NCLEX-PN
Nclex Questions Management of Care
1. Under what circumstances can an individual receive medical care without giving informed consent?
- A. when the durable power of attorney for health care is not available
- B. in an emergency, life-or-death situation
- C. when the physician is not available for discussion with the client
- D. when they (clients) are not able to speak for themselves
Correct answer: B
Rationale: An individual may receive medical care without giving informed consent in an emergency, life-or-death situation. This exception allows healthcare providers to provide immediate treatment to save a person's life or prevent serious harm when time is of the essence. Choices A, C, and D are incorrect because in all other situations, informed consent is required. The durable power of attorney for health care should be involved if available, the physician should have a discussion with the client in non-life-threatening situations, and in cases where clients are unable to speak for themselves, their designated representative or responsible party should be involved in the consent process.
2. The advanced directive in a client's chart is dated August 12, 1998. The client's daughter produces a Power of Attorney for Health Care, dated 2003, which contains different care directions. What should the nurse do?
- A. Follow the 1998 version because it's part of the legal chart.
- B. Follow the 1998 version because the physician's code order is based on it.
- C. Follow the 2003 version, place it in the chart, and communicate the update appropriately.
- D. Follow neither until clarified by the unit manager.
Correct answer: C
Rationale: The document dated 2003 supersedes the previous version and should be used as a basis for care directions. The nurse should follow the 2003 version, place it in the chart, and communicate the update appropriately to ensure that the most current care directions are followed. Choices A and B are incorrect because the 1998 version is now outdated, and the nurse should not rely on it for care decisions. Choice D is incorrect because the nurse should not delay following the updated document, and seeking clarification from the unit manager can lead to avoidable delays in care.
3. A gastroenterologist should be consulted for clients suffering from:
- A. digestive system diseases
- B. urinary system diseases
- C. female reproductive system diseases
- D. nervous system diseases
Correct answer: A
Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.
4. Why is accurate documentation of assessment findings regarding pressure ulcers crucial?
- A. To comply with legal requirements for documenting lesions.
- B. To meet hospital policies for documenting lesions.
- C. To fulfill physician's documentation requirements for lesions.
- D. Because the nursing assessment of ulcers is a standard of nursing practice.
Correct answer: D
Rationale: Accurate documentation of assessment findings regarding pressure ulcers is crucial because the nursing assessment of ulcers is a standard practice in nursing care. Documenting these findings not only ensures continuity of care but also plays a vital role in preventing further progression of the ulcer. Choices A, B, and C are incorrect because while laws, hospital policies, and physician requirements may influence documentation practices, the primary reason for accurate documentation lies in the standards of nursing practice and the quality of patient care.
5. While caring for the following clients, a pediatric nurse tells the charge nurse she must leave due to a family emergency. Which client would the charge nurse reassign to an LPN?
- A. An eight-year-old in diabetic ketoacidosis
- B. A six-year-old in sickle cell crisis
- C. A two-month-old with dehydration
- D. A five-year-old in skeletal traction
Correct answer: D
Rationale: The correct answer is a five-year-old in skeletal traction. This task is within the scope of practice for an LPN and would need minimal assistance from an RN. The children with diabetic ketoacidosis, sickle cell crisis, and dehydration require close observation, good assessment skills, IVF needs, and medications that would be better managed by an RN. Reassigning the child in skeletal traction to an LPN ensures appropriate care while allowing the RN to focus on the more critical cases.
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