NCLEX PN Test Bank

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A health care provider repeatedly asks a nurse to write his verbal prescriptions in his clients' charts after he makes his rounds. The nurse is uncomfortable with writing the prescriptions and explains this to the health care provider, but the health care provider tells the nurse that she will be reported if she does not write the prescriptions. How should the nurse manage this conflict?

  • A. Stating to the health care provider, 'I don't really care whether you report me. I am not writing your prescriptions.'
  • B. Fulfilling the health care provider's request
  • C. Discussing the situation with the nurse manager
  • D. Reporting the health care provider to the chief of medicine at the hospital
Correct Answer: C

Rationale: When a conflict arises, it is most appropriate to try resolving the conflict directly. In this situation, the nurse has tried to explain why she is uncomfortable with the health care provider's request but has been unable to resolve the conflict. The nurse would then most appropriately use organizational channels of communication and discuss the issue with the nurse manager, who would then proceed to resolve the conflict. The nurse manager may attempt to discuss the situation with the health care provider or seek assistance from the nursing supervisor. Fulfilling the health care provider's request and writing the prescriptions in the clients' charts ignores the issue. Reporting the health care provider to the chief of medicine is inappropriate because the nurse should use the appropriate organizational channels of communication to resolve the conflict. Stating 'I don't really care whether you report me. I am not writing your prescriptions.' is an inappropriate statement and will result in further conflict between the nurse and health care provider.

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In a centralized decision-making process within an organization, where is the authority to make decisions vested?

  • A. Every employee
  • B. A few individuals, such as the board of directors
  • C. Many individuals, with decisions filtering down to the individual employee
  • D. All nursing employees, pharmacists, and hospital health care providers
Correct Answer: B

Rationale: In a centralized decision-making process within an organization, the authority to make decisions is concentrated in a few individuals, such as the board of directors. This means that key decision-making power is held by a select group at the top of the organizational hierarchy. Choices A, C, and D are incorrect because in a centralized structure, decision-making authority is not distributed among every employee, does not filter down to individual employees, and is not shared among all nursing employees, pharmacists, or hospital health care providers. Centralized decision-making implies a more top-down approach.

When planning task assignments for five clients on the skilled nursing unit in a long-term care facility, which task should a licensed practical nurse (LPN) assign to another LPN?

  • A. Bathing a client who is confused and requires assistance with a shower
  • B. Administering regular insulin in accordance with a sliding-dosage scale every 4 hours to a client with diabetes mellitus
  • C. Assisting a client requiring a bed bath and frequent ambulation with a cane
  • D. Transporting a client who must be accompanied to physical therapy twice during the shift
Correct Answer: B

Rationale: When assigning tasks, the nurse must consider the skills and educational level of the nursing staff. The nursing assistant may be assigned tasks like caring for a confused client, assisting with a shower or a bed bath, ambulating a client with a cane, and accompanying a client to physical therapy. The LPN is educated to administer medications like regular insulin in accordance with a sliding scale. This task requires a higher level of training and knowledge than the tasks that can be delegated to a nursing assistant. Administering insulin involves assessing blood glucose levels, calculating dosages, and understanding the effects of insulin therapy on the client's condition. Therefore, the correct answer is administering regular insulin to a client with diabetes mellitus. Choices A, C, and D involve tasks that are within the scope of practice of a nursing assistant, not an LPN.

Which of the following ethnic groups is at highest risk in the United States for pesticide-related injuries?

  • A. Native American
  • B. Asian-Pacific
  • C. Norwegian
  • D. Hispanic
Correct Answer: D

Rationale: The correct answer is 'Hispanic.' Hispanic individuals in the United States are at a higher risk for pesticide-related injuries due to their representation among migrant workers in agricultural settings. This exposure to pesticides in their work environments increases their risk compared to other ethnic groups. Choice A, 'Native American,' although indigenous populations may face environmental health disparities, the higher risk in this context is among Hispanic individuals. Choice B, 'Asian-Pacific,' and Choice C, 'Norwegian,' do not have the same level of exposure to pesticides as Hispanic migrant workers, making them less susceptible to pesticide-related injuries.

A nursing care plan for a client with sleep problems has been implemented. All of the following should be expected outcomes except:

  • A. the client reports no episodes of awakening during the night.
  • B. the client falls asleep within 1 hour of going to bed.
  • C. the client reports satisfaction with their amount of sleep.
  • D. the client rates sleep as an 8 or more on the visual analog scale.
Correct Answer: B

Rationale: An expected outcome for a nursing care plan targeting sleep problems is that the client reports no episodes of awakening during the night, the client reports satisfaction with their amount of sleep, and the client rates sleep as an 8 or more on the visual analog scale. Falling asleep within 1 hour of going to bed is not necessarily an expected outcome. While it is generally desirable for individuals to fall asleep within a reasonable time frame, this specific timeframe may vary among individuals, and it is not a strict criterion for successful sleep outcomes. Therefore, the correct answer is that the client falls asleep within 1 hour of going to bed, as this is not a definitive measure of the effectiveness of the nursing care plan for sleep problems.

A nurse who works in a medical care unit is told that she must float to the intensive care unit because of a short-staffing problem on that unit. The nurse reports to the unit and is assigned to three clients. The nurse is angry with the assignment because she believes that the assignment is more difficult than the assignment delegated to other nurses on the unit and because the intensive care unit nurses are each assigned only one client. The nurse should most appropriately take which action?

  • A. Refuse to do the assignment
  • B. Tell the nurse manager to call the nursing supervisor
  • C. Return to the medical care unit and discuss the assignment with the nurse manager on that unit
  • D. Ask the nurse manager of the intensive care unit to discuss the assignment
Correct Answer: D

Rationale: In this scenario, the nurse feeling that the assignment is more difficult than what other nurses received should approach the nurse manager of the intensive care unit to discuss the assignment. By doing so, the nurse can seek clarification on the rationale for the assignment or confirm if it is genuinely more challenging. Refusing the assignment is not appropriate as it could impact patient care. Returning to the medical care unit would be considered client abandonment and does not directly address the conflict at hand. Instructing the nurse manager to involve the nursing supervisor is an aggressive approach that does not directly resolve the issue.

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