testing site, it is essential that the test - taker: 7) A) Have a bottle of water and a nutritious snack to take along to the test. B) Select one review book to take along for last - minute checking should something come to mind. C) On the day of the test, plan time to have a leisurely breakfast or lunch, depending upon the scheduled testing time. D) Make sure that the name and address on the test - taker's identification matches the information provided to the board and testing site. Answer: D 9
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Explanation: A) If there is a discrepancy in the name, address, or any other form of identification (photo, fingerprints), the candidate will not be allowed to sit for the examination, regardless of having a scheduled appointment. Taking a bottle of water and a nutritious snack is a good idea, but it is not essential to taking the test. Having a leisurely breakfast or lunch may be a good idea, but it is not essential. Eating moderately, limiting sugar, increasing protein food sources, and relaxing during a meal at least 1 to 2 hours before the test will help to stabilize the blood sugar and provide energy for thinking and doing. Plan to leave all review books at home. Attempting to "look up" everything one might think of during this time will likely increase anxiety. Assessment Safe, Effective Care Environment - Coordinated Care Application B) If there is a discrepancy in the name, address, or any other form of identification (photo, fingerprints), the candidate will not be allowed to sit for the examination, regardless of having a scheduled appointment. Taking a bottle of water and a nutritious snack is a good idea, but it is not essential to taking the test. Having a leisurely breakfast or lunch may be a good idea, but it is not essential. Eating moderately, limiting sugar, increasing protein food sources, and relaxing during a meal at least 1 to 2 hours before the test will help to stabilize the blood sugar and provide energy for thinking and doing. Plan to leave all review books at home. Attempting to "look up" everything one might think of during this time will likely increase anxiety. Assessment Safe, Effective Care Environment - Coordinated Care Application C) If there is a discrepancy in the name, address, or any other form of identification (photo, fingerprints), the candidate will not be allowed to sit for the examination, regardless of having a scheduled appointment. Taking a bottle of water and a nutritious snack is a good idea, but it is not essential to taking the test. Having a leisurely breakfast or lunch may be a good idea, but it is not essential. Eating moderately, limiting sugar, increasing protein food sources, and relaxing during a meal at least 1 to 2 hours before the test will help to stabilize the blood sugar and provide energy for thinking and doing. Plan to leave all review books at home. Attempting to "look up" everything one might think of during this time will likely increase anxiety. Assessment Safe, Effective Care Environment - Coordinated Care Application D) If there is a discrepancy in the name, address, or any other form of identification (photo, fingerprints), the candidate will not be allowed to sit for the examination, regardless of having a scheduled appointment. Taking a bottle of water and a nutritious snack is a good idea, but it is not essential to taking the test. Having a leisurely breakfast or lunch may be a good idea, but it is not essential. Eating moderately, limiting sugar, increasing protein food sources, and relaxing during a meal at least 1 to 2 hours before the test will help to stabilize the blood sugar and provide energy for thinking and doing. Plan to leave all review books at home. Attempting to "look up" everything one might think of during this time will likely increase anxiety. Assessment Safe, Effective Care Environment - Coordinated Care Application 10
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8) A client's religious preference on the admission form is indicated as Orthodox Jewish. The nurse is delivering a full liquid meal tray to this client. The client is receiving chemotherapy for cancer and is being encouraged to have a high caloric intake. Before giving the meal tray to the client, the nurse should recognize that which of the items may need to be removed from the tray? (Select all that apply.) 8) A) Tea and sugar B) Ensure C) Cream of chicken soup D) Fruit smoothie E) Plain vanilla custard pudding F) 2 percent milk Answer: C, E, F Explanation: A) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis B) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis C) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis D) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis 11
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E) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis F) The dietary laws and practices for the Orthodox Jewish person include the separation of milk and meat at a meal. If this cannot be avoided, the milk products are consumed before the meat products. Cream of chicken soup, 2 percent milk, and vanilla custard pudding are all milk - based products. In addition, cream of chicken soup contains a meat base or flavoring. All of the food items are allowed on a full liquid diet. Assessment Psychosocial Integrity Analysis 9) A 17 - year - old client has returned to the hospital for reparative intestinal and orthopedic surgery for multiple gunshot wounds that were received 1 month previously. The client has an ileostomy that he has been caring for. The client also has a methicillin - resistant staphylococcus aureus infection in a nonhealed incision where hip surgery was done. All of the following medication orders have been written for the client. Which of the following orders will the nurse not need to communicate with the physician about? 9) A) Bisacodyl (Dulcolax) suppository 10 mg PR prn. Hold for loose stools. B) Loperamide (Imodium) 5 ml PO after each loose stool. Do not exceed three doses in 24 hours. C) Simethicone (Mylanta) 40 mg Chewable tablet after meals prn for excess flatus D) Ducosate sodium (Colace) 100 mg PO every day prn. Hold for loose stools. Answer: C Explanation: A) The client has an ileostomy and will always have loose stools, which makes ducosate sodium, bisacodyl suppository, and loperamide inappropriate for this client. Simethicone (Mylanta) is used as an antiflatulent to relieve gas accumulation in the gastrointestinal system. Clients with ileostomies often have increased flatulence, which can be controlled by antiflatulent medications and avoiding gas - forming foods. Assessment Physiological Integrity - Pharmacological Therapies Analysis B) The client has an ileostomy and will always have loose stools, which makes ducosate sodium, bisacodyl suppository, and loperamide inappropriate for this client. Simethicone (Mylanta) is used as an antiflatulent to relieve gas accumulation in the gastrointestinal system. Clients with ileostomies often have increased flatulence, which can be controlled by antiflatulent medications and avoiding gas - forming foods. Assessment Physiological Integrity - Pharmacological Therapies Analysis 12
