NCLEX-PN TEST BANK

Safe and Effective Care Environment Nclex PN Questions

Common problems for supervisors include all of the following except:

    A. the supervisor facilitates development of staff members

    B. the supervisor micromanages staff members

    C. the supervisor wants to control the style in which a staff member correctly performs a task

    D. the supervisor does not delegate

Correct Answer: the supervisor facilitates development of staff members
Rationale: Common problems for supervisors include micromanaging staff members, wanting to control the style in which a staff member performs a task, and not delegating tasks effectively. These behaviors can hinder team building and overall effectiveness. Facilitating the development of staff members, on the other hand, is a positive attribute for a supervisor as it helps in nurturing the skills and growth of the team members. Therefore, the correct answer is 'the supervisor facilitates development of staff members' as this is not a common problem but a desirable quality in a supervisor.

An LPN is caring for a primarily bedridden client. Which finding should be of least concern?

  • A. swollen feet
  • B. brown discoloration above the ankles
  • C. leg pain
  • D. capillary refill time of 3 seconds on the big toe

Correct Answer: capillary refill time of 3 seconds on the big toe
Rationale: The correct answer is the capillary refill time of 3 seconds on the big toe. A capillary refill time longer than three seconds may indicate inadequate blood flow. Swollen feet, brown discoloration above the ankles, and leg pain are all signs of venous insufficiency to the lower extremities. These findings can suggest circulation issues and require further assessment and intervention. Therefore, they should be of more concern compared to the capillary refill time of 3 seconds on the big toe, which is within the normal range of 2-3 seconds.

As part of the teaching plan for a client with type I diabetes mellitus, the nurse should include that carbohydrate needs might increase when:

  • A. an infection is present.
  • B. there is an emotional upset.
  • C. a large meal is eaten.
  • D. active exercise is performed.

Correct Answer: active exercise is performed.
Rationale: During active exercise, insulin sensitivity increases, leading to lower blood glucose levels. To balance the effect of increased insulin sensitivity, additional carbohydrates might be needed. The other choices are incorrect because: A) an infection typically raises blood glucose levels rather than increasing the need for carbohydrates; B) emotional upset can impact blood glucose but does not directly affect carbohydrate needs; C) while a large meal can raise blood glucose levels, it does not necessarily mean an increase in carbohydrate needs.

The nurse is preparing task assignments for the day. Which task should the nurse assign to a nursing assistant?

  • A. Monitoring for bleeding for a client who has just undergone cardiac catheterization
  • B. Assisting a client who is getting up to ambulate for the first time after surgery
  • C. Providing oral care to an unconscious client who requires oral care
  • D. Completing the preoperative checklist for a client scheduled for a liver biopsy

Correct Answer: Providing oral care to an unconscious client who requires oral care
Rationale: When delegating tasks, the nurse must consider the state nursing practice act guidelines and job descriptions. Providing oral care to an unconscious client is a task suitable for delegation to a nursing assistant. The nurse should give clear instructions on adapting the procedure for the client's needs and the signs of complications to watch for. Monitoring for bleeding after cardiac catheterization necessitates immediate nursing assessment, which requires critical thinking and intervention that exceeds a nursing assistant's scope of practice. Assisting a client with ambulation post-surgery carries the risk of orthostatic hypotension and should be performed by a licensed nurse. Completing a preoperative checklist for a client scheduled for a liver biopsy involves critical assessment and preparation that are within the nurse's scope of practice.

Which of the following medications should be held 24–48 hours prior to an electroencephalogram (EEG)?

  • A. Lasix (furosemide)
  • B. Cardizem (diltiazem)
  • C. Lanoxin (digoxin)
  • D. Dilantin (phenytoin)

Correct Answer: Dilantin (phenytoin)
Rationale: Anticonvulsants like Dilantin should be held 24–48 hours before an EEG to prevent interference with the test results. Medications such as tranquilizers, barbiturates, and other sedatives should also be avoided. Lasix, Cardizem, and Lanoxin do not belong to these categories and are not known to interfere with EEG results.

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