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The nurse is planning client assignments for a licensed practical/vocational nurse (LPN/VN). Which client assignment would be appropriate? A client
- A. in an arm cast who is suspected to have compartment syndrome.
- B. immediately post-operative from a prostate resection reporting bladder spasms.
- C. with a paralytic ileus requiring the insertion of a nasogastric tube.
- D. newly diagnosed with Hepatitis A and requires discharge teaching.
Correct Answer: B, D
Rationale: LPNs can manage stable clients with bladder spasms post-prostate resection (B) and provide discharge teaching for Hepatitis A (D), within their scope. Compartment syndrome (A) requires RN assessment for urgent intervention, and NG tube insertion (C) is typically an RN task due to complexity.
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The charge nurse is planning client care assignments for a registered nurse (RN) and licensed practical/vocational nurse (LPN/VN). Which of the following clients would be most appropriate to assign to the LPN? Select all that apply. A client
- A. receiving oral antibiotics for lower extremity cellulitis.
- B. newly admitted with an exacerbation of myasthenia gravis.
- C. with a chest tube and receiving mechanical ventilation.
- D. requiring a referral to an outpatient support group.
- E. needing to receive intramuscular RhoGAM.
- F. needing scheduled tube feedings and colostomy irrigations.
Correct Answer: A, E, F
Rationale: Oral antibiotics for cellulitis (A), intramuscular RhoGAM (E), and tube feedings/colostomy irrigations (F) are stable tasks within the LPN’s scope. Myasthenia gravis exacerbation (B), chest tube/ventilation (C), and support group referral (D) require RN assessment or coordination due to instability or complexity.
The nurse is caring for assigned clients. The nurse should initially follow up on the client who is
- A. three days postoperative following transsphenoidal hypophysectomy and has a temperature of 101°F (38.3°C).
- B. connected to a chest tube for a pneumothorax and has absent breath sounds on the affected side.
- C. receiving albuterol via a nebulizer and telling the unlicensed assistive personnel they feel nervous.
- D. receiving peritoneal dialysis and reports cramping as the solution is being instilled.
Correct Answer: B
Rationale: Absent breath sounds with a chest tube for pneumothorax (B) indicate a life-threatening complication, such as tube dislodgement or re-collapse, requiring immediate assessment. A fever post-hypophysectomy (A) suggests infection but is less urgent. Nervousness from albuterol (C) is a common side effect, and cramping during dialysis (D) is less critical unless severe.
The nurse is discussing advance care planning with a client and emphasizes the importance of a Medical Power of Attorney (POA). The nurse explains that a Medical POA allows the client to do which of the following?
- A. Designate a family member to make financial decisions on their behalf.
- B. Specify funeral arrangements and preferences for end-of-life care.
- C. Appoint a trusted individual to make healthcare decisions in case of incapacity.
- D. Choose the primary physician for ongoing medical care.
Correct Answer: C
Rationale: A Medical Power of Attorney (C) allows the client to appoint someone to make healthcare decisions if incapacitated. Financial decisions (A), funeral arrangements (B), and physician selection (D) are not covered by a medical POA.
The nurse has received the following information about assigned clients. The nurse should first assess the client with
- A. chronic obstructive pulmonary disease (COPD) and has respiratory acidosis on the most recent arterial blood gas (ABG).
- B. atrial fibrillation taking prescribed warfarin and reports black, tarry stools.
- C. diabetes mellitus who refuses to eat following the administration of glargine insulin.
- D. acute pancreatitis and reports nausea with epigastric pain rated as a 3 on the Numerical Rating Scale.
Correct Answer: B
Rationale: Black, tarry stools in a client on warfarin (B) suggest gastrointestinal bleeding, a life-threatening complication requiring immediate assessment. Respiratory acidosis (A) is concerning but less acute if stable. Refusing to eat post-insulin (C) risks hypoglycemia but is less urgent. Pancreatitis pain (D) rated 3/10 is manageable.
The nurse manager reviews the results of a staff satisfaction survey. The feedback requests better engagement from the manager and staff involvement in unit-based decisions. Based on this feedback, the nurse manager plans to adjust their management style to
- A. democratic.
- B. transactional.
- C. laissez-faire.
- D. autocratic.
Correct Answer: A
Rationale: A democratic management style (A) involves staff in decision-making, addressing the feedback for better engagement and involvement. Transactional (B), laissez-faire (C), and autocratic (D) styles do not promote collaborative decision-making.