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C) The client has an ileostomy and will always have loose stools, which makes ducosate sodium, bisacodyl suppository, and loperamide inappropriate for this client. Simethicone (Mylanta) is used as an antiflatulent to relieve gas accumulation in the gastrointestinal system. Clients with ileostomies often have increased flatulence, which can be controlled by antiflatulent medications and avoiding gas - forming foods. Assessment Physiological Integrity - Pharmacological Therapies Analysis D) The client has an ileostomy and will always have loose stools, which makes ducosate sodium, bisacodyl suppository, and loperamide inappropriate for this client. Simethicone (Mylanta) is used as an antiflatulent to relieve gas accumulation in the gastrointestinal system. Clients with ileostomies often have increased flatulence, which can be controlled by antiflatulent medications and avoiding gas - forming foods. Assessment Physiological Integrity - Pharmacological Therapies Analysis 10) A graduate practical/vocational nurse is preparing to take the licensing examination and decides to write to the National Council of State Boards of Nursing to obtain information about the NCLEX - PN® test plan. The graduate nurse will most correctly expect that this information will include: 10) A) Suggestions for review books that have been helpful for test preparation. B) The percentage of accuracy required to pass the examination. C) The distribution of content in the four categories of client needs. D) Who to contact to schedule a time and place to take the licensing examination. Answer: C Explanation: A) The National Council of State Boards of Nursing provides information about the NCLEX - PN® exam that includes the percentages given to content in each of the four categories of client needs. Individual state boards of practical/vocational nursing will notify the testing service of the candidate's eligibility to test. The testing service will then provide testing site information as well as an authorization to test (ATT). The NCSBN does not publish a passing score or percentage. An abbreviated version of the test plan, along with practice questions, can be found in the preface or first chapter of many NCLEX - PN® review books and is beneficial to read. The information from the NCSBN does not provide suggestions for review books. Planning Safe, Effective Care Environment - Coordinated Care Analysis 13
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B) The National Council of State Boards of Nursing provides information about the NCLEX - PN® exam that includes the percentages given to content in each of the four categories of client needs. Individual state boards of practical/vocational nursing will notify the testing service of the candidate's eligibility to test. The testing service will then provide testing site information as well as an authorization to test (ATT). The NCSBN does not publish a passing score or percentage. An abbreviated version of the test plan, along with practice questions, can be found in the preface or first chapter of many NCLEX - PN® review books and is beneficial to read. The information from the NCSBN does not provide suggestions for review books. Planning Safe, Effective Care Environment - Coordinated Care Analysis C) The National Council of State Boards of Nursing provides information about the NCLEX - PN® exam that includes the percentages given to content in each of the four categories of client needs. Individual state boards of practical/vocational nursing will notify the testing service of the candidate's eligibility to test. The testing service will then provide testing site information as well as an authorization to test (ATT). The NCSBN does not publish a passing score or percentage. An abbreviated version of the test plan, along with practice questions, can be found in the preface or first chapter of many NCLEX - PN® review books and is beneficial to read. The information from the NCSBN does not provide suggestions for review books. Planning Safe, Effective Care Environment - Coordinated Care Analysis D) The National Council of State Boards of Nursing provides information about the NCLEX - PN® exam that includes the percentages given to content in each of the four categories of client needs. Individual state boards of practical/vocational nursing will notify the testing service of the candidate's eligibility to test. The testing service will then provide testing site information as well as an authorization to test (ATT). The NCSBN does not publish a passing score or percentage. An abbreviated version of the test plan, along with practice questions, can be found in the preface or first chapter of many NCLEX - PN® review books and is beneficial to read. The information from the NCSBN does not provide suggestions for review books. Planning Safe, Effective Care Environment - Coordinated Care Analysis 11) A licensed practical/vocational nurse is deciding whether to apply for a nursing position in a state that adjoins the one in which she is licensed. The job advertisement indicates that the state has a nurse licensure compact with the state in which the LPN/LVN is licensed. Should the nurse be employed in the second state, her primary legal responsibility is to: 11) A) Be certified for basic life support as a healthcare provider CPR (cardiopulmonary resuscitation) with AED (automatic external defibrillator) for infants, children, and adults, in the state of employment. B) Notify the board of nursing in the compact state of her intent to practice there. C) Understand the meaning of nurse licensure compact. D) Read the nurse practice act of the compact state. Answer: B 14
