NCLEX-PN
Nclex Questions Management of Care
1. Pulling is easier than pushing. So pulling a client rather than pushing them has which of the following advantages?
- A. reduces workload
- B. decreases opposition from gravity
- C. maintains stability
- D. prevents muscle strain
Correct answer: A
Rationale: When pulling a client, you work with the gravitational force instead of opposing it, which reduces the workload on your muscles. Choosing to pull a client minimizes the effort required compared to pushing. Choice B is incorrect because the force of gravity remains constant regardless of pushing or pulling. Choice C is irrelevant as stability is not directly related to the advantage of pulling over pushing. Choice D is inaccurate because pulling can still strain muscles if not executed correctly, but it generally reduces the overall workload in comparison to pushing.
2. When documenting in the client’s record, what type of information should be recorded?
- A. educated predictions of outcomes
- B. personal opinions
- C. objective information
- D. subjective information
Correct answer: C
Rationale: When documenting in a client's record, it is crucial to record objective information. Objective information is factual, based on observations and measurable data. This type of information is essential for accurate and effective communication among healthcare professionals involved in the client's care. Choices A and B, educated predictions of outcomes and personal opinions, are subjective in nature and may not provide an accurate representation of the client's condition. Choice D, subjective information, includes personal feelings, interpretations, and opinions, which are not ideal for documentation as they can be biased and unreliable.
3. An LPN on a Continuous Quality Improvement (CQI) team is tasked with implementing strategies to reduce medication errors. Which of the following strategies would be most beneficial for the LPN to implement?
- A. Track individuals who commit medication errors and report them to administration.
- B. Remind staff of the five rights of medication administration.
- C. Ensure that all staff members are proficient in completing incident reports if a medication error occurs.
- D. Double-check that staff document medication administration in the electronic medical record.
Correct answer: C
Rationale: The most beneficial strategy for the LPN on a CQI team to implement is to ensure that all staff members are proficient in completing incident reports if a medication error occurs. Organized and accurate incident reports are crucial in tracking and understanding why errors occurred. CQI teams utilize incident reports to develop new policies or enhance existing ones to standardize medical processes and reduce errors. Tracking individuals with medication errors (Choice A) may create a culture of blame rather than focusing on system improvements. Reminding staff of the five rights of medication administration (Choice B) is important for knowledge reinforcement but does not directly address the process improvement aspect. Double-checking documentation in the electronic medical record (Choice D) is necessary for accuracy but does not provide the detailed insights obtained from incident reports for process improvement.
4. The client is going for surgery and mentions their religious objection to blood transfusions. Which of the following responses would be most appropriate?
- A. "I can ask pastoral care to send someone to speak with you about this concern since it would not be safe to refuse a blood transfusion."?
- B. "I understand, and you have the right to refuse blood transfusions."?
- C. "While I understand, if there is excessive bleeding during surgery, we may need to transfuse blood to stabilize you."?
- D. "I have received a blood transfusion before, and I do not think you understand the risks versus the benefits of refusing this."?
Correct answer: B
Rationale: The most appropriate response is, '"I understand, and you have the right to refuse blood transfusions."? This answer shows respect for the client's autonomy and religious beliefs. It is crucial for healthcare providers to acknowledge and support a patient's decision-making regarding their care, even if it conflicts with medical advice. Option A is not ideal as it might seem dismissive of the client's beliefs. Option C introduces a potential negative outcome of refusing a blood transfusion, which could induce fear or coercion. Option D is inappropriate because it implies judgment and does not uphold the client's autonomy.
5. What is the most effective way to prevent skin breakdown?
- A. assistive devices
- B. repositioning
- C. topical medications
- D. avoiding tape and bandages
Correct answer: V
Rationale: Repositioning is the most effective way to prevent skin breakdown. Repositioning helps relieve pressure on specific areas of the skin, reducing the risk of developing pressure ulcers. While assistive devices (Choice A) may be beneficial in some cases, they are not universally as effective as repositioning. Topical medications (Choice C) are primarily used for treating skin conditions and are not the primary focus for preventing skin breakdown. Avoiding tape and bandages (Choice D) is crucial to prevent skin irritation, but repositioning remains the most effective method to prevent skin breakdown.
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