NCSBN - National Council of State Boards of Nursing Management of Care Questions and Answers — Questions and Answers
Question 1: A nurse is prioritizing care for four clients at the beginning of the shift. Which client should the nurse assess first?
- A client with a history of asthma who has a new onset of wheezing and shortness of breath. (Correct answer)
- A client scheduled for a routine dressing change for a surgical wound with no signs of infection.
- An elderly client who needs assistance with breakfast and morning medications.
- A client awaiting discharge who has a prescription for a new antihypertensive medication.
Correct answer: A client with a history of asthma who has a new onset of wheezing and shortness of breath.
The nurse should prioritize the client with asthma who is experiencing acute respiratory distress. According to the ABCs (Airway, Breathing, Circulation) of prioritization, this client has an immediate physiological need that could be life-threatening. The other clients are stable and their needs are not as urgent.
Question 2: A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel (UAP). Which of the following tasks is appropriate for the RN to delegate?
- Administering a scheduled oral pain medication to a client with chronic pain.
- Performing a sterile dressing change on a client with a central line.
- Developing a plan of care for a newly admitted client with diabetes.
- Assisting a stable client with ambulation to the bathroom. (Correct answer)
Correct answer: Assisting a stable client with ambulation to the bathroom.
Assisting a stable client with ambulation is within the scope of practice for a UAP. Medication administration, sterile procedures, and developing the plan of care are complex tasks that require the assessment and clinical judgment of a registered nurse and cannot be delegated to a UAP.
Question 3: A client with a terminal illness tells the nurse, 'I have a living will, and I don't want any heroic measures.' The client's family, however, insists on aggressive treatment. What is the nurse's primary responsibility in this situation?
- Follow the family's wishes as they are the client's support system.
- Explain the client's wishes to the family and facilitate a discussion with the healthcare provider. (Correct answer)
- Contact the hospital's ethics committee immediately to make the decision.
- Inform the family that they have no legal right to make decisions for the client.
Correct answer: Explain the client's wishes to the family and facilitate a discussion with the healthcare provider.
The nurse's primary role is to act as a client advocate. This involves respecting the client's autonomy and their advance directives. The nurse should communicate the client's wishes to the family and the healthcare team to ensure the plan of care aligns with the living will.
Question 4: A nurse is preparing to obtain informed consent from a client for a surgical procedure. Which of the following is a key element of informed consent?
- The nurse's personal opinion about the procedure.
- A guarantee of a successful outcome.
- A description of alternative treatments and the risks of no treatment. (Correct answer)
- The cost of the procedure and the client's insurance coverage.
Correct answer: A description of alternative treatments and the risks of no treatment.
Informed consent requires that the client receives a clear explanation of the proposed procedure, including its risks, benefits, alternative treatments, and the potential consequences of refusing treatment. This information allows the client to make an autonomous and informed decision.
Question 5: During a team meeting, a nurse and a physical therapist have a disagreement about the best mobility plan for a client. Which of the following actions demonstrates effective conflict resolution?
- Avoiding the physical therapist and creating a separate mobility plan.
- Asking the nurse manager to decide who is right.
- Arranging a private meeting to discuss their different perspectives and find a mutually agreeable solution. (Correct answer)
- Voicing the disagreement loudly in the hallway to get input from other staff.
Correct answer: Arranging a private meeting to discuss their different perspectives and find a mutually agreeable solution.
Effective conflict resolution involves direct communication and collaboration. Arranging a private meeting allows both parties to express their professional opinions respectfully and work together to develop a client-centered plan that incorporates both nursing and physical therapy perspectives.
Question 6: A nurse is providing a hand-off report to the oncoming nurse for a client being transferred to another unit. Which information is most essential to include in the report to ensure continuity of care?
- The client's family visiting hours and preferences.
- The client's current vital signs, pending lab results, and response to recent interventions. (Correct answer)
- A detailed social history of the client from admission.
- The nurse's personal feelings about the client's progress.
Correct answer: The client's current vital signs, pending lab results, and response to recent interventions.
The most critical information for a hand-off report is the client's current clinical status. This includes vital signs, any outstanding diagnostic results, and how the client has responded to treatments. This information is vital for the receiving nurse to safely continue the client's care without interruption or error.
NCSBN - National Council of State Boards of Nursing Management of Care Questions and Answers
A nurse is prioritizing care for four clients at the beginning of the shift.
Which client should the nurse assess first?