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Explanation: A) The nurse licensure compact (a multistate compact) is an agreement between and among states that licensed nurses may practice in those states without having a license in that state. The agreement (or compact) is based on similarities in the nurse practice act of the collaborating states. Legally, the nurse must notify the board of nursing of that state, be free of any disciplinary action against him or her, and will be subject to the laws of the employing state. Reading the relevant nurse practice act and understanding the meaning are not legal requirements, they are both actions the professional nurse will use to increase knowledge. Basic life support certification does not limit practice to one state or area. Evaluation Safe, Effective Care Environment - Coordinated Care Application B) The nurse licensure compact (a multistate compact) is an agreement between and among states that licensed nurses may practice in those states without having a license in that state. The agreement (or compact) is based on similarities in the nurse practice act of the collaborating states. Legally, the nurse must notify the board of nursing of that state, be free of any disciplinary action against him or her, and will be subject to the laws of the employing state. Reading the relevant nurse practice act and understanding the meaning are not legal requirements, they are both actions the professional nurse will use to increase knowledge. Basic life support certification does not limit practice to one state or area. Evaluation Safe, Effective Care Environment - Coordinated Care Application C) The nurse licensure compact (a multistate compact) is an agreement between and among states that licensed nurses may practice in those states without having a license in that state. The agreement (or compact) is based on similarities in the nurse practice act of the collaborating states. Legally, the nurse must notify the board of nursing of that state, be free of any disciplinary action against him or her, and will be subject to the laws of the employing state. Reading the relevant nurse practice act and understanding the meaning are not legal requirements, they are both actions the professional nurse will use to increase knowledge. Basic life support certification does not limit practice to one state or area. Evaluation Safe, Effective Care Environment - Coordinated Care Application D) The nurse licensure compact (a multistate compact) is an agreement between and among states that licensed nurses may practice in those states without having a license in that state. The agreement (or compact) is based on similarities in the nurse practice act of the collaborating states. Legally, the nurse must notify the board of nursing of that state, be free of any disciplinary action against him or her, and will be subject to the laws of the employing state. Reading the relevant nurse practice act and understanding the meaning are not legal requirements, they are both actions the professional nurse will use to increase knowledge. Basic life support certification does not limit practice to one state or area. Evaluation Safe, Effective Care Environment - Coordinated Care Application 15
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12) An applicant for practical/vocational nursing licensure has been determined to be eligible for the NCLEX - PN® by the board of nursing of the state where he plans to practice nursing. As part of the application and testing process, the test - taker will not be allowed to: 12) A) Wear a watch during the examination. B) Request additional time if a learning disability is present. C) Change the testing date once without paying a penalty. D) Take the test in a state other than the one in which he will be licensed. Answer: A Explanation: A) NCLEX test - takers are not allowed to have watches, pagers, cell phones, personal calculators, and translators while they are testing. The NCLEX - PN® is a national examination and can be taken in any state or U.S. territory. After passing the examination, the license will be from the state that determined that the applicant was eligible to test. A test date may be changed once within the test service's policy regarding notification without paying a penalty. Modifications are allowed in the testing time for test - takers who have learning disabilities. This must be approved in advance of the testing day. Implementation Safe, Effective Care Environment - Coordinated Care Application B) NCLEX test - takers are not allowed to have watches, pagers, cell phones, personal calculators, and translators while they are testing. The NCLEX - PN® is a national examination and can be taken in any state or U.S. territory. After passing the examination, the license will be from the state that determined that the applicant was eligible to test. A test date may be changed once within the test service's policy regarding notification without paying a penalty. Modifications are allowed in the testing time for test - takers who have learning disabilities. This must be approved in advance of the testing day. Implementation Safe, Effective Care Environment - Coordinated Care Application C) NCLEX test - takers are not allowed to have watches, pagers, cell phones, personal calculators, and translators while they are testing. The NCLEX - PN® is a national examination and can be taken in any state or U.S. territory. After passing the examination, the license will be from the state that determined that the applicant was eligible to test. A test date may be changed once within the test service's policy regarding notification without paying a penalty. Modifications are allowed in the testing time for test - takers who have learning disabilities. This must be approved in advance of the testing day. Implementation Safe, Effective Care Environment - Coordinated Care Application D) NCLEX test - takers are not allowed to have watches, pagers, cell phones, personal calculators, and translators while they are testing. The NCLEX - PN® is a national examination and can be taken in any state or U.S. territory. After passing the examination, the license will be from the state that determined that the applicant was eligible to test. A test date may be changed once within the test service's policy regarding notification without paying a penalty. Modifications are allowed in the testing time for test - takers who have learning disabilities. This must be approved in advance of the testing day. Implementation Safe, Effective Care Environment - Coordinated Care Application 16
