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Safe and Effective Care Environment Nclex PN Questions

Which of the following statements indicates adequate dietary understanding in a client with constipation?

    A. “I should decrease my intake of fluids.”

    B. “I should decrease my level of activity.”

    C. “I should increase my intake of apples.”

    D. “I should increase my intake of milk.”

Correct Answer: “I should increase my intake of apples.”
Rationale: The correct answer is, “I should increase my intake of apples.” This statement indicates adequate dietary understanding in a client with constipation because apples are a good source of fiber, which helps alleviate constipation. Adequate fiber intake is essential for promoting bowel regularity. Choices A and B are incorrect as decreasing fluids and activity level can worsen constipation. Insufficient fluid intake can lead to hard stools, exacerbating constipation. Decreasing activity can also slow down bowel movements. Choice D is incorrect because milk is not a high-fiber food and may not effectively address constipation. While milk can have a mild laxative effect on some individuals, it is not a primary solution for constipation, especially when compared to high-fiber foods like apples.

A client is having an abortion in a women’s clinic, and the nurse caring for the client does not think the reasoning is appropriate. The nurse asks, “Are you sure you want to do this? It can’t be undone. Have you read about your other options? Adoption is always a good choice.” The client states she understands all options and is comfortable with her choice. The nurse nods and leaves the room to discuss the procedure with the physician. Which client right did the nurse violate with her actions?

  • A. the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion
  • B. the client’s right to be left alone without unsolicited attention, as the nurse inserted herself in the client’s healthcare scenario and offered uninvited advice
  • C. the client’s right to confidentiality, as the nurse is talking to the physician about the client and the abortion
  • D. the client’s right to respectful care, as the nurse clearly made it known that she did not approve of the abortion

Correct Answer: the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion
Rationale: A client has the right to make decisions about their healthcare without interference from healthcare team members. In this scenario, the nurse violated the client's right to make personal health decisions without interference by trying to influence the client's decision-making and healthcare choice in the direction of not having an abortion. It is essential for healthcare providers to respect patients' autonomy and decisions, regardless of personal beliefs. Choices B, C, and D are incorrect because the primary violation in this situation is related to the client's right to make their own healthcare decisions without interference.

A 51-year-old client with amyotrophic lateral sclerosis (Lou Gehrig disease) is admitted to the hospital because his condition is deteriorating. The client tells the nurse that he wants a do-not-resuscitate (DNR) order. The nurse should provide the client with which information?

  • A. Oral consent is not sufficient, and the client’s request will be honored by all healthcare providers.
  • B. Consent must be obtained from the family.
  • C. The DNR request should be discussed with the healthcare provider, who will write the order.
  • D. The healthcare provider makes the final decision about a DNR request.

Correct Answer: The DNR request should be discussed with the healthcare provider, who will write the order.
Rationale: When a client requests a DNR order, the nurse should contact the healthcare provider so that the provider may discuss the request with the client. A DNR order should be written, not verbal, following agency and state guidelines. Therefore, the correct answer is that the DNR request should be discussed with the healthcare provider, who will write the order. Option A is incorrect as oral consent is not sufficient for a DNR order. Option B is incorrect because the client, not the family, has the authority to request a DNR order. Option D is incorrect because the healthcare provider discusses the request with the client but does not make the final decision.

Which of the following is not an advanced directive?

  • A. informed consent
  • B. living will
  • C. durable power of attorney for health care
  • D. health care proxy

Correct Answer: informed consent
Rationale: Informed consent is the process of obtaining permission from a patient before conducting a healthcare intervention. It is not considered an advanced directive. A living will is a legal document that outlines a person's preferences for medical treatment if they are unable to communicate. A durable power of attorney for health care designates a person to make medical decisions on behalf of the patient. A health care proxy, which is another term for a durable power of attorney for health care, also involves appointing someone to make healthcare decisions for an individual if they become unable to do so. Therefore, the correct answer is 'informed consent,' as it is not an advanced directive but rather a different aspect of patient care.

Delegation of tasks to appropriate personnel allows the nurse to:

  • A. ensure tasks are appropriately distributed.
  • B. keep other members of the team productive.
  • C. maintain tight control of all aspects of the workflow.
  • D. recognize the importance of team members' roles.

Correct Answer: keep other members of the team productive.
Rationale: Delegating tasks to appropriate personnel is essential for a nurse to keep other team members productive. By assigning tasks that align with the specific roles and responsibilities of team members, the nurse can enhance work effectiveness and efficiency. Option A is incorrect because delegation is not primarily about ensuring tasks are evenly distributed but rather about utilizing team members' skills effectively. Option C is incorrect as maintaining tight control of all aspects of the workflow can hinder teamwork and limit individual growth. Option D is incorrect because effective delegation involves empowering team members to make decisions within their scope of practice, rather than solely recognizing the importance of their roles.

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