Nclex Questions Management of Care

Nclex Questions Management of Care Related

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A discharge planning nurse is making arrangements for a client with an epidural catheter for continuous infusion of opioids to be placed in a long-term care facility. The family prefers a facility in its neighborhood to facilitate visiting. The neighborhood facility has never cared for a client with this type of need. What is the most appropriate action by the discharge planning nurse?

  • A. Arrange for immediate in-services for the long-term care facility staff on pain management using epidural catheters.
  • B. Explain the situation to the client and family and seek another long-term care facility for discharge from the hospital.
  • C. Encourage the family to hire private duty nurses skilled in epidural catheter pain management to allow the client to be transferred to the neighborhood facility.
  • D. None of the above
Correct Answer: B

Rationale: In this scenario, the priority is the safety and well-being of the client. The neighborhood facility's lack of experience in caring for a client with an epidural catheter for continuous opioid infusion raises concerns about the quality of care they can provide. Therefore, the most appropriate action for the discharge planning nurse is to explain the situation to the client and family and seek another long-term care facility that can provide the necessary care. Option A, arranging for immediate in-services, may not be feasible or timely, considering the urgent need for appropriate care. Option C, encouraging the family to hire private duty nurses, does not ensure the facility's overall capability to manage the client's complex needs. Option D, 'None of the above,' is not the best choice as the client's safety should be the priority in this situation.

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Which medication might the healthcare provider prescribe if the client expresses discomfort with being in the enclosed space of a CT scanner?

  • A. Valium (diazepam)
  • B. Clozaril (clozapine)
  • C. Catapres (clonidine)
  • D. Lasix (furosemide)
Correct Answer: A

Rationale: Valium (diazepam) is a sedative that might be prescribed to help a client who feels uncomfortable in the confined space of a CT scanner. Diazepam can help reduce anxiety and promote relaxation, making the scanning process more tolerable. Clozaril (clozapine), Catapres (clonidine), and Lasix (furosemide) are not sedatives and wouldn't be appropriate for alleviating discomfort related to being in an enclosed space. Clozaril is an antipsychotic used to treat schizophrenia, Catapres is a blood pressure medication, and Lasix is a diuretic used to treat fluid retention, so they are not indicated for this situation.

Which of the following conditions has a severe complication of respiratory failure?

  • A. Bell's palsy
  • B. Guillain-Barré syndrome
  • C. Trigeminal neuralgia
  • D. Tetanus
Correct Answer: B

Rationale: Guillain-Barré syndrome is characterized by a severe complication of respiratory failure due to the involvement of the peripheral nerves that control breathing. While Bell's palsy, trigeminal neuralgia, and tetanus are also conditions affecting peripheral nerves, they do not typically lead to respiratory failure like Guillain-Barré syndrome. Bell's palsy causes facial muscle weakness, trigeminal neuralgia results in severe facial pain, and tetanus leads to muscle stiffness and spasms, but none of these conditions directly involve respiratory failure.

Following an automobile accident that caused a head injury to an adult client, the nurse observes that the client sleeps for long periods of time. The nurse determines that the client has experienced injury to the:

  • A. hypothalamus.
  • B. thalamus.
  • C. cortex.
  • D. medulla.
Correct Answer: A

Rationale: The hypothalamus is responsible for regulating sleep patterns among other functions. Injury to the hypothalamus can disrupt the sleep-wake cycle, leading to excessive sleepiness or changes in sleep patterns. Choices B, C, and D are incorrect as they do not primarily control sleep regulation. The thalamus is involved in relaying sensory information, the cortex is responsible for higher brain functions, and the medulla controls vital functions such as heartbeat and breathing.

The nurse provides a postoperative client with an analgesic medication and darkens the room before the client goes to sleep for the night. The nurse's actions:

  • A. help decrease stimuli from the cerebral cortex.
  • B. stimulate hormonal changes in the brain.
  • C. help the client's circadian rhythm.
  • D. alert the hypothalamus in the brain.
Correct Answer: A

Rationale: The nurse's actions of providing an analgesic medication and darkening the room aim to decrease stimuli from the cerebral cortex. Reduction of environmental stimuli, especially light and noise, from the cerebral cortex, which is an area of arousal, facilitates sleep. By decreasing input to this area, the client is more likely to fall asleep and stay asleep. Choices B, C, and D are incorrect because the scenario does not involve stimulating hormonal changes, influencing the circadian rhythm, or alerting the hypothalamus.

What is a common side effect of Rifampin concerning the client's contact lenses?

  • A. The client's urine might turn blue.
  • B. The client remains infectious to others for 48 hours.
  • C. The client's contact lenses might be stained orange.
  • D. The client's skin might take on a crimson glow.
Correct Answer: C

Rationale: The correct answer is that the client's contact lenses might be stained orange. Rifampin has the unusual effect of turning body fluids an orange color. Soft contact lenses might become permanently stained, making this an important side effect for the client to be aware of. Choices A, B, and D are incorrect. There is no documented effect of Rifampin causing the client's urine to turn blue, the client remaining infectious for 48 hours, or the client's skin taking on a crimson glow.

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