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13) A graduate nurse has gathered various suggestions for decreasing test - taking anxiety as part of his/her preparation for the practical/vocational nurse licensing examination. In the time prior to actually taking the examination, it will be most beneficial for the candidate to: (Select all that apply.) 13) A) Travel to the testing site prior to the scheduled testing appointment, and duplicate as much as possible the circumstances of the actual testing day. B) Consciously change thoughts of failure to thoughts of success. C) Stop all intake of coffee, tea, and alcohol. D) Attend a 2 - day professional review course the week before taking the examination. E) Create and use daily a visualization of taking the test, feeling comfortable and in control, and answering questions accurately. F) Practice deep relaxation exercises before and while answering review questions. Answer: A, B, E Explanation: A) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis 17
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B) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis C) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis 18
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D) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis E) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis 19
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F) Incorporating anxiety - reducing strategies into the overall plan of review for the NCLEX - PN® gives the test - taker the opportunity to determine which ones are helpful and less helpful. It also reinforces the strategy, which strengthens it as a positive habit. Focus on success rather than failure. Take control of as much of the process as possible, reduce the unknown, and have a realistic travel plan. In addition to Plan A, have at least one optional plan (for potential changes in child care arrangements, transportation, weather, etc.). Visualizing the actual testing experience provides information for the candidate that can be incorporated into positive habit changes, as well as increasing overall comfort, self - confidence, and success. Completely ceasing the intake of these beverages is not necessary, and may cause increased anxiety. Intake should be limited, especially the day before and the day of the test. The use of deep relaxation exercises before and while answering questions is not appropriate or helpful. A mild level of anxiety in the test - taker is physiologically and psychologically helpful. Short, focused relaxation strategies are more helpful during the test time, such as counting from 10 to 1, moving the body and/or the chair back from the computer screen to remind the test - taker to be objective and to provide a little space, or taking several deep, slow breaths. Many candidates for the licensing examination benefit from taking a professional review course. Two - day courses are generally quite intense and would be better taken earlier than 1 week before the exam is scheduled. Implementation Psychosocial Integrity Analysis 14) A student nurse who is within 2 weeks of graduating from nursing school is caring for a client who is a retired nurse who graduated from an LPN/LVN program in 1963. As part of the conversation during morning care, the retired nurse and the student talk about how nursing has stayed the same and how it has changed over 40 years. Which comment by the retired nurse will be of most value for the student in preparing for the licensing examination? 14) A) "I've heard that the exam is now given on a computer. I suppose it's faster that way." B) "Having a license means that the public is protected from having unqualified people practice as nurses." C) "The examination was given several times during the year and sometimes there were over 1,000 people taking the exam at the same time." D) "I always renewed my license when it was due, whether I was working or not. In fact, it's still current. I like going to various workshops to hear what is new in nursing and healthcare and getting my continuing education units." Answer: B Explanation: A) The purpose of licensing examinations in nursing (both for the LPN/LVN and the RN) has been, since Mississippi first passed laws for this in 1914, to protect the public by setting minimum qualifying safety and effectiveness standards for nursing performance. Knowing how the examination was given in the past is interesting, but not of much value for preparing for the current examination. A student who is almost ready to graduate should, by now, have the information that the licensing examination is computerized. The statement about renewing the license is good information for the student to remind him or her not to let a license lapse and that continuing education units will be required. It has no direct value for the student nurse who is preparing for the licensing examination. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 20
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B) The purpose of licensing examinations in nursing (both for the LPN/LVN and the RN) has been, since Mississippi first passed laws for this in 1914, to protect the public by setting minimum qualifying safety and effectiveness standards for nursing performance. Knowing how the examination was given in the past is interesting, but not of much value for preparing for the current examination. A student who is almost ready to graduate should, by now, have the information that the licensing examination is computerized. The statement about renewing the license is good information for the student to remind him or her not to let a license lapse and that continuing education units will be required. It has no direct value for the student nurse who is preparing for the licensing examination. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis C) The purpose of licensing examinations in nursing (both for the LPN/LVN and the RN) has been, since Mississippi first passed laws for this in 1914, to protect the public by setting minimum qualifying safety and effectiveness standards for nursing performance. Knowing how the examination was given in the past is interesting, but not of much value for preparing for the current examination. A student who is almost ready to graduate should, by now, have the information that the licensing examination is computerized. The statement about renewing the license is good information for the student to remind him or her not to let a license lapse and that continuing education units will be required. It has no direct value for the student nurse who is preparing for the licensing examination. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis D) The purpose of licensing examinations in nursing (both for the LPN/LVN and the RN) has been, since Mississippi first passed laws for this in 1914, to protect the public by setting minimum qualifying safety and effectiveness standards for nursing performance. Knowing how the examination was given in the past is interesting, but not of much value for preparing for the current examination. A student who is almost ready to graduate should, by now, have the information that the licensing examination is computerized. The statement about renewing the license is good information for the student to remind him or her not to let a license lapse and that continuing education units will be required. It has no direct value for the student nurse who is preparing for the licensing examination. Evaluation Safe, Effective Care Environment - Coordinated Care Analysis 15) It is the first day of class for beginning vocational nursing students. There are 50 students in the class. During the general discussion of the course, the instructor mentions that to become a licensed vocational nurse, the graduate must take a national examination called the NCLEX - PN®. The instructor then asks the class when they think it would be appropriate to begin studying for the examination. Which of the following is the most appropriate suggestion by a student? 15) A) "When we start practicing what we are learning in the classroom and lab in the clinical setting." B) "Within 2 weeks after we finish the course because the sooner we take the exam, the better we will remember the information." C) "About halfway through the program when we have had some theory and practice." D) "Today, as we begin our classes." Answer: C 21
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Explanation: A) In order to study for the licensing examination, the student must have begun to establish a knowledge base of nursing theory and practice. The student can begin to prepare for the licensing examination by listening carefully, taking notes, and clarifying information as needed. The student should apply the study and test - taking habits from the course to the licensing examination. The question requires critical thinking, application of prior learned information, and recognizing that the student has a personal responsibility for his or her learning beginning the first day of the course. Halfway through a nursing program, the student can reinforce previous learning and assist with learning new information by practicing NCLEX - PN® questions. Assessment Safe, Effective Care Environment - Coordinated Care Analysis B) In order to study for the licensing examination, the student must have begun to establish a knowledge base of nursing theory and practice. The student can begin to prepare for the licensing examination by listening carefully, taking notes, and clarifying information as needed. The student should apply the study and test - taking habits from the course to the licensing examination. The question requires critical thinking, application of prior learned information, and recognizing that the student has a personal responsibility for his or her learning beginning the first day of the course. Halfway through a nursing program, the student can reinforce previous learning and assist with learning new information by practicing NCLEX - PN® questions. Assessment Safe, Effective Care Environment - Coordinated Care Analysis C) In order to study for the licensing examination, the student must have begun to establish a knowledge base of nursing theory and practice. The student can begin to prepare for the licensing examination by listening carefully, taking notes, and clarifying information as needed. The student should apply the study and test - taking habits from the course to the licensing examination. The question requires critical thinking, application of prior learned information, and recognizing that the student has a personal responsibility for his or her learning beginning the first day of the course. Halfway through a nursing program, the student can reinforce previous learning and assist with learning new information by practicing NCLEX - PN® questions. Assessment Safe, Effective Care Environment - Coordinated Care Analysis D) In order to study for the licensing examination, the student must have begun to establish a knowledge base of nursing theory and practice. The student can begin to prepare for the licensing examination by listening carefully, taking notes, and clarifying information as needed. The student should apply the study and test - taking habits from the course to the licensing examination. The question requires critical thinking, application of prior learned information, and recognizing that the student has a personal responsibility for his or her learning beginning the first day of the course. Halfway through a nursing program, the student can reinforce previous learning and assist with learning new information by practicing NCLEX - PN® questions. Assessment Safe, Effective Care Environment - Coordinated Care Analysis 22
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Answer Key Testname: C37 1) A 2) D 3) A 4) C 5) A, C, F 6) B 7) D 8) C, E, F 9) C 10) C 11) B 12) A 13) A, B, E 14) B 15) C 23
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Exam Name___________________________________ MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Many hospitals are no longer allowing the use of the letter "Q" as an abbreviation either alone or in combination (such as QID, QW, or QS). What is the primary reason for this action? 1) A) It is more accurate to write "every" instead of "Q". B) Errors are reduced when fewer abbreviations are used in orders and in communicating information. C) Not all nurses know that "Q" means "quaque" in Latin. D) A hospital may not have computerized ordering and physicians' handwriting is often hard to read. Answer: B Explanation: A) Overuse of abbreviations is a major contributing factor in medication administration errors; overuse of abbreviations also reduces clarity in communication. It is not about accuracy as much as clear communication, although certainly if written communication is not clear, errors are more likely to occur. Any person who enters data in a client's record must write clearly so that the information can be read by all others. The Latin meaning of a term has no bearing on this scenario. Evaluation Safe, Effective Care Environment - Safety and Infection Control Analysis B) Overuse of abbreviations is a major contributing factor in medication administration errors; overuse of abbreviations also reduces clarity in communication. It is not about accuracy as much as clear communication, although certainly if written communication is not clear, errors are more likely to occur. Any person who enters data in a client's record must write clearly so that the information can be read by all others. The Latin meaning of a term has no bearing on this scenario. Evaluation Safe, Effective Care Environment - Safety and Infection Control Analysis C) Overuse of abbreviations is a major contributing factor in medication administration errors; overuse of abbreviations also reduces clarity in communication. It is not about accuracy as much as clear communication, although certainly if written communication is not clear, errors are more likely to occur. Any person who enters data in a client's record must write clearly so that the information can be read by all others. The Latin meaning of a term has no bearing on this scenario. Evaluation Safe, Effective Care Environment - Safety and Infection Control Analysis 1
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D) Overuse of abbreviations is a major contributing factor in medication administration errors; overuse of abbreviations also reduces clarity in communication. It is not about accuracy as much as clear communication, although certainly if written communication is not clear, errors are more likely to occur. Any person who enters data in a client's record must write clearly so that the information can be read by all others. The Latin meaning of a term has no bearing on this scenario. Evaluation Safe, Effective Care Environment - Safety and Infection Control Analysis 2) A student nurse is documenting client care in a client's medical record. The client's wife, who is a physician on the hospital staff, asks the student for the client's chart. The most appropriate action by the student nurse at this time is to: 2) A) Refer the physician to the charge nurse. B) Give the chart to the physician and complete the nursing documentation when the chart is available. C) Tell the physician that she is not allowed to read the chart unless she is involved in her husband's care. D) Ask the client's wife if her husband has given his permission for the chart to be read. Answer: A Explanation: A) A client's medical record is confidential information and is to be read only by those directly involved in the client's care. Regardless of the relationship of the physician to the client and the physician's status as a hospital staff member, this information cannot be legally or ethically shared in this scenario. The charted information can be shared with the client's wife only after certain criteria are met, such as written client and attending physician consent (or as indicated by agency policy). Referring this matter to the nurse in charge of the unit is the only choice given that is acceptable. Implementation Safe, Effective Care Environment - Coordinated Care Analysis B) A client's medical record is confidential information and is to be read only by those directly involved in the client's care. Regardless of the relationship of the physician to the client and the physician's status as a hospital staff member, this information cannot be legally or ethically shared in this scenario. The charted information can be shared with the client's wife only after certain criteria are met, such as written client and attending physician consent (or as indicated by agency policy). Referring this matter to the nurse in charge of the unit is the only choice given that is acceptable. Implementation Safe, Effective Care Environment - Coordinated Care Analysis 2
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C) A client's medical record is confidential information and is to be read only by those directly involved in the client's care. Regardless of the relationship of the physician to the client and the physician's status as a hospital staff member, this information cannot be legally or ethically shared in this scenario. The charted information can be shared with the client's wife only after certain criteria are met, such as written client and attending physician consent (or as indicated by agency policy). Referring this matter to the nurse in charge of the unit is the only choice given that is acceptable. Implementation Safe, Effective Care Environment - Coordinated Care Analysis D) A client's medical record is confidential information and is to be read only by those directly involved in the client's care. Regardless of the relationship of the physician to the client and the physician's status as a hospital staff member, this information cannot be legally or ethically shared in this scenario. The charted information can be shared with the client's wife only after certain criteria are met, such as written client and attending physician consent (or as indicated by agency policy). Referring this matter to the nurse in charge of the unit is the only choice given that is acceptable. Implementation Safe, Effective Care Environment - Coordinated Care Analysis 3) A newly licensed nurse has accepted a position with a nursing registry. The nurse will be going to several different hospitals and will be required to document according to each particular facility's policy. Regardless of the documentation method or system, the nurse knows that the primary focus of client documentation is: 3) A) To communicate client status and responses using the nursing process. B) To record nursing actions performed in accordance with medical and nursing diagnoses. C) To prevent legal action should an error be made during a client's hospital stay. D) To coordinate all members of the healthcare team. Answer: A Explanation: A) A client's medical record documents the client's ongoing status, regardless of the system or method used. The focus should be on the client, not on the nurse or other healthcare providers involved in the client's care. The use of the nursing process as a guideline in documentation enables nurses to have a common basis from which to record data and promotes completeness and clarity in communication. Assessment Safe, Effective Care Environment - Coordinated Care Application B) A client's medical record documents the client's ongoing status, regardless of the system or method used. The focus should be on the client, not on the nurse or other healthcare providers involved in the client's care. The use of the nursing process as a guideline in documentation enables nurses to have a common basis from which to record data and promotes completeness and clarity in communication. Assessment Safe, Effective Care Environment - Coordinated Care Application 3
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C) A client's medical record documents the client's ongoing status, regardless of the system or method used. The focus should be on the client, not on the nurse or other healthcare providers involved in the client's care. The use of the nursing process as a guideline in documentation enables nurses to have a common basis from which to record data and promotes completeness and clarity in communication. Assessment Safe, Effective Care Environment - Coordinated Care Application D) A client's medical record documents the client's ongoing status, regardless of the system or method used. The focus should be on the client, not on the nurse or other healthcare providers involved in the client's care. The use of the nursing process as a guideline in documentation enables nurses to have a common basis from which to record data and promotes completeness and clarity in communication. Assessment Safe, Effective Care Environment - Coordinated Care Application 4) A home health nurse is making an initial visit to a homebound client. Based on the assessment data, the nurse recognizes that all of the following activities need to be done. Which activity should the nurse plan to do first? 4) A) Contact the client's pastor to convey the client's request for a visit. B) Confer with the client's weekly housekeeper about the client's safety needs. C) Contact the physician to suggest that the client be prescribed a daily laxative. D) Arrange for the client to receive daily meals from Meals on Wheels. Answer: B Explanation: A) In this question, safety takes priority in determining how to plan the nursing tasks. Two choices indicate physiological level needs (nutrition, elimination) that need to be addressed. The scenario does not indicate that either need is of an urgent or emergency nature. Spiritual/psychosocial needs will not take priority over safety or physiological needs. Planning Safe, Effective Care Environment - Coordinated Care Analysis B) In this question, safety takes priority in determining how to plan the nursing tasks. Two choices indicate physiological level needs (nutrition, elimination) that need to be addressed. The scenario does not indicate that either need is of an urgent or emergency nature. Spiritual/psychosocial needs will not take priority over safety or physiological needs. Planning Safe, Effective Care Environment - Coordinated Care Analysis C) In this question, safety takes priority in determining how to plan the nursing tasks. Two choices indicate physiological level needs (nutrition, elimination) that need to be addressed. The scenario does not indicate that either need is of an urgent or emergency nature. Spiritual/psychosocial needs will not take priority over safety or physiological needs. Planning Safe, Effective Care Environment - Coordinated Care Analysis 4
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D) In this question, safety takes priority in determining how to plan the nursing tasks. Two choices indicate physiological level needs (nutrition, elimination) that need to be addressed. The scenario does not indicate that either need is of an urgent or emergency nature. Spiritual/psychosocial needs will not take priority over safety or physiological needs. Planning Safe, Effective Care Environment - Coordinated Care Analysis 5) A client is being assisted to ambulate for the first time after abdominal surgery. Which of the following observations by the nurse during the ambulation is most important to include in the narrative charting? 5) A) Fatigue after ambulating B) Mild nausea when first getting up C) Moderate pain during ambulation D) Syncope during ambulation Answer: D Explanation: A) Lightheadedness and dizziness during ambulation are safety concerns. It is essential that this information be communicated verbally and in written form. Fatigue, mild nausea, and pain are expected when a client is ambulating for the first time after surgery, and with abdominal surgery. It is appropriate to comment on all of the observations, but it is most important to comment on a major variance. Assessment Physiological Integrity - Reduction of Risk Potential Analysis B) Lightheadedness and dizziness during ambulation are safety concerns. It is essential that this information be communicated verbally and in written form. Fatigue, mild nausea, and pain are expected when a client is ambulating for the first time after surgery, and with abdominal surgery. It is appropriate to comment on all of the observations, but it is most important to comment on a major variance. Assessment Physiological Integrity - Reduction of Risk Potential Analysis C) Lightheadedness and dizziness during ambulation are safety concerns. It is essential that this information be communicated verbally and in written form. Fatigue, mild nausea, and pain are expected when a client is ambulating for the first time after surgery, and with abdominal surgery. It is appropriate to comment on all of the observations, but it is most important to comment on a major variance. Assessment Physiological Integrity - Reduction of Risk Potential Analysis D) Lightheadedness and dizziness during ambulation are safety concerns. It is essential that this information be communicated verbally and in written form. Fatigue, mild nausea, and pain are expected when a client is ambulating for the first time after surgery, and with abdominal surgery. It is appropriate to comment on all of the observations, but it is most important to comment on a major variance. Assessment Physiological Integrity - Reduction of Risk Potential Analysis 5
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6) A client has an order for morphine sulfate 10 mg sc every 3 - 4 hours prn. The nurse knows that each time the medication is given to the client, it is essential to perform narrative nursing documentation to communicate the: 6) A) Subjective symptoms observed to determine level of pain. B) Medication was given subcutaneously as ordered. C) Client's blood pressure before the medication is given. D) Effect of the medication. Answer: D Explanation: A) Each time a "prn" medication is administered (or other nursing activity is done on a "prn" basis), additional narrative charting is required to communicate the effect of the action. It is more important to assess respirations prior to administering morphine sulfate. Route of administration is designated on the medication administration record and only one route has been ordered. The question asks for appropriate documentation after the medication is given, not before. Evaluation Physiological Integrity - Pharmacologic and Parenteral Therapies Application B) Each time a "prn" medication is administered (or other nursing activity is done on a "prn" basis), additional narrative charting is required to communicate the effect of the action. It is more important to assess respirations prior to administering morphine sulfate. Route of administration is designated on the medication administration record and only one route has been ordered. The question asks for appropriate documentation after the medication is given, not before. Evaluation Physiological Integrity - Pharmacologic and Parenteral Therapies Application C) Each time a "prn" medication is administered (or other nursing activity is done on a "prn" basis), additional narrative charting is required to communicate the effect of the action. It is more important to assess respirations prior to administering morphine sulfate. Route of administration is designated on the medication administration record and only one route has been ordered. The question asks for appropriate documentation after the medication is given, not before. Evaluation Physiological Integrity - Pharmacologic and Parenteral Therapies Application D) Each time a "prn" medication is administered (or other nursing activity is done on a "prn" basis), additional narrative charting is required to communicate the effect of the action. It is more important to assess respirations prior to administering morphine sulfate. Route of administration is designated on the medication administration record and only one route has been ordered. The question asks for appropriate documentation after the medication is given, not before. Evaluation Physiological Integrity - Pharmacologic and Parenteral Therapies Application 7) A nurse is to transport a client to dialysis. The client is not in her room and cannot be found on the nursing unit. Of the following possible actions, the nurse will most appropriately first contact the: 7) A) Facility security to request their assistance. B) Client's physician to report that the client cannot be found. C) Client's family to see if the client is there. D) Hospital cafeteria because the client said she was hungry. Answer: A 6
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Explanation: A) When a client cannot be located on a hospital unit, it is appropriate to request the assistance of hospital security before calling the family. Depending upon the type of facility, the protocol may vary; i.e., a residential facility may not have on - site security or the client may have a history of leaving the facility and returning to where he/she previously lived. Facility policies will vary and may call for initially using the paging system to request that the client return to his or her room. The physician does not have to be notified as the first contact. Although the client may be in the cafeteria, security can assist in obtaining this information. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis B) When a client cannot be located on a hospital unit, it is appropriate to request the assistance of hospital security before calling the family. Depending upon the type of facility, the protocol may vary; i.e., a residential facility may not have on - site security or the client may have a history of leaving the facility and returning to where he/she previously lived. Facility policies will vary and may call for initially using the paging system to request that the client return to his or her room. The physician does not have to be notified as the first contact. Although the client may be in the cafeteria, security can assist in obtaining this information. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis C) When a client cannot be located on a hospital unit, it is appropriate to request the assistance of hospital security before calling the family. Depending upon the type of facility, the protocol may vary; i.e., a residential facility may not have on - site security or the client may have a history of leaving the facility and returning to where he/she previously lived. Facility policies will vary and may call for initially using the paging system to request that the client return to his or her room. The physician does not have to be notified as the first contact. Although the client may be in the cafeteria, security can assist in obtaining this information. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis D) When a client cannot be located on a hospital unit, it is appropriate to request the assistance of hospital security before calling the family. Depending upon the type of facility, the protocol may vary; i.e., a residential facility may not have on - site security or the client may have a history of leaving the facility and returning to where he/she previously lived. Facility policies will vary and may call for initially using the paging system to request that the client return to his or her room. The physician does not have to be notified as the first contact. Although the client may be in the cafeteria, security can assist in obtaining this information. Implementation Safe, Effective Care Environment - Safety and Infection Control Analysis 8) A resident of a long - term care facility has been discharged after a five - day stay in an acute care facility and is returning to the long - term care facility. The resident was hospitalized with bacterial pneumonia. It is most important that the charge nurse in the long - term care facility: 8) A) Change the dates for the every 90 - day required review of the client's comprehensive assessment and care plan. B) Continue respiratory isolation measures for one more week. C) Facilitate the client's interaction with other residents after the five - day absence. D) Perform an admission assessment to determine current client needs. 